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Pract Neurol. 2016 Aug;16(4):300-3. doi: 10.1136/practneurol-2015-001341. Epub 2016 Mar 11.

Sneddon's syndrome: it is all in the ectoderm.

Author information

1
Department of Neurology, King's College Hospital, London, UK.
2
Department of Dermatology, King's College Hospital, London, UK.
3
Department of Haematology, King's College Hospital, London, UK.

Abstract

A 51-year-old man gave a 2-year history of worsening mobility, cognitive decline and headaches. He had a history of thromboembolic stroke, recurrent transient ischaemic attacks and a spontaneous intraventricular haemorrhage. On examination, he had livedo reticularis and perniosis and a systolic murmur. Catheter cerebral angiography showed peripheral small-vessel and medium-vessel vasculopathy resulting in pruning of the distal cortical vessels and tortuous irregular distal collaterals. Skin biopsy showed subtle vasculopathy with ectasia of capillaries and postcapillary venules but no frank vasculitis or arterial thrombosis. Repeated serum antiphospholipid antibody titres were negative. The clinical features, skin biopsy and angiogram findings strongly supported a diagnosis of Sneddon's syndrome. Clinicians should consider Sneddon's syndrome in patients with livedo reticularis and stroke. There are treatment dilemmas in this situation when ischaemic and haemorrhagic cerebral events coexist.

KEYWORDS:

CEREBROVASCULAR DISEASE; HAEMATOLOGY; RHEUMATOLOGY; STROKE; VASCULITIS

PMID:
26968196
DOI:
10.1136/practneurol-2015-001341
[Indexed for MEDLINE]

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