Acute Charcot’s foot and small vessel vasculitis
24 December 2012
Charcot arthopathy can develop without any history of trauma .In acute phase the foot is warm and swollen. Patient may or may not have pain .The neurovascular and neurotraumatic aetiology explains the pathogenesis of Charcot foot . Although diabetes, alcohol, leprosy are prominent aetiology, but other small vessel vasculopathy are a sinister cause .The other connective tissues involved are: systemic lupus erythematosus, polyarteritis nodosa, sjogren, Churgh Strauss syndrome, CREST syndrome, cryoglobulinemia. Another term is lymphocytoclastic vasculitis (LCV also known as hypersensitive vasculitis and cutaneous necrotising vasculitis).It is a type III injury of vessels. Various triggers has been described. The inflammation of the small blood vessel, most commonly post capillary venules is the cardinal feature of LCV .The skin followed by joints are the common organ involved. Histological features of LCV can occur in any vasculitis but also in neurovascular disease such as neutrophillic dermatosis .Immunofluoroscent staining may reveal (immunoglobulin G, M) and complement (C3, C4) deposition on the skin basement membrane suggest Immuno-complex deposition. The treatment involves leg elevation, removal of trigger factor.
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Competing interests: None declared
East Surrey Hospital , Redhill , Surrey ,UK
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