Image in medicine
Lingual and lower lip necrosis in giant cell arteritis
Necrosis lingual y de labio inferior en la arteritis de células gigantes
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She presented with a 2 week history of extensive and painful ulcerative necrotic lesions on the tongue and lower lip (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), cervical pain and jaw claudication. The temporal arteries were normal on examination. Laboratory data showed an erythrocyte sedimentation rate of 76 mm/h and C-reactive protein 58.6 mg/l. Cervical CT angiography showed occlusion of both external carotid arteries from their origin. Cranial CT angiography and temporal artery Doppler ultrasound were normal and <span class="elsevierStyleSup">18</span>F-FDG positron emission tomography showed no pathological hypermetabolic lesions. Temporal artery biopsy revealed changes compatible with giant cell arteritis. A progressive improvement of the described lesions was observed steroid treatment initiation (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Once the inflammation had stabilised, the lower lip was surgically reconstructed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical considerations</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors' site protocols for obtaining consent and maintaining patient privacy were followed.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0015" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 679 "Ancho" => 905 "Tamanyo" => 78324 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 681 "Ancho" => 905 "Tamanyo" => 86983 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016100000008/v1_202310190859/S2387020623003911/v1_202310190859/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000008/v1_202310190859/S2387020623003911/v1_202310190859/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623003911?idApp=UINPBA00004N" ]
