Superficial (nodular) thrombophlebitis as a heterogeneous entity with distinctive clinico‐pathological aspects: Correlation with the underlying conditions. (17th October 2022)

• Record Type: Journal Article
• Authors: Gales, Lynn; Cribier, Bernard; Lipsker, Dan; Lenormand, Cédric
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 37:Number 2(2023)
• Page Start: 436
• Page End: 442
• Publication Date: 2022-10-17
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.18630
• Languages: English
• ISSNs: 0926-9959

Abstract

Abstract: Background: Superficial (nodular) thrombophlebitis, referring to a thrombo‐inflammatory disorder of dermal‐subcutaneous veins, encompass a spectrum of nodular lesions often associated with inflammatory, infectious, neoplastic or thrombophilic diseases. Objective: We postulate that distinct clinico‐pathological features may correlate with the underlying conditions. Methods: We conducted a retrospective monocentric study of all patients seen in our dermatology department for a superficial thrombophlebitis, completed with a literature review. Clinical and pathological data were extracted from the patient files and articles. Results: A total of 108 cases of superficial thrombophlebitis was analysed. Forty‐five percent manifested as elongated nodules clearly evoking vascular involvement, while the other 55% were presenting as nodules or plaques. The elongated phenotype was strongly associated with malignancy or thrombophilia if a pure thrombosis was demonstrated histopathologically, while tuberculosis was the main underlying condition if a granulomatous vasculitis was present. Panniculitis‐like lesions were mainly corresponding to erythema‐nodosum‐like lesions of Behçet's disease, characterized by the distinctive feature of thrombotic veins with an associated leukocytoclastic vasculitis. Limitations: Retrospective design and risk of publication bias. Conclusion: Superficial (nodular) thrombophlebitis is a heterogeneous entity with a distinct clinico‐pathological presentation that strongly points to the nature of the underlying medical condition, thus guiding the medical workup.