Abstract
Introduction: Piezogenic pedal papules (PPP), which are forms of responses to internal mechanical pressure, appear on the wrists and especially on feet. Repeated trauma or an inherent collagen defect mainly as Ehlers–Danlos syndrome can cause pain symptoms in heels. The PPP are mostly asymptomatic and noticed incidentally. Case Reports: Unlike the majority of PPP cases, two patients (both housewives), who took part in the present study, were older and they had severe pain associated with PPP. One injection of a solution of equal amounts of betamethasone and prilocaine was applied in treatment of pain in both patients. Conclusion: During follow-ups the patients did not report any clinical complaints considering the PPP and their VAS score remained significantly low. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 7 No. 2, February 2016. ISSN – [0976-3198] Int J Case Rep Images 2016;7(2):81–84. www.ijcasereportsandimages.com Hayta et al. 81 CASE REPORT OPEN ACCESS Pain in heels: Two cases with piezogenic pedal papules Emrullah Hayta, Sibel Berksoy Hayta, Melih Akyol, Ozlem Sahin, Sedat Ozcelik
Highlights
Takayasu’s arteritis is a chronic systemic vasculitis, mainly involving aorta and its major branches
Case Series: We report a series of five patients with the diagnosis of Takayasu’s arteritis
The one presenting with stroke and other presenting with limb claudication, were classified as Takayasu’s type-I; Two of the patients with heart failure were labeled as Takayasu’s typeII and III
Summary
Takayasu’s arteritis (TAK) is a rare, systemic, vasculitis of unknown aetiology. The disease has been reported worldwide, but it appears to be more prevalent in certain Asian countries, such as Japan, Korea, China, India, Thailand, Singapore, etc. ACR criteria is used to classify TAK, which include age, claudication of extremity, blood pressure difference in arms, presence of bruits in aorta or subclavian arteries and angiographic evidence of narrowing or occlusion of aorta or its major branches. There was narrowing of aorta distal to the origin of left subclavian artery This patient was labeled as Takayasu’s type-III. Computed tomography angiography showed circumferential thickening of aortic arch and descending thoracic aorta, with stenosis of both subclavian arteries. She was diagnosed as Takayasu’s type II, and was treated with azathioprine. Aortic arch, descending thoracic aorta, stenosis of both subclavian arteries
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