Scalp necrosis and visual loss in giant cell arteritis: the importance of recognising atypical cutaneous clues.
Samira Jafari, Niv Levi, Edward Margolin
✦ AI-curated · Sources linked
Case in brief
A 70-year-old woman presented with left hemifacial pain and bilateral forehead skin plaques, initially diagnosed as shingles. Two weeks later, she experienced sudden vision loss in the left eye, accompanied by left optic disc edema and necrotic scalp lesions. A temporal artery biopsy confirmed active temporal arteritis, leading to a diagnosis of giant cell arteritis.
What made this case unusual
The case highlights scalp necrosis as a rare presentation of giant cell arteritis, which can mimic varicella zoster infection, potentially delaying critical treatment.
Diagnostic / clinical pearl
Clinicians should recognize that atypical cutaneous signs, such as scalp necrosis, may indicate giant cell arteritis, necessitating prompt evaluation to prevent vision loss.
Why it matters
Awareness of these atypical presentations can improve early diagnosis and management of giant cell arteritis, reducing the risk of severe complications.