eMedicine Specialties > Dermatology > Diseases of the Vessels

Temporal (Giant Cell) Arteritis: Follow-up

Author: John G Albertini, MD, Consulting Staff, Dermatologic Surgery, The Skin Surgery Center
Coauthor(s): Victor J Marks, MD, Associate, Department of Dermatology, Section Chief, Dermatologic Surgery, Geisinger Health System; Hyland Cronin, MD, Resident, Dermatology Department, Geisinger Health System, Danville, Pennsylvania
Contributor Information and Disclosures

Updated: May 29, 2009

Follow-up

Deterrence/Prevention

  • Sun avoidance and protection of the head and the face from photodamage may eventually prove to be important preventive measures for temporal arteritis (TA).

Complications

  • Ophthalmic complications are common.
    • Clinical manifestations include visual disturbances, amaurosis fugax, diplopia, and blindness.
    • Visual loss may be temporary or permanent and partial or complete in either one eye or both eyes.
    • Blindness usually occurs abruptly and painlessly.
    • Ischemic optic neuritis with eventual optic atrophy is the most common cause of visual loss and occurs in 15% of patients.
    • Mesenteric vasculitis resulting in small bowel infarction has rarely been described in persons with temporal arteritis, but it represents a serious and potentially treatable complication.17

Prognosis

  • Overall, with prompt diagnosis and treatment, temporal arteritis is a well-controlled disease. Symptoms from temporal arteritis improve within days of treatment. Corticosteroids can usually be tapered within the first 4-6 weeks and eventually discontinued. The prognosis for patients is excellent.
    • Some patients' conditions respond well, but damage prior to treatment is irreversible.
    • Rarely, a response to steroid therapy does not occur or doses cannot be tapered. Cytotoxic or immunosuppressive drugs have been recommended, but more data are needed.

Miscellaneous

Medicolegal Pitfalls

  • Improper technique during TABx can rarely result in facial nerve damage. Understanding the temporal anatomic danger zone and planning the procedure accordingly, with execution within the superficial temporal fascia, can prevent nerve injury.
 


More on Temporal (Giant Cell) Arteritis

Overview: Temporal (Giant Cell) Arteritis
Differential Diagnoses & Workup: Temporal (Giant Cell) Arteritis
Treatment & Medication: Temporal (Giant Cell) Arteritis
Follow-up: Temporal (Giant Cell) Arteritis
References
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References

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Further Reading

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Keywords

temporal arteritis, giant cell arteritis, arteritis temporalis, arteritis cranialis, Horton disease, Horton's disease, granulomatous arteritis, arteritis of the aged, cranial arteritis, systemic vasculitis, TA, giant cell arteritis, temporal arteritis

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Contributor Information and Disclosures

Author

John G Albertini, MD, Consulting Staff, Dermatologic Surgery, The Skin Surgery Center
John G Albertini, MD is a member of the following medical societies: American Academy of Dermatology and American College of Mohs Micrographic Surgery and Cutaneous Oncology
Disclosure: Nothing to disclose.

Coauthor(s)

Victor J Marks, MD, Associate, Department of Dermatology, Section Chief, Dermatologic Surgery, Geisinger Health System
Victor J Marks, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Micrographic Surgery and Cutaneous Oncology, American College of Physicians, American Medical Association, and Pennsylvania Medical Society
Disclosure: Nothing to disclose.

Hyland Cronin, MD, Resident, Dermatology Department, Geisinger Health System, Danville, Pennsylvania
Disclosure: Nothing to disclose.

Medical Editor

Russell Hall, MD, Chief, Professor, Department of Internal Medicine, Division of Dermatology, Duke University
Russell Hall, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Federation for Medical Research, American Society for Clinical Investigation, and Society for Investigative Dermatology
Disclosure: Genetech Grant/research funds Principle Investigator; Centecor  Grant/research funds Principle Investigator

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Julia R Nunley, MD, Professor, Program Director, Dermatology Residency, Department of Dermatology, Virginia Commonwealth University Medical Center
Julia R Nunley, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Nephrology, International Society of Nephrology, Medical Dermatology Society, Medical Society of Virginia, National Kidney Foundation, Phi Beta Kappa, and Women's Dermatologic Society
Disclosure: Johnson and Johnson stock holder dividends; Amgen stock holder dividends; Forest Lab, Inc stock holder dividends; Galaxo Smith Klein stock holder dividends; Covidien stock holder dividends; Novartis Grant/research funds Consulting; Biolex  sub-investigator

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

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