Malignant Atrophic Papulosis Treatment & Management

  • Author: L Campbell Levy, MD; Chief Editor: Julian Katz, MD   more...
 
Updated: Jan 8, 2010
 

Medical Care

  • Because most patients initially present with skin manifestations, they typically are seen by a dermatologist, at which time a diagnosis usually is made. The skin lesions are not painful, usually do not itch, and generally do not require treatment. Patients who have gastrointestinal or neurologic symptoms should undergo an appropriate workup to detect systemic disease, which is an important determinant of prognosis.
  • Many medications have been tried for treatment of malignant atrophic papulosis, without consistent success. Degos suggested that anticoagulants might be effective, but others have shown them to be of no benefit. Isolated cases of benign cutaneous disease have responded to nicotine patches (5 mg/d transdermal patch) and pentoxifylline plus aspirin. Similarly, antiplatelet drugs, such as aspirin and dipyridamole, may reduce the number of new papules but have not shown any consistent benefit in systemic disease. Other drugs (eg, corticosteroids, immunosuppressants, sulfonamide, tetracycline, penicillin, interferon 2 alpha) have been shown to be ineffective in altering the course of the disease.
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Surgical Care

  • Surgical treatment usually is required for patients who develop complications such as gastrointestinal bleeding, intestinal perforation, bowel infarction, or intracranial bleeding.
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Consultations

  • Dermatologists
  • Gastroenterologists
  • Neurologists
  • General surgeons
  • Neurosurgeons
  • Rheumatologists
  • Ophthalmologists
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Diet

No special diet is required.

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Activity

No restriction of physical activity is required.

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Contributor Information and Disclosures
Author

L Campbell Levy, MD  Fellow, Section of Gastroenterology and Hepatology, Department of Internal Medicine, Dartmouth Hitchcock Medical Center

L Campbell Levy, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Coauthor(s)

Robert J MacNeal, MD  Staff Physician, Department of Dermatology, Critical Care Fellowship Reviewer, Dartmouth-Hitchcock Medical Center; Supervising Medical Officer, Veterans Administration Hospital, White River Junction, Vermont

Robert J MacNeal, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Brian E Lacy, MD, PhD  Associate Professor of Medicine, Dartmouth Medical School; Director of GI Motility Laboratory, Department of Gastroenterology, Dartmouth Hitchcock Medical Center

Brian E Lacy, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American College of Gastroenterology, American Gastroenterological Association, American Motility Society, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Hemant Pande, MD  Consulting Staff, Department of Gastroenterology, Leesville Surgical Clinic and Digestive Disease Center

Hemant Pande, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Lawrence J Cheskin, MD  Director, Johns Hopkins Weight Management Center; Associate Professor, Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health; Joint Appointment, Department of Medicine, Division of Gastroenterology, Johns Hopkins University School of Medicine; International Health/Human Nutrition, JH Bloomberg School of Public Health

Lawrence J Cheskin, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, and American Gastroenterological Association

Disclosure: Medifast Salary Employment; Mushroom Council Grant/research funds research grant; Medifast Honoraria Board membership

Specialty Editor Board

David Eric Bernstein, MD  Chief, Section of Hepatology, North Shore University Hospital, Director, Associate Professor, Department of Internal Medicine, Division of Hepatology, New York University School of Medicine

David Eric Bernstein, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Douglas M Heuman, MD, FACP, FACG, AGAF  Chief of Hepatology, Hunter Holmes McGuire Department of Veterans Affairs Medical Center; Professor, Department of Internal Medicine, Division of Gastroenterology, Virginia Commonwealth University School of Medicine

Douglas M Heuman, MD, FACP, FACG, AGAF is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Physicians, and American Gastroenterological Association

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

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