Giant cell arteritis characterised by scalp necrosis

Abstract

Giant cell arteritis is a granulomatous vasculitis, primarily affecting individuals over 50 years of age. It exists in two forms: the cranial form, which involves the medium- caliber temporal artery, and the extracranial form, which affects large vessels, primarily the ascending aorta. Scalp necrosis is a rare complication of giant cell arteritis. The authors present the case of a 71-year-old male patient hospitalized for giant cell arteritis with severe necrotic symptoms on the scalp, accompanied by painful headaches, pronounced scalp tenderness, difficulty opening the mouth, jaw claudication, occasional dizziness, and fatigue. Despite negative imaging findings, the ACR/ EULAR criteria for temporal arteritis were met, leading to the initiation of parenteral and then oral high-dose steroid therapy. Initially, the patient’s condition improved, but systemic progression of the disease was subsequently observed, ultimately leading to generalized multi-orga failure. This case illustrates the severity and complexity of the condition, and the necessity of interdisciplinary collaboration.