Lupus & antiphospholipid syndrome
Skin involvement in the catastrophic antiphospholipid syndrome: A review from catastrophic antiphospholipid syndrome (CAPS) registry
Authors' conclusion
The presence of skin involvement in patients with CAPS is frequent. The most frequent manifestations were livedo reticularis and skin necrosis. Skin involvement does not seem to be associated to mortality.
Study context
- Population
- Patients with CAPS in the CAPS Registry (European Forum on aPL), April 1992 to December 2024377 episodes
- Exposure
- CAPS episodes with vs without skin involvement
- Skin involvementn = 377
- Outcome
- Prevalence of skin involvement in CAPS
Methodological detailsregistry-based, Female 49.4%; mean age 39.4 (SD ± 17.9) years
- Registry-based
- Female 49.4%; mean age 39.4 (SD ± 17.9) years
Main finding
As reported in the abstract
Cutaneous involvement (prevalence)
Skin involvement
47%
377
Observational data: associations, not effects.
Further findings
Most frequent skin manifestations
- Livedo reticularis
- 17.6%
- Skin necrosis
- 13%
- Ischemic ulcers
- 10.4%
- Skin ischemic
- 9.7%
- Skin purpura
- 7.1%
- Gangrene
- 5%
- Splinter haemorrhages
- 2.6%
- RP
- 1.5%
Most frequently affected organs in CAPS episodes with skin involvement
- Kidneys
- 72%
- Lungs
- 61%
- Central nervous system
- 54.5%
- Heart
- 54.4%
Thrombocytopenia and hemolysis features
- More common in patients with skin involvement
- P < 0.05 for all
Predominant pathological finding
- Thrombotic microangiopathy, episodes
- 82 (68.3%)
Mortality, episodes with vs without skin involvement
- No difference: 29.3% vs 32.1%
- P = 0.42
Original publication
Skin involvement in the catastrophic antiphospholipid syndrome: A review from CAPS registry. Lupus. Published 15 June 2026. doi:10.
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