Cutaneous Manifestations of Giant Cell Arteritis

A 68 year old woman with advanced giant cell arteritis presented with progressive tongue, lip, and scalp necrosis. She was initially misdiagnosed and treated for oral thrush by her primary care physician and emergency department personnel. She was ultimately correctly diagnosed with giant cell arteritis after she developed a left central retinal artery occlusion, ischemic optic neuropathy, and third cranial nerve palsy. She was treated with corticosteroids and the vasculitis was arrested. She was left with permanent defects in her tongue and lip as well as blindness in the left eye.