By Gary M. White, MD

The superficial temporal artery is enlarged, tortuous and tender in temporal arteritis, also known as giant cell arteritis. Headache, fever and a high ESR are common in this disease of patients over 50 years of age. There is a strong association with polymyalgia rheumatica. Ocular involvement with visual impairment or blindness may occur. A temporal artery biopsy establishes the diagnosis. An NSAID (etodolac) caused a hypersensitivity vasculitis which clinically mimicked temporal arteritis [J Rheum 1996;23;183].


Necrosis and ulceration of that portion of the scalp supplied by the temporal artery may occur.


Referral to a rheumatologist is in order. Prednisone 40-60 mg/d has been started initially for control. The FDA has recently approved subcutaneous tocilizumab (Actemra) for the treatment of giant cell arteritis.


Dermatology Online Journal 18 (6)


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