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Dimitrios Daoussis, Chelena Geropoulou, Odysseas Kargiotis, Nikolaos Maltezos, Maria Melachrinou, Painless, eosinophilic infiltration of temporal arteries, Rheumatology, Volume 58, Issue 11, November 2019, Pages 2065–2067, https://doi.org/10.1093/rheumatology/kez149
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Sir, A 49-year-old Caucasian female with an unremarkable medical history was referred to the Rheumatology Clinic by dermatologists. She reported that during the past 4 months she developed several ‘lumps’ at both temporal areas that were completely painless but associated with profound pruritus. When she was first seen she was in excellent general status and denied any systemic symptoms. She had no fever, headache or jaw claudication. On physical examination she had several painless masses at both temporal areas corresponding to peripheral branches of the temporal artery, with a normal overlying skin and no lymphadenopathy (Fig. 1A). A detailed ultrasound exam verified that these masses were directly associated to the temporal artery causing narrowing of the lumen at the left side and an almost complete obstruction at the right side. Moreover, a halo sign was evident bilaterally, indicative of vasculitis (Fig. 1B and C). Extensive laboratory workup revealed only a mild peripheral eosinophilia. Inflammatory markers were normal and no autoantibodies were present. A temporal artery biopsy showed an eosinophilic panarteritis with associated narrowing of the lumen, thrombosis and focal breakdown of the internal elastic lamina but no giant cells (Fig. 1D) leading to a diagnosis of ‘juvenile temporal arteritis’ (JTA).
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