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Colegio de Medicina Interna de México.

2015, Number 1

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Med Int Mex 2015; 31 (1)

Leukocytoclastic vasculitis: a diagnostic challenge for the internist

Meza-Ayala CM, Dehesa-López E, Ruelas-Perea AG, Peña-Martínez E

Language: Spanish
References: 13
Page: 113-118
PDF size: 440.36 Kb.


ABSTRACT

This paper reports the case of a 33-year-old female patient who had previous smoking history and a three years diagnosis of systemic lupus erythematosus (SLE) with mucocutaneous and articular activity. She was admitted in the Internal Medicine department in order to diagnose and treat painful purpuric lesions. These purpuric lesions had a recent onset and were localized predominantly on the face and upper and lower extremities. The skin lesions progressed into extensive painful purpuric plaques on both legs and thighs, including large areas of necrosis. The patient denied symptoms of lupus activity in other organs. She referred three previous episodes with similar clinical findings but with minor skin involvement. On admission DNA antibodies, antinuclear antibodies and rheumatoid factor were positive. Skin biopsy reported leukocytoclastic vasculitis and other systemic involvement for vasculitis were discarded. A final diagnosis of leukocytoclastic vasculitis associated with SLE was made. Patient was treated with systemic steroids and intravenous antibiotics due to the large area of skin involvement.


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