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A palpable clue to vasculitis
1Rush-Presbyterian Medical Center, Chicago, USA.
Postgraduate Medicine
|March 23, 1999
Summary
A recurrent leg rash in a 57-year-old woman was diagnosed as leukocytoclastic vasculitis. Treatment with prednisone and erythromycin successfully resolved the rash without recurrence.
Area of Science:
- Dermatology
- Immunology
- Pathology
Background:
- Recurrent rash presentation in a middle-aged woman.
- Initial treatments with prednisone and amoxicillin were ineffective.
- Elevated antistreptolysin O titer noted, with other labs normal.
Observation:
- Physical examination revealed a palpable purpuric rash on the lower legs.
- Histopathologic examination of a punch biopsy confirmed leukocytoclastic vasculitis.
Findings:
- Leukocytoclastic vasculitis diagnosed via skin biopsy.
- Successful treatment achieved with oral prednisone (60 mg/day, tapered) and erythromycin.
- Rash resolved within 2-3 weeks, with no recurrence in the following year.
Implications:
- Highlights the importance of biopsy for diagnosing vasculitis.
- Suggests a potential link between streptococcal infection and vasculitis.
- Demonstrates effective management of leukocytoclastic vasculitis with corticosteroids and antibiotics.