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Published on: December 15, 2011
Microscopic polyangiitis presenting urticarial erythema and Henoch-Schonlein purpura: two case reports
Hideki Maejima1, Kyoumi Shirai, Yumi Shimamura
1Department of Dermatology, Kitasato University Hospital, Kanagawa, Japan.
Abstract:
Microscopic polyangiitis (MPA) is well known as a life-threatening member of a group of systemic vasculitis diseases. We report two cases of MPA. Case 1 was a 79-year-old-man who had been diagnosed with anti-neutrophil-cytoplasmic-antibody associated vasculitis (ANCA associated vasculitis) with alveolar hemorrhage and crescentric glomerulonephritis (CrGN). He presented with urticarial erythema in the abdomen, legs and back. The skin biopsy specimens showed leukocytoclastic vasculitis on the upper dermis. Case 2 was a 74-year-old-man, who presented with purpura on the abdomen, buttocks and legs that were similar to Henoch-Schonlein purpura (HSP). He also suffered from interstinal pneumonia. His renal biopsy specimens showed glomerulosclerosis and the peripheral pattern anti-neutrophil cytoplasmic antibody (P-ANCA) was positive. We reviewed the skin eruptions that had been reported with MPA, including our cases.
Insights
Microscopic polyangiitis (MPA) can manifest with diverse skin eruptions, including urticarial erythema and purpura. This review highlights MPA
Area of Science:
- Rheumatology
- Dermatology
- Nephrology
Background:
- Microscopic polyangiitis (MPA) is a severe systemic vasculitis.
- MPA diagnosis often involves anti-neutrophil cytoplasmic antibodies (ANCA).
- Skin manifestations in MPA are varied and can mimic other conditions.
Observation:
- Two cases of MPA are presented with distinct skin findings.
- Case 1: 79-year-old male with ANCA-associated vasculitis, alveolar hemorrhage, crescentric glomerulonephritis, and urticarial erythema.
- Case 2: 74-year-old male with purpura, intestinal pneumonia, glomerulosclerosis, and positive P-ANCA.
Findings:
- Skin biopsy in Case 1 revealed leukocytoclastic vasculitis.
- Skin lesions in Case 2 resembled Henoch-Schonlein purpura (HSP).
- This review correlates reported skin eruptions with MPA diagnoses.
Implications:
- Recognizing diverse cutaneous presentations is crucial for early MPA diagnosis.
- Skin biopsy and serological markers aid in differentiating MPA from other vasculitides.
- Understanding MPA's dermatologic spectrum improves patient outcomes.
