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[Pustular vasculitis disclosing Behçet disease]
J Castanet1, S Carmignani, J P Lacour
1Service de Dermatologie, Hôpital Pasteur, Nice.
Annales De Dermatologie Et De Venereologie
|January 1, 1994
Summary
Pustular vasculitis, a Behçet's disease symptom, can present with unique arch-shaped lesions. This case highlights lymphocytic infiltration in histology and effective colchicine treatment for skin relapses.
Area of Science:
- Dermatology
- Rheumatology
- Immunology
Background:
- Pustular vasculitis is a recognized manifestation of Behçet's disease.
- Behçet's disease is a multisystem inflammatory disorder characterized by recurrent oral aphthae, genital ulcers, skin lesions, and ocular inflammation.
- The case details a patient diagnosed with Behçet's disease based on specific clinical criteria.
Observation:
- A 29-year-old patient presented with recurrent, episodic papulopustular skin eruptions forming an unusual arch pattern.
- Histological examination of the skin lesions revealed a predominant lymphocytic infiltration.
- The patient had a history of recurrent oral aphthosis, accompanied by lymphocytic meningitis, uveitis, and erythema nodosum.
Findings:
- The patient's papulopustular eruption exhibited a distinct arch formation.
- Histopathology demonstrated a predominantly lymphocytic infiltrate, contrasting with the typical polynuclear infiltration seen in pustular vasculitis.
- While corticosteroids were initially effective, they did not prevent relapses, necessitating alternative treatment.
Implications:
- The findings suggest that predominant lymphocytic infiltration in pustular vasculitis may be a specific indicator for Behçet's disease, potentially linked to a pathergy phenomenon.
- Colchicine proved effective in managing skin relapses, although the precise mechanism of action in this context requires further elucidation.
- This case expands the understanding of pustular vasculitis presentations and treatment responses in Behçet's disease.