PMC9932180_01
Purpuric rash on the dorsa of the feet of a patient hospitalised for a pulmonary infection.
gr1.jpg
PMC9932180_01_gr1.jpg
fig1
Two photos of H&E (x200 and x400): fig 2a and fig 2b showing the neutrophilic and eosinophilic perivascular infiltrate. (2a) Skin biopsy exhibiting a mild predominantly superficial perivascular lymphoneutrophilic infiltrate with scattered eosinophils and neutrophilic debris. The overlying epidermis is essentially unremarkable. Direct immunofluorescence studies reveal positive immunostaining only with C3 in a granular pattern around superficial blood vessels within the papillary dermis. (2b) Skin biopsy exhibiting a mild superficial perivascular lymphocytic infiltrate with scattered siderophages. The overlying epidermis is unremarkable.
gr2.jpg
PMC9932180_01_gr2.jpg
fig2
The differential diagnosis includes: Vasculitis associated with cystic fibrosis, rheumatic vasculitis, septic vasculitis, drug induced vasculitis, etc ...(See Fig. 2, Fig. 3, Fig. 4). Fig. 2a are consistent with leukocytoclastic vasculitis in spite of the absence of fibrinoid degeneration of the vessel walls. Findings of biopsy 2 Fig. 2b are less specific but may represent the late stages of leukocytoclastic vasculitis.
Complete macroscopic resolution of the purpuric rash after one month of colchicine regimen instauration, despite a new cystic fibrosis infectious flare-up.
gr4.jpg
PMC9932180_01_gr4.jpg
fig4
The differential diagnosis includes: Vasculitis associated with cystic fibrosis, rheumatic vasculitis, septic vasculitis, drug induced vasculitis, etc ...(See Fig. 2, Fig. 3, Fig. 4). No rash was observed (Fig. 4).