PMC3623783_01
Generalized exanthematous rash on the trunk and extremities of our patient.
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F1
After two weeks of anti-tuberculosis medication, a generalized exanthematous rash appeared on his trunk and extremities (Figure 1).
Multiple, well-defined, non-blanchable, erythematous macules and papules in an annular arrangement.
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F2
One day later, multiple well-defined, non-blanchable, erythematous-to-purplish macules and papules, some of which showed an annular arrangement, were noticed (Figure 2).
Histology of a purpuric annular lesion on our patient's leg.
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F3
A skin biopsy from a purpuric annular lesion on his leg showed peri-vascular and interstitial infiltration of neutrophils with extravasation of erythrocytes and fibrin deposition (Figure 3), characteristic of LCV.
Direct immunofluorescence revealed positive IgA, IgM and C3 results along superficial dermal blood vessels.
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F4
A direct immunofluorescence (DIF) study was positive for IgA, IgM and C3 along superficial dermal blood vessels, consistent with cutaneous small vessel vasculitis (Figure 4).