PMC8486499_01
The patient had been prescribed oral mesalamine 2.4 g twice a day in the past as a treatment for his ulcerative colitis, but the patient admitted to noncompliance due to inability to care for himself.
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fig1
A 79-year-old male with a significant history of mild-moderate ulcerative colitis on oral mesalamine 2.4 g daily and pyoderma gangrenosum, hypertension, coronary artery disease, and benign prostatic hypertrophy presented to the emergency department for evaluation of bilateral polyarthralgia with associated weakness and swelling (including the metacarpal joints and ankles; see Figure 1), diffuse lower extremity purpura, violaceous rash (see Figure 2), and scrotal ulcerations.
Status post skin biopsy, initiation of pulse-dose Solu-Medrol.
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fig2
A 79-year-old male with a significant history of mild-moderate ulcerative colitis on oral mesalamine 2.4 g daily and pyoderma gangrenosum, hypertension, coronary artery disease, and benign prostatic hypertrophy presented to the emergency department for evaluation of bilateral polyarthralgia with associated weakness and swelling (including the metacarpal joints and ankles; see Figure 1), diffuse lower extremity purpura, violaceous rash (see Figure 2), and scrotal ulcerations.
3 days post-Solu-Medrol treatment with improvement in purpura and arthralgias.
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fig3
Figure 3), and kidney function continued to improve day to day under the high-dose Solu-Medrol regimen. Final pathology of left leg skin biopsy, along with clinical correlates, demonstrated findings compatible with leukocytoclastic vasculitis.