PMC5779747_01
Photographs of skin lesions. Plaques and subcutaneous nodules were found around the joints of forearms and lower legs, and part of them was ulcerated.
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F1
Multiple tender red plaques were found on her arms, buttocks, and left lateral ankle joint, part of which had already had ulcerations (Fig. 1).
Pathological findings of a skin biopsy. Dense inflammatory cells including lymphocytes, histiocytes, and some neutrophil granulocytes infiltrated within the dermis and subcutaneous fat tissue. In addition, hyaline necrosis of fat lobules and thickening of blood vessel walls were also observed. (A and B, hematoxylin and eosin stain; original magnifications: (A) x200; (B) x400).
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F2
In addition, hyaline necrosis of fat lobules and thickening of blood vessel walls were also observed (Fig. 2).
Pathological and immunofluorescence findings of a renal biopsy. (A) A glomerulus with segmental endocapillary hypercellularity, mesangial hypercellularity, and mesangial matrix proliferation with deposits, with partial atrophy of tubules is shown (hematoxylin and eosin stain; original magnification: x200). (B-F) Direct immunofluorescence study of glomerular deposits of C1q, C3, immunoglobulin A, immunoglobulin G, and immunoglobulin M, respectively is shown.
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F3
A light micrograph showed that most glomeruli had segmental endocapillary hypercellularity, mesangial hypercellularity, and mesangial matrix proliferation with deposits, partial atrophy of the tubules, mild interstitial fibrosis, and inflammation (Fig. 3). A direct immunofluorescence study revealed glomerular deposits of immunoglobulin G, immunoglobulin M, immunoglobulin A, C3, and C1q (Fig. 3).