PMC6864317_01
Prominent hyperkeratosis, mucin deposition and upper dermal perivascular mononuclear infiltrates.
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Skin biopsy showed hyperkeratosis, mucin deposition and upper dermal perivascular mononuclear infiltrates (Fig. 1).
Intra-operative findings: 1.5-cm perforation hole over jejunum. The bowel around the perforation was found to be inflamed and ugly looking. Overall color of bowel and mesentery turned dark.
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A 2 x 1 cm sized perforation in the antimesenteric border of proximal jejunum was identified (Fig. 2).
Post-operative findings: Specimen of the resected segment of the small bowel showing massive intestinal and mesenteric infarction.
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Approximately 50 cm of discolored jejunum, including the perforation, was resected and end-to-end anastomosis was performed (Fig. 3).
(A) Mesenteric small-vessel vasculitis. (B) Vascular thrombosis with a perivascular inflammatory cell infiltration.
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Pathologic examination showed mesenteric small-vessel vasculitis (Fig. 4-A). In addition, there was vascular thrombosis with a perivascular inflammatory cell infiltration (Fig. 4-B).