PMC8203330_01
Image of patient's rash, showing non-blanching, purpuric lesions extending from the dorsa of the bilateral feet up to the knees.
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fig1
Gradually, these spots coalesced into a purpuric rash spreading up the bilateral lower extremities and to both arms, sparing the trunk and face (Figure 1).
Skin biopsy (H&E stain, 20x magnification) demonstrates dermal inflammation with leukocytoclastic debris (single arrow), extravasated red blood cells (double arrow), and fibrinoid vascular degeneration (triple arrow) consistent with leukocytoclastic vasculitis.
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fig2
Skin biopsies were performed (Figure 2). The skin biopsy showed perivascular inflammatory-cell infiltrate, comprised predominantly of neutrophils with fibrin deposition within the walls of some small-caliber blood vessels, suggesting disruption with hints of extravasated erythrocytes (Figure 2).