PMC9381251_01
Vasculitic ulcer occurring at the groin. Multiple hypopigmented macules on the anterior abdominal wall, extensor surface of the right upper limb, and thigh.
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In a year, although there was mild improvement in the muscle weakness, he developed multiple vasculitic ulcers (Figure 1) which were deep-seated and slow in healing.
PMC9381251_02
PMC9381251_03
PMC9381251_04
X-ray images showing gas pockets in the right thigh and leg.
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An X-ray of the affected limb was also suggestive of necrotizing fasciitis (Figure 2).
Initial debridement-offensive abscesses in the anterior and lateral aspects of the right thigh, right hip, and right lower leg.
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Intraoperatively, extensive necrotizing fasciitis involving the anterior and lateral aspects of the thigh, leg, hip, and posterior aspects of the thigh and hip with pockets of copious offensive abscesses were found (Figure 3).
Areas of perforation on the proximal ascending colon.
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Exploratory laparotomy was done during which three posteriorly located perforations (Figure 4) in the proximal ascending colon, communicating with the gluteal wound, were found.
PMC9381251_05