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Skin examination on admission a. Right upper arm, b. Right calf.
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There were bilateral lung wheezes, and multiple painful ecchymosis with several hemorrhagic bullae over his trunk and extremities (Fig. 1).
CXR and CT of the chest on admission a. CXR, b. CT chest on admission. Both demonstrate bilateral multifocal infiltrates.
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The Xray and computed tomography (CT) of the chest showed multifocal alveolar infiltrates; there was no evident pulmonary embolism on a CT angiogram (Fig. 2).
Pathological Findings of punch skin biopsy.. Superficial and deep dermal thrombotic paucicellular vasculitis/vasculopathy involving adnexa without leukocytoclasia.
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The histopathological findings revealed a superficial and deep dermal thrombotic paucicellular vasculitis/vasculopathy involving skin appendages without significant neutrophils or leukocytoclasia (Fig. 3).