PMC4857370_01
Leukocytoclastic vasculitis involving the foot. The photographs show the progression of the (a)-(c) vasculitis lesion and (d) the resulting scar.
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On the fourth day of hospitalization, she developed frank arthritis of her left wrist and the metacarpophalangeal joint of her right index finger as well as a discrete non-blanching red plaque with surrounding edema over the metatarsophalangeal joint of her left fifth toe (Figure 1).
Colonoscopic findings: (a) Colonoscopy showed severe pancolitis with edema, loss of haustral folds, erythema, and friability. (b) There was more severe involvement of the left colon, with diffuse pseudopolyp formation and the presence of a mucosal bridge.
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Repeat colonoscopy showed marked worsening of the colitis, with development of diffuse pseudopolyps in the left colon (Figure 2).
Leukocytoclastic vasculitis involving the arm. The photographs show the progression of the (a)-(c) vasculitis lesion and (d) the resulting scar.
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On the third day, she developed an ecchymotic rash at the site of her intravenous catheter (Figure 3).
Histological findings of skin biopsy. (a) A punch biopsy of the lesion showed a dermal process consisting of a perivascular and intravascular infiltrate composed of polymorphonuclear leukocytes. (b) Higher magnification reveals red blood cell extravasation (asterisk), (c) the formation of nuclear dust (leukocytoclasis; black arrow), and (d) fibrinoid necrosis of vessel walls (white arrow).
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A punch biopsy was obtained and showed features of LV (Figure 4).