PMC4531694_01
Palpable purpura on the foot.
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Physical examination showed multiple purpura on legs and buttock and swelling and tenderness on both elbows and ankles (Figure 1).
(A) Skin biopsy shows necrotizing leukocytoclastic vasculitis (H&E, x200).. (B) Immunofluorescent examination shows IgA deposition on the wall of vessel.
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A biopsy specimen of skin lesions showed leukocytoclastic vasculitis and immunofluorescent study revealed IgA depositions on vessels (Figure 2).
Colonoscopic findings show multiple ulcers with hemorrhage.
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Gastrofibroscopic examination revealed hemorrhagic gastritis and colonoscopy revealed multiple ulcerations (Figure 3).
Colon biopsy shows neutrophils and nuclear debris infiltration on the wall of vessels (H&E, x400).
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Biopsy specimens from the colon showed ulcerations with neutrophils infiltration and fibrin thrombi formation in vessels (Figure 4).
Improved purpura with pigmentation.
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Finally, we used 400 mg/day of thalidomide and purpura was improved (Figure 5).