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An atypical cutaneous presentation of vasculitis with features of Churg–Strauss syndrome, associated with anti‐neutrophil cytoplasmic antibodies and anti‐glomerular basement membrane antibodies
Author(s) -
Gleeson C. M.,
Levy J. B.,
Cook H. T.,
Francis N. D.,
Robson A.,
Pope F. M.
Publication year - 2009
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/j.1365-2230.2009.03248.x
Subject(s) - medicine , fibrinoid necrosis , pathology , vasculitis , anti neutrophil cytoplasmic antibody , eosinophilia , rapidly progressive glomerulonephritis , renal biopsy , glomerulonephritis , necrotizing vasculitis , biopsy , kidney , disease
Summary We report the case of a 59‐year‐old woman who presented with a persistent papular and nodular cutaneous eruption and new‐onset asthma, with normal renal function but persistent haematuria and proteinuria. Investigations revealed eosinophilia, both antineutrophil cytoplasmic antibodies and antiglomerular basement membrane antibodies on serological testing (double‐positive vasculitis), and a focal necrotizing glomerulonephritis on renal biopsy. Histological examination of a skin biopsy showed a dense neutrophilic infiltrate with focal fibrinoid necrosis and few eosinophils. The clinical and pathological features suggested a double‐positive vasculitis/Churg–Strauss overlap syndrome presenting with a predominantly neutrophilic dermatosis. Specific cutaneous features in patients with double‐positive vasculitis have not been documented previously. The patient has responded extremely well to immunosuppressive treatment and her disease is currently in remission.