head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2019, vol. 25, issue1
Subject Area: Medicine
DOI: 10.5272/jimab.2019251.2443
Published online: 22 March 2019

Case report

J of IMAB. 2019 Jan-Mar;25(1):2443-2446
Desislava Tsvetanova1ORCID logo Corresponding Autoremail, Ivelina Yordanova1ORCID logo, Hristina Haidudova1, Klimentina Gospodinova1, Verka Pavlova1, Maya Alexieva1, Milen Karaivanov2, Dimitar Gospodinov1ORCID logo,
1) Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University-Pleven, Bulgaria.
2) Department of Pathoanatomy, Faculty of Medicine, Medical University - Pleven, Bulgaria.

Combination between Leucocytoclastic vasculitis and Subacute cutaneous lupus erythematosus has been only rarely reported in the literature. Pathological cutaneous lesions are presented by purpura, erythematous macules, urticarial, nodules and necroses.We present a 58-year-old woman with painful nodular lesions on the left thigh.The disease started in June 2015 with photosensitivity and psoriasiform rashes on the back. Pathological cutaneous changes affected lateral and dorsal surface of the left thigh. It was presented by painful, indurated in base, ulcerative plaques, with unclear borders and necrotic surface.  There were no deviations from complete blood count and biochemistry. Immunological investigations revealed elevated levels of MPO(рАNCA) – 1.38 U/ml, antinuclear antibodies (ANA)- 134.1 U/ml, SS-A(Ro) antibodies – 233.7 U/ml  CRP- 12.7mg/l. Urine analysis revealed positive protein results.Escherichia coli was isolated from microbiology testing. Histopathological result from ulcerative lesions from the left thigh of the patient revealed necrotizing leukocytoclastic vasculitis.  The result from direct immunofluorescence microscopy of lesional skin corresponded to lupus erythematosus.The diagnosis lupus vasculitis was made. Systemic therapy with chloroquine phosphate, methylprednisolone, methotrexate  was administered. Topical treatment included proteolytic enzyme in dressings and vacuum therapy with good effect.

Keywords: Lupus vasculitis, antinuclear antibodies (ANA), SS-A(Ro) antibodies, vacuum therapy, chloroquine phosphate, methylprednisolone, methotrexate,

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Please cite this article as: Tsvetanova D, Yordanova I, Haidudova H, Gospodinova K, Pavlova V, Alexieva M, Karaivanov M, Gospodinov D. Lupus vasculitis. J of IMAB. 2019 Jan-Mar;25(1):2443-2446. DOI: 10.5272/jimab.2019251.2443

Corresponding AutorCorrespondence to: Desislava Tsvetanova, Department of Dermatology, venereology and allergology, Medical Universisty Pleven, Bulgaria; 91, Gen. Vladimir Vazov str., Pleven, Bulgaria; E-mail: desi_tzvetanova@abv.bg

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Received: 12 November 2018
Published online: 22 March 2019

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