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July 2012

A 32-Year-Old Man With Grouped Papules and Vesicles—Diagnosis

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2012;148(7):850. doi:10.1001/archderm.148.7.850-b
MICROSCOPIC FINDINGS AND CLINICAL COURSE

Microscopic examination with hematoxylin-eosin showed a subepidermal blister with abundant neutrophils and dermal leukocytoclastic vasculitis. Direct immunofluorescence of the perilesional skin showed fibrin deposition on dermal small vessels, with negativity for other immunorreactants (IgG, IgM, IgA, and C3).

MICROSCOPIC FINDINGS AND CLINICAL COURSE

Additional blood test investigations showed an elevated erythrocyte sedimentation rate (106 mm/h; range, 1-20 mm/h), elevated titers of antineutrophil cystoplasmic antibodies against proteinase 3 (PR3-ANCA) (320 U/mL; reference range, <25 U/mL), and negative results for antimyeloperoxidase antibodies.

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