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June 2003

Palpable Purpura in an Asthmatic Woman With Eosinophilia—Diagnosis

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Copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2003

Arch Dermatol. 2003;139(6):803-808. doi:10.1001/archderm.139.6.803-a

Microscopic examination of the biopsy specimen revealed a dermal perivascular and interstitial infiltrate with neutrophils, red blood cells, and numerous eosinophils as well as obliterated blood vessel walls with nuclear dust and neutrophils, consistent with a leukocytoclastic vasculitis.

Additional laboratory studies demonstrated an elevated white blood cell count of 17 000/µL (reference range [RR], 4500-11 000/µL) and eosinophilia of 32% (RR, 1%-3%). The IgE level was elevated at 1828 IU/mL (RR, 0-160 IU/mL). Serologic tests were negative for perinuclear and cytoplasmic pattern antineutrophil cytoplasmic antibodies. Radiography and computed tomography of the chest showed transient pulmonary infiltrates. The findings of bronchoscopy and transbronchial biopsy were unremarkable.

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