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Necrotizing Panniculitis. Dermal Vasculitis? Presented by Dr. John T. McCarthy
A 48-year-old white woman was well until February 1966 when she developed fever and malaise, and noted a cessation of her menses. Following this, intermittent swelling and pain with involvement of the ankles, knees, and metacarpal phalangeal joints appeared. A diagnosis of rheumatoid arthritis was made, but a later fixation test was negative. The joint symptoms gradually abated but in August she developed tender nodules on the posterior aspects of the legs which progressed to deep painful ulcers. Hemorrhagic vesicles appeared on the dorsa of the feet. A biopsy revealed panniculitis.
Both legs revealed deep necrotic ulcers of the calves. On the dorsa of the feet and ankles there were tense hemorrhagic vesicles.
Laboratory studies disclosed the following values: complete blood cell count (CBC), urinalysis, and serologic test for syphilis were negative; erythrocyte sedimentation
NEW YORK DERMATOLOGICAL SOCIETY. Arch Dermatol. 1967;96(1):108-110. doi:10.1001/archderm.1967.01610010114021