July 1997

Nonhealing Ulcers on the Lower Extremities

Author Affiliations

The Johns Hopkins University School of Medicine, Baltimore, Md

Arch Dermatol. 1997;133(7):914. doi:10.1001/archderm.1997.03890430135022

REPORT OF A CASE  A 40-year-old white woman presented with a 3-month history of painful, nonhealing ulcers on her lower extremities. Her medical history was remarkable for hepatitis C virus (HCV) infection.Her physical examination revealed multiple 1- to 5-cm discrete ulcers with surrounding hyperpigmented macules on the lower extremities (Figure 1). The pulses in the lower extremities were full, symmetrical, and without bruits. Trace edema of the lower extremities was present without cyanosis. Diagnostic workup and laboratory tests revealed the following: HCV antigen (Ag) was detected in the serum sample by polymerase chain reaction; serum transaminase and alkaline phosphatase levels were moderately elevated; findings of a liver biopsy were consistent with active hepatitis; the antinuclear antibody (Ab) titer was 1:40; serologic tests were negative for hepatitis B Ab and Ag and anticardiolipin antibody and positive for HCV Ab; and the serum ceruloplasmin and α1-antitrypsin activity were

First Page Preview View Large
First page PDF preview
First page PDF preview