We read with interest the article by Irvine et al1 in a recent issue of the ARCHIVES that describes a "cutaneous-limited variant of microscopic polyangiitis associated with antimyeloperoxidase autoantibody."
The authors describe a 34-year-old man with a 22-year history of cutaneous purpuric generalized lesions. Several skin biopsy specimens showed a neutrophilic perivascular inflammatory infiltrate with leukocytoclasis, but evidence of dermal vessel necrosis was not demonstrated. Direct immunofluorescence revealed no vascular deposit of immunoreactants. Extracutaneous involvement other than myalgia, fever, anorexia, and synovitis was not documented (although neither electromyography nor angiography were performed). Antimyeloperoxidase titers closely correlated with disease activity.