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Dermal Vasculitis. Presented by Carl T. Nelson, MD.
White man, aged 46.
Four years ago the patient developed cervical pain followed by polyarthritis involving especially the ankles, metacarpal, and distal interphalangeal joints. X-rays, two years ago, demonstrated proliferative bony changes compatible with Reiter's disease, ankylosing spondylitis, or rheumatoid arthritis. At that time and currently, hemoglobin 11.6 gm; ESR 118 mm/hr; uric acid 6.7 mg%; serum γ-globulin, 1.3 gm%; latex fixation test and STS, negative. Butazolidin and prednisone 20 mg per day provided no clinical improvement. Fourteen months ago he noted urticaria on the buttocks. This became generalized and included papules, vesicles, and purpura. All have persisted. History of drug intake includes Chlor-Trimeton, Benadryl and, rarely, Seconal.
A generalized polymorphic eruption including urticaria, macules, papules, vesicles, and petechiae. The petechiae are predominantly on the legs. Joint changes appear in the ankles, and there is rigidity of the cervical
NEW YORK DERMATOLOGICAL SOCIETY. Arch Dermatol. 1964;90(4):448–450. doi:10.1001/archderm.1964.01600040076019
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