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Disseminated tuberculosis presenting as cutaneous leucocytoclastic vasculitis
  1. Abhishek Verma,
  2. Sunita Aggarwal,
  3. Ranvijay Singh and
  4. Tushar Mittal
  1. Medicine, Maulana Azad Medical College, New Delhi, Delhi, India
  1. Correspondence to Professor Sunita Aggarwal; drsunita.mamc{at}gmail.com

Abstract

Cutaneous leucocytoclastic vasculitis (CLV) is a type of small vessel vasculitis, predominantly presenting with palpable purpuras and sometimes with systemic manifestations. The following report describes the case of a woman, who presented with fever, anorexia and maculopapular lesions over both lower limbs. Skin biopsy revealed CLV. CT scan demonstrated bilateral pulmonary nodules, ileocecal wall thickening and generalised lymphadenopathy. Colonoscopy guided biopsy obtained from ileocecal valve ulcer showed epitheloid cell granuloma with Langhans-type giant cells and caseous necrosis. Rapid clinical improvement was seen with anti-tubercular therapy. Among infectious causes, although rare and an uncommon presentation, Mycobacterium tuberculosis should be considered as an important cause of CLV.

  • Immunology
  • Dermatological
  • Tuberculosis
  • Vasculitis

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Footnotes

  • Contributors Supervised by SA. Patient was under the care of SA, AV, RS and TM. AV, RS and TM were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. SA and AV gave the final approval of the manuscript. Is the patient one of the authors of this manuscript? No.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.