Cutaneous small vessel vasculitis and pulmonary tuberculosis: an unusual association.

摘要

Cutaneous small vessel vasculitis (CSW) may present as "palpable" purpura, erythema, urticaria, bullae, or skin infraction leading to ulceration. Causative factors vary. Mycobacterium tuberculosis is a rather uncommon etiologic agent for CSW. Our case report deals with the infrequent coexistence of pulmonary tuberculosis (PT) and CSW. A 39-year-old Greek man presented to our hospital with a 3-month history of an eruption located mainly on the legs, which began with the appearance of erythema progressing to sparse palpable purpuric macules. Medical history revealed a low-grade fever, a slight nonproductive cough and a weight loss of 5-8 kg over the last 5 months. There was non-associated medication use. Initial investigations showed an erythrocyte sedimentation rate of 68 nm/h and a white cell count of 12.,650-cells/mL. Blood chemistries and urine anal- ysis were normal. Antinuclear antibodies, anti-DNA, anti-Sm, anti-Ro, anti-La, anticardiolipin, lupus anticoagulant, cytoplasmic, and perinuclear antineutrophil antibodies were all negative. C-reactive protein, cryoglobulins, and complement levels were found within normal ranges. Immu-noglobulins fraction revealed a slight elevation of IgG and IgA. The viral serology was negative for hepatitis B, C, and acquired human immunodeficiency virus. Chest X-rays showed calcificated lymph nodes and a few confluent opacities in the upper pulmonary segments.