A case of cutaneous extravascular necrotizing granuloma without systemic manifestations

Abstract

Cutaneous extravascular necrotizing granuloma, an unusual palisading dermal granuloma, was first described by Churg and Strauss in 1951 in association with the syndrome of allergic granulomatosis (Churg-Strauss syndrome), for which it was though to be pathognomonic. It has subsequently been described in association with a number of autoimmune and immunoreactive diseases, and is regarded as a cutaneous marker of systemic pathology. To our knowledge, only one patient has been reported with clinical features confined to the skin. We report a 46-year-old woman with recurrent cutaneous lesions over a 10-year period and the classic histopathological pattern, but no underlying systemic disease.

Painful ulceration of the lower legs in a young woman

“…Certain drugs have also been reported to trigger a microscopically identical eruption, and there are several recent reports of PNGD occurring in patients receiving tumour necrosis factor‐α inhibitor therapy 4 . Rarely, there is no detectable associated condition 5 . In our patient, a full autoantibody screen and rheumatoid factor were negative.…”

“…4 Rarely, there is no detectable associated condition. 5 In our patient, a full autoantibody screen and rheumatoid factor were negative. Full screening for associated disorders in our patient was unremarkable.…”

Сutaneous vasculitis: classification, diagnosis and differential diagnosis (part 1)

“…В подавляющем большинстве случаев это васкулиты, индуцированные лекарственными препаратами (лекарственно-индуцированный ANCA-ассоциированный васкулит), при которых чаще выявляются антитела MPO-ANCA, чем PR3-ANCA. Критерием диагностики является наличие связи между приемом медикаментов и началом развития изменений в коже, а также быстрое разрешение высыпаний после прекращения поступления лекарственного препарата в организм [11][12][13]. Все васкулиты, обусловленные отложением иммунных комплексов, за исключением анти-GBM болезни (Glomerular Basement Membrane IgG antibody -болезнь с образованием антител к базальной мембране клубочков), могут поражать сосуды кожи.…”

“…Vestnik Dermatologii i Venerologii. 2020; 96 (1): [10][11][12][13][14][15][16][17] Вестник дерматологии и венерологии. 2020; 96 (1): 10-17 № 1, 2020 В настоящее время нет общепринятой терминологии и классификации васкулитов и сосудистых нарушений кожи.…”

Nomenclature of Cutaneous Vasculitis

“…Most of them are drug‐induced cutaneous AAVs (see more details below). However, there are single case reports of AAV limited to the skin with no linkage to disease‐eliciting drugs or other causal factors (Table ).…”