Dermatology online journal
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Dermatol. Online J. · Aug 2015
Case ReportsAtypical propylthiouracil-induced ANCA-positive vasculitis: report of a case with unusual clinical and histopathologic findings.
The side effects of propylthiouracil, including cytopenia and vasculitis, are well established. We present an interesting case in which cytopenia and cutaneous vasculopathy occurred concomitantly in a critically ill patient. The patient was initially treated for suspected infection until dermatologic and rheumatologic workup revealed ANCA-positivity and vasculopathy on histopathology, most consistent with an atypical presentation of ANCA-positive vasculitis. Upon initiation of immunosuppressive therapy, the patient's condition rapidly improved emphasizing the importance of early recognition of this condition.
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Dermatol. Online J. · Aug 2015
Case ReportsVesicular erythema migrans: an atypical and easily misdiagnosed form of Lyme disease.
Erythema migrans is the initial sign in the majority of patients infected with Borrelia, the genus of spirochetes that causes Lyme disease. Early identification and treatment decrease the risk of progression to later stages of disease. ⋯ Herein, we describe the case of a patient with Lyme disease in which the presence of atypical vesicular features, in conjunction with the initial absence of clearing, resulted in multiple misdiagnoses and delayed treatment. We also review the literature on the epidemiology and management of erythema migrans for cases in which the diagnosis may pose a challenge.