Cutaneous leukocytoclastic vasculitis in the presence of\nmethimazole therapy
Female patient, 33-years-old, black, host to GD for over 6 years, using MTM since the\nonset of symptoms. Patient was advised to seek dermatology assistance due to the\nemergence of superficial skin lesions in the lower limbs over a period of 20 days,\nassociated with fever, joint pain and tremor of the extremities. The dermatological exam\nexposed erythematous purpuric lesions on the dorsum of the feet and plantar cavus tense\nblisters with hemorrhagic content in the malleolar region which spread to large necrotic\nareas. (, and ).\nThe chest x-ray and renal function tests failed to detect significant changes. The\nabsence of hematuria was also noted. Laboratory data is presented in\nA biopsy of the superficial skin lesion was in addition performed in the right lateral\nmalleolus region. Histopathological examination revealed neutrophilic leukocytoclastic\nvasculitis of small vessels ().\nIn view of the tests feedback, we decided to discontinue MTM and start therapy with\nprednisone (1mg/kg). We were able to observe continuous improvement after 7 days ().