Annular vasculitis in association with sarcoidosis.

We report a case of cutaneous vasculitis with annular features in association with sarcoidosis. A 36-year-old woman presented with fever, polyarthralgias, erythema nodosum, bilateral hilar lymphadenopathy, and induration of a long-standing scar on the face. In addition, she developed annular, erythematous, and purpuric patches over her thighs and buttocks that were histologically characterized by a small vessel leukocytoclastic vasculitis. The presence of circulating immune complexes in the early stages of sarcoidosis might be related to the occurrence of the vascular damage.     

Annular lesions of cutaneous sarcoidosis with granulomatous vasculitis

Sarcoidosis is known to be involved in diseases with vasculitis as sarcoid vasculitis. However, vasculitis in cutaneous sarcoidal lesions is extremely rare. Here we describe a case of sarcoidosis with multiple annular skin lesions with granulomatous vasculitis. A 62‐year‐old female was diagnosed with sarcoidosis by chest‐abdominal computed tomographic examination and laboratory tests. The skin lesions had appeared on her lower limbs 2 years before. Physical examination showed multiple infiltrated annular eruptions on the lower extremities. A skin biopsy of an area of erythema showed multiple non‐caseating epithelioid cell granulomas in the dermis and subcutaneous fat and granulomatous vasculitis with fibrinoid degeneration in the subcutaneous fat. There are two types of vasculitis in sarcoidosis: leukocytoclastic and granulomatous vasculitis. Ulcers and livedo were more common in granulomatous vasculitis than in leukocytoclastic vasculitis. The present case had unique annular skin lesions of sarcoidosis with granulomatous vasculitis.     

Annular vasculitis associated with pregnancy

A 29-year-old woman presented in the 31st week of pregnancy with an unusual bilateral, erythematous eruption on the posterior calves, which clinically resembled erythema annulare centrifugum. A biopsy showed features of a mild leucocytoclastic vasculitis. Within 2 days of delivery the rash had almost resolved, suggesting that its activity was related to the pregnancy. The diagnosis is consistent with ‘annular vasculitis’. which we suggest represents a distinct variant of leucocytoclastic vasculitis, and a distinct clinicopathological entity. We are not aware of any previous reports of an association between annular vasculitis and pregnancy.     

Ulcerative sarcoidosis in the legs with granulomatous vasculitis

We present a case of a patient with pulmonary sarcoidosis who developed ulcerative sarcoidosis with granulomatous vasculitis on the lower legs. Ulceration is a rare presentation for sarcoidosis and this case gives further evidence that an underlying vasculitis may be an aetiological factor. Granulomatous vasculitis, classically associated with Wegener's granulomatosis, lymphomatoid granulomatosis, or Churg-Strauss syndrome, is also commonly described in pulmonary sarcoidosis. It has, however, only rarely been described in cutaneous sarcoidosis. Our patient's leg ulcers have responded well to immunosuppressive therapy with tapered corticosteroid and low-dose azathioprine.     

Cutaneous vasculitis in a patient with acute brucellosis

A patient suffering from brucellosis developed maculonodular and purpuric lesions. The skin biopsy showed granulomatous vasculitis with no deposition of immunoglobulins and complement on the vessels.     

Urticarial vasculitis and dermatomyositis in a patient with nasopharyngeal carcinoma

Urticarial vasculitis has rarely been described in association with polymyositis. We report the case of a 37-year-old man with dermatomyositis and nasopharyngeal carcinoma who presented initially with urticarial vasculitis. The lesions of urticarial vasculitis were initially photodistributed, indicating photosensitivity. The patient was treated with systemic steroids, chemotherapy (cisplatin and fluorouracil), and radiation therapy. The tumor and urticarial vasculitis completely resolved, and the myositis improved.     

Managing cutaneous vasculitis in a patient with lupus erythematosus

Lesions and rashes are the most common dermatologic manifestation in patients who have lupus erythematosus and are directly related to inflammation of the small and medium-size vessels of the skin. Inflammation of these vessels is known as cutaneous vasculitis and is often an indicator that a more severe, life-threatening inflammatory process could be occurring in the major organs of the body.