Cutaneous‐limited, initially strongly unilateral microscopic polyangiitis

Abstract

A 44-year-old female patient presented in good general health, but with obesity. Strictly limited to the left half of the body, up to 20 painful, reddish, roundish macules with a hemorrhagic appearance were found. The lesions were particularly prominent on the upper body, including the left half of the face and the left arm. In the dependent areas, especially on the lower legs, the macules developed into infiltrated, hemorrhagic plaques and ultimately to hemorrhagic necroses and ulcerations (Figure 1). The symptoms had initially started one month before with a single painful ulcer on the left lower leg. Chills and other signs of infection were denied. The patient reported joint pain and episodes of abdominal pain and nausea. The physical status, including the neurological status, was unremarkable.