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A 27-year-old woman presented with 6 weeks’ history of painful, raised purpuric lesions followed by blisters and sheet-like desquamation on the face, extremities and trunk involving approximately 30% of body surface area. She had oral ulcers, joint pains and photosensitivity. Cutaneous examination revealed hyperpigmented patches with irregular borders on the malar regions and haemorrhagic crusting on the lips (figure 1A). Ill-defined purpuric papules and plaques, bullae and extensive erosions on the face, trunk and extremities (figure 1B) and chilblain-like lesions on the tip of the digits (figure 1C) were observed. Laboratory investigations revealed anaemia, leucocytosis and thrombocytopaenia, with increased 24-hour urinary protein (618 mg). The antinuclear antibodies …
Contributors SK, VT and DD had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis, and were responsible for the study concept and design. SK, VT and DA drafted the manuscript. DD, BDR and SH contributed to the critical revision of the manuscript for important intellectual content and supervised the study. All authors contributed to the acquisition, analysis and interpretation of the data.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.