Severe, chronic anorexia and extensive leg ulcerations as presenting signs of primary Sjögren's syndrome.
We report the case of a 75-year-old woman with a 15-year history of inappetance resulting in weight loss of approximately 40 kg. On physical examination, the skin of the lower extremities was markedly hyperpigmented with a brown-greyish hue. In addition, the skin of the legs was infiltrated, erythematous, riddled with erosions and necrotic ulcers. Clinical and laboratory evaluation revealed sicca syndrome, a pronounced polyclonal hypergammaglobulinemia (60 g/l), high levels of antinuclear, anti-SSA and anti-SSB antibodies. Histological examination of involved skin demonstrated a leukocytoclastic vasculitis.
Guggisberg
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D
Service de Dermatologie, Centre Hospitalier Universitaire Vaudois, DHURDV, Lausanne, Suisse.
Perrenoud
D
D
Frenk
E
E
D000251:Adenosine Triphosphatases / Q000276:immunology; D000368:Aged; D000855:Anorexia / Q000175:diagnosis / Q000473:pathology*; D001323:Autoantibodies / Q000032:analysis; D001324:Autoantigens / Q000032:analysis; D002908:Chronic Disease; D004890:Erythema / Q000473:pathology; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000473:pathology; D017495:Hyperpigmentation / Q000473:pathology; D007871:Leg Ulcer / Q000473:pathology*; D009336:Necrosis; D020733:RNA, Small Cytoplasmic; D012261:Ribonucleoproteins / Q000032:analysis; D012859:Sjogren's Syndrome / Q000175:diagnosis / Q000473:pathology*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000473:pathology; D015431:Weight Loss; D000097585:SS-B Antigen; D000099207:SS-A Antigen
D000251:Adenosine Triphosphatases; D001323:Autoantibodies; D001324:Autoantigens; D020733:RNA, Small Cytoplasmic; D012261:Ribonucleoproteins; D000097585:SS-B Antigen; D000099207:SS-A Antigen; C116006:RO60 protein, human