title: Nodular vasculitis in systemic lupus erythematosus.
abstract: A 42-year-old man presented with fever, photosensitivity, headaches, myalgia, hyperhidrosis, muscle weakness, alopecia, nasal crustae, weight loss, painful nails, arthritis, oral ulcers, erythema, discoid cutaneous lesions, and painful subcutaneous nodes. We made a diagnosis of systemic lupus erythematosus (SLE), type II cryoglobulinemia, and nodular vasculitis. In the skin, different types of vasculitis may be observed. Typically, histology shows leukocytoclastic vasculitis of superficial vessels both in SLE and mixed cryoglobulinemia, which clinically results in palpable purpura. In our patient, however, histopathological examination of the subcutaneous nodes not only revealed leukocytoclastic vasculitis of the superficial vasculature but also showed even more extensive involvement of dermal and subdermal small and medium sized vessels, giving rise to a nodular vasculitis.
authors.affiliation: Department of Dermatology, University Hospital Maastricht, University Hospital Maastricht, The Netherlands. awes@sder.azm.nl
authors.forename: Annet
authors.initials: A
authors.lastname: Westers-Attema
authors.forename: A
authors.initials: A
authors.lastname: van Tubergen
authors.forename: H
authors.initials: H
authors.lastname: Plasschaert
authors.forename: A M W
authors.initials: AM
authors.lastname: van Marion
authors.forename: J
authors.initials: J
authors.lastname: Frank
authors.forename: P
authors.initials: P
authors.lastname: Poblete-Gutiérrez
mesh_terms: D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D012867:Skin / Q000473:pathology; D012871:Skin Diseases / Q000175:diagnosis* / Q000209:etiology*; D014657:Vasculitis / Q000175:diagnosis* / Q000209:etiology*