title: Churg-Strauss syndrome: a case report.
abstract: BACKGROUND
  Churg-Strauss syndrome (CSS) is an allergic granulomatous angiitis, a rare disease of small and medium arteries and veins, associated with the presence of perinuclear antineutrophil cytoplasmic antibodies (p-ANCA). According to the American College of Rheumatology (ACR), there are four or more criteria out of six for the diagnosis: asthma, eosinophilia (> 10% in peripheral blood), paranasal sinusitis, pulmonary infiltrates, histological evidence of vasculitis with extravascular eosinophils, and mononeuritis multiplex or polyneuropathy.
  
  
  METHODS
  We reported a female patient, aged 80 years, with asthma for many decades and repeatedly verified eosinophilia in peripheral blood, in which CSS was suspected only after the occurrence of skin changes in the form of vesicles, vesiculopustule, purpuric macula, papule and petechiae. Further tests verified pulmonary infiltrates, paranasal sinusitis, extravascular eosinophils on histopathologic sample of skin tissue, and polyneuropathy. The treatment started with methylprednisolone (60 mg/d, with decreasing doses), and continued with pulse doses of cyclophosphamide (800 mg once monthly), also corticosteroid ointment for skin lesions.
  
  
  CONCLUSIONS
  Despite long-standing pulmonary symptoms and laboratory findings of eosinophilia, the appearance of skin changes raised suspicion of possible CSS. Skin changes resolved and the patient was reffered to rheumatologist.
authors.affiliation: Department of Dermatovenerology, Military Medical Academy, Belgrade, Serbia. miroslavdinic@hotmail.com
authors.forename: Miroslav Z
authors.initials: MZ
authors.lastname: Dinić
authors.forename: Lidija Kandolf
authors.initials: LK
authors.lastname: Sekulović
authors.forename: Lidija
authors.initials: L
authors.lastname: Zolotarevski
authors.forename: Rados D
authors.initials: RD
authors.lastname: Zecević
mesh_terms: D000369:Aged, 80 and over; D015267:Churg-Strauss Syndrome / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D012867:Skin / Q000473:pathology*; D014057:Tomography, X-Ray Computed