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Antineutrophil Cytoplasmic Antibody–Positive Cutaneous Leukocytoclastic Vasculitis Associated With Propylthiouracil Therapy
Yi-Shuan Sheen, MD;
Chia-Yu Chu, MD;
Hsin-Su Yu, MD, PhD
Arch Dermatol. 2006;142:879-880.
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INTRODUCTION
Administration of propylthiouracil therapy has been associated with a hypersensitivity syndrome that typically manifests as vasculitis.1 Most cases of propylthiouracil therapy–induced antineutrophil cytoplasmic antibody (ANCA) positivity react to perinuclear ANCA (p-ANCA).1 We describe a patient who presented with cutaneous manifestations of propylthiouracil therapy hypersensitivity vasculitis with ANCA positivity.
REPORT OF A CASE
A 43-year-old woman with hyperthyroidism presented to our institution with generalized eruptions. The patient's hyperthyroidism had been controlled with propylthiouracil, 100 mg/d, for the previous 3 years. Cutaneous examination revealed many irregularly shaped, purpuric plaques with necrotic centers and surrounding rims of erythema on the face, ears, trunk, and extremities (Figure 1). The p-ANCA level was 901 U/mL (reference range, <7 U/mL). The cytoplasmic ANCA (c-ANCA) level was within the reference range (<4.4 U/mL) (Fluoro ANCA test; MBL, Nagoya, Japan). A skin biopsy sample demonstrated leukocytoclastic vasculitis (Figure 2. . . [Full Text of this Article]
COMMENT
AUTHOR INFORMATION
Author Affiliations: Departments of Dermatology, National Taiwan University Hospital (Drs Sheen, Chu, and Yu), and College of Medicine, National Taiwan University (Dr Yu), Taipei.
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