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Laurent Machet, MD; Loïc Vaillant, MD; Nathalie Gironnet, MD; Brigitte Bouchindhomme, MD; Dominique Perrotin, MD; Gérard Lorette, MD
Services de Dermatologie, d'Anatomie Pathologique, et de Réanimation Médicale CHU Tours F-37044 Tours Cedex, France

Arch Dermatol. 1997;133(3):389-390.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In a recent issue of the ARCHIVES, McGovern et al¹ reported the efficacy of plasmapheresis in 2 patients with recalcitrant leg ulcers secondary to cryoglobulinemia (types I and II, one case each). The authors proposed using plasmapheresis as a second-line therapy, and even as a first-line therapy, in patients with rapidly progressive disease with painful purpura or ulcerations. They did not discuss the possibility that failure of plasmapheresis might occur, which we would like to address.

Report of a Case.

A 60-year-old woman presented with a 2-year history of purpura. A mixed cryoglobulinemia (IgM- and IgG) was discovered. A cutaneous biopsy specimen showed leukocytoclasis and fibrinoid necrosis of the dermal vessels. Painful necrotic ulcerations, peripheral neuropathy, and mild renal involvement (maximum proteinuria level, 0.6 g/d with normal creatinine levels) occurred a few months later. Blood cell count and liver function test results were normal. Antinuclear antibody and serologic test . . . [Full Text PDF of this Article]

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