Cutaneous vasculitis (CV) is a disease that may occur as a primary pro¬cess or be secondary to a wide and het¬erogeneous
group of disorders, including drug reactions, infections, connective tissue diseases, autoimmune disorders and malignancies.
There are several different cutaneous manifestations, including palpable purpura, urticarial papules and plaques,
nodules, ulcers, and livedo reticularis. Skin biopsy is the gold standard for the diagnosis of CV. However, the presence of a
leukocytoclastic vasculitis is not sufficient to establish the specific underlying aetiology.
Herein, we summarize a case report of a 15-year-old woman affected with non-pruriginous skin lesions, predominantly in
the lower limbs (up to thighs), without fever or signs of systemic or localized infection. The hysthopatological study of skin
lesions showed orthokeratotic epidermis with underlying dermis with vascular changes with slight proliferation of capillaries,
small vessels lesions, endothelial cell swelling, deposits of eosinophilic fibrin bands, and fibrinoid degradation. Neutrophil
polymorphonuclear predominant inflammatory infiltrate around vessels with endothelial damage and nuclear dust
(leukocytoclastia). In addition, an urine cultura showed a Peptoniphilus spp infection. With the diagnosis of of CV caused by
a Peptoniphilus spp isolated in an urinary tract infection, the patient was treated with corticosteroids and amoxicilin. After
1 week, all the skins lesions were resolved.
nancies. Clinically, it is mainly characterised by palpable
purpura, involving usually the lower extremities with
histopathologic findings that have in common vascular inflammation
and blood vessel damage. Skin biopsy is the gold
standard for the diagnosis of CV. However, the presence of a
leukocytoclastic vasculitis is not sufficient to establish the specific
underlying aetiology. Current pharmacological treatment
of primary CV is mainly based on corti¬costeroids, while,
immunosuppressive agents can be added in the most severe
cases. However, when CV is secondary to an underlying bacterial
infection, this treatment may lead to a deleterious effects
in patients.
Herein, we describe a case of CV secondary to a urinary tract
infection produced by Peptoniphilus spp with a short review of
the literature. For our knowledge, this is the first case reported
of CV caused by a Peptoniphilus spp isolated in an urinary
tract infection.
A previously healthy 15-year-old woman with no prior significant
medical history was admitted in our Emergency Department
affected with non-pruriginous skin lesions, predominantly
in the lower limbs (up to thighs), without fever or signs
of systemic or localized infection. No apparent possibility
of insect bite. Requesting any abnormalities in the previous
weeks, the patient referred a respiratory tract infection treated
symptomatically 1 week ago.
Attending to the physical examination, cardiopulmonary as
well as abdominal explorations were anodyne. Any disturbs
were observed at oropharyngeal level. The patient presented
edemas in distal region of lower extremities without fovea. At
skin level in lower extremities, macular and purpuric lesions
of different sizes were observed. These lesions were not erasable
to the digital pressure. The smallest lesions were petechiae
like, while the largest lesions were confluent up to 4-5
cm in their largest diameter (Figure 1 and 2). On left forearm,
the patient showed 2-3 petechiae lesions on extensor face.
On right hand, 2 millimetric petechiae on the dorsal side were
also observed.
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