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What is your diagnosis? • An. Bras. Dermatol. 96 (2) • Mar-Apr 2021 • https://doi.org/10.1016/j.abd.2020.06.009   copy

Case for diagnosis. Cutaneous small vessel vasculitis (anti-proteinase 3 positive), fever, hemoptysis, and lung cavitation in an adult☆ ☆ How to cite this article: Campos LM, de Ré MR, Lacerda PN, Miot HA. Case for diagnosis. Cutaneous small vessel vasculitis (anti-proteinase 3 positive), fever, hemoptysis, and lung cavitation in an adult. An Bras Dermatol. 2021;96:240-2. ,☆☆ ☆☆ Study conducted at the Department of Dermatology and Radiotherapy, School of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.

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Abstract

Small vessel vasculitis with anti-proteinase antibodies 3 is an atypical clinical presentation of tuberculosis. The authors present the case of a 47-year-old male patient, with palpable purpura and palmoplantar hemorrhagic blisters, with subsequent dissemination. He presented severe pulmonary symptoms with cavitation, fever, hemoptysis, and high levels of anti-proteinase 3. Histopathological assessment of the skin revealed small vessel vasculitis; pulmonary histopathology showed granulomas with caseation. Bronchoalveolar lavage was positive for alcohol-acid-fast bacilli. In countries with a high prevalence of tuberculosis, the presence of autoantibodies in a patient with vasculitis, fever, and pulmonary cavitation requires investigation of infectious causes.

KEYWORDS
Anti-neutrophil cytoplasmic antibodies; Anti-neutrophil cytoplasmic antibody-associated vasculitis; Tuberculosis; Vasculitis

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