Necrotising Cutaneous Lesions in Anti neutrophil Cytoplasmic Antibodies- Associated Vasculitis Mimicking Necrotising Fasciitis
Necrotising vasculitis is a very rare occurrence and commonly caused by an underlying autoimmune pathology. Anti neutrophil Cytoplasmic Antibodies (ANCA) associated vasculitis is an established cause for cutaneous manifestations of necrotising vasculitis, and is associated with multisystemic invol...
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| Format: | Article |
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JCDR Research and Publications Private Limited
2021-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/14974/47864_CE[Ra1]_F[IK]_PF1(PS_SHU)_KM_PFA(PS_KM)_PN(KM).pdf |
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| author | AHMAD ARIEFF ATAN KHONG WEE LEE SUGHILAN SUNDARA MURTHI MUHAMMAD AZRI MOHAMED MANSOOR MUSTAQIM AFIFI |
| author_facet | AHMAD ARIEFF ATAN KHONG WEE LEE SUGHILAN SUNDARA MURTHI MUHAMMAD AZRI MOHAMED MANSOOR MUSTAQIM AFIFI |
| author_sort | AHMAD ARIEFF ATAN |
| collection | DOAJ |
| description | Necrotising vasculitis is a very rare occurrence and commonly caused by an underlying autoimmune pathology. Anti neutrophil
Cytoplasmic Antibodies (ANCA) associated vasculitis is an established cause for cutaneous manifestations of necrotising vasculitis,
and is associated with multisystemic involvement, in which presentations of one system may feature predominantly and lead to
misdiagnosis. A 33-year-old male presented with acute history of shortness of breath and necrotising blisters over both his ankles
and arms. He was initially provisionally diagnosed with necrotising fasciitis, which was eventually ruled out as the serological
biomarkers (including low level of C3 and presence of cytoplasmic type of ANCA on indirect immunofluorescence) drew suspicion
of an autoimmune pathology. A multidisciplinary approach led to the commencement of steroid, which improved the patient’s
condition rapidly. The histological examination of sample from the skin biopsy later confirmed the diagnosis of ANCA-Associated
Vasculitis (AAV). The patient eventually recovered with excellent outcomes. Despite its rarity, any abnormal skin lesion may be a
subtle presentation of necrotising cutaneous vasculitis. A high index of suspicion through a multidisciplinary approach, coupled
with meticulous investigative process including serological biomarkers and skin biopsy, helps to avoid misdiagnosis which may be
detrimental to the patient. |
| first_indexed | 2024-12-18T23:18:30Z |
| format | Article |
| id | doaj.art-18b54a51ece34deb8b1f78552b1f4126 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-18T23:18:30Z |
| publishDate | 2021-07-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-18b54a51ece34deb8b1f78552b1f41262022-12-21T20:48:05ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-07-011507010410.7860/JCDR/2021/47864:14974Necrotising Cutaneous Lesions in Anti neutrophil Cytoplasmic Antibodies- Associated Vasculitis Mimicking Necrotising FasciitisAHMAD ARIEFF ATAN0KHONG WEE LEE1SUGHILAN SUNDARA MURTHI2MUHAMMAD AZRI MOHAMED MANSOOR3MUSTAQIM AFIFI4Orthopaedic Surgeon, Department of Orthopaedics, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan, Malaysia.Orthopaedic Medical Officer, Department of Orthopaedics, Hospital Tawau, Sabah, Malaysia.Orthopaedic Medical Officer, Department of Orthopaedics, Hospital Tawau, Sabah, Malaysia.Orthopaedic Medical Officer, Department of Orthopaedics, Hospital Tawau, Sabah, MalaysiaOrthopaedic Surgeon, Department of Orthopaedics, Hospital Tawau, Sabah, Malaysia.Necrotising vasculitis is a very rare occurrence and commonly caused by an underlying autoimmune pathology. Anti neutrophil Cytoplasmic Antibodies (ANCA) associated vasculitis is an established cause for cutaneous manifestations of necrotising vasculitis, and is associated with multisystemic involvement, in which presentations of one system may feature predominantly and lead to misdiagnosis. A 33-year-old male presented with acute history of shortness of breath and necrotising blisters over both his ankles and arms. He was initially provisionally diagnosed with necrotising fasciitis, which was eventually ruled out as the serological biomarkers (including low level of C3 and presence of cytoplasmic type of ANCA on indirect immunofluorescence) drew suspicion of an autoimmune pathology. A multidisciplinary approach led to the commencement of steroid, which improved the patient’s condition rapidly. The histological examination of sample from the skin biopsy later confirmed the diagnosis of ANCA-Associated Vasculitis (AAV). The patient eventually recovered with excellent outcomes. Despite its rarity, any abnormal skin lesion may be a subtle presentation of necrotising cutaneous vasculitis. A high index of suspicion through a multidisciplinary approach, coupled with meticulous investigative process including serological biomarkers and skin biopsy, helps to avoid misdiagnosis which may be detrimental to the patient.https://jcdr.net/articles/PDF/14974/47864_CE[Ra1]_F[IK]_PF1(PS_SHU)_KM_PFA(PS_KM)_PN(KM).pdfblistersskin biopsysteroid |
| spellingShingle | AHMAD ARIEFF ATAN KHONG WEE LEE SUGHILAN SUNDARA MURTHI MUHAMMAD AZRI MOHAMED MANSOOR MUSTAQIM AFIFI Necrotising Cutaneous Lesions in Anti neutrophil Cytoplasmic Antibodies- Associated Vasculitis Mimicking Necrotising Fasciitis Journal of Clinical and Diagnostic Research blisters skin biopsy steroid |
| title | Necrotising Cutaneous Lesions in Anti neutrophil Cytoplasmic Antibodies- Associated Vasculitis Mimicking Necrotising Fasciitis |
| title_full | Necrotising Cutaneous Lesions in Anti neutrophil Cytoplasmic Antibodies- Associated Vasculitis Mimicking Necrotising Fasciitis |
| title_fullStr | Necrotising Cutaneous Lesions in Anti neutrophil Cytoplasmic Antibodies- Associated Vasculitis Mimicking Necrotising Fasciitis |
| title_full_unstemmed | Necrotising Cutaneous Lesions in Anti neutrophil Cytoplasmic Antibodies- Associated Vasculitis Mimicking Necrotising Fasciitis |
| title_short | Necrotising Cutaneous Lesions in Anti neutrophil Cytoplasmic Antibodies- Associated Vasculitis Mimicking Necrotising Fasciitis |
| title_sort | necrotising cutaneous lesions in anti neutrophil cytoplasmic antibodies associated vasculitis mimicking necrotising fasciitis |
| topic | blisters skin biopsy steroid |
| url | https://jcdr.net/articles/PDF/14974/47864_CE[Ra1]_F[IK]_PF1(PS_SHU)_KM_PFA(PS_KM)_PN(KM).pdf |
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