A 48 year old man with an onset of macules and papules, ulcers and eschars on the upper and lower extremities, hands, genitals, face, as well as nasal and oral mucosae. The rash was accompanied by severe malaise, fever, ahralgia, paraesthesia, and microhematuria. Cryoglobulins and high titers of circulating immune complexes were noted. Steroid treatment was instituted together with plasmapheresis with good results. This is most likely secondary to:
High-Yield Explanation
vasculitic ulcer * Significantly elevated antinuclear antibodies, rheumatoid factors, or other more specific immunologic tests may tend to suppo the diagnosis of vasculitic process.