Title: Henoch-Schönlein purpura - application of thermal imaging inthediagnosticand monitoring - a case report
- Danuta Mikulska, Joanna Stosio-Rostecka, Romuald Maleszka
- Case Reports
- Clinical Dermatology
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- Final page:
- leukocytoclastic vasculitis, Henoch-Schönlein purpura, thermography
Male patient aged 23 years was admitted to the Department of Skin and Venereal Diseases due to painful ulceration, localized on dorsal area of the right foot. The patient was hospitalized twice (two years and two months ago) in the Department of Internal Medicine with diagnosis of Henoch-Schönlein purpura. In the second episode of the disease apart from purpura changes, necrotic lesions localized on dorsal area of right foot were observed. The ulceration that appeared after surgical removal of necrotic tissue did not heal for about one month. During admission to the Department of Skin and Venereal Diseases a painful, deep ulceration of six centimeters diameter, penetrating to the fascia, localized on the right foot and additionally solitary foci of necrosis on both feet were observed. Results of laboratory tests were in normal range, except leucocytosis. In the histopatological examination of seemingly healthy skin of the left lower extremity leukocytoclastic vasculitis was diagnosed. The thermographic examination revealed decreased temperature of the skin of the right lower extremity and mild hypothermia of the left foot area. Doppler's ultrasonography and the computer tomography of the vessels showed the disturbances of the blood flow in the arteries in both lower extremities with the predominance of the right side. In the treatment antibiotics over month and immunosuppressive therapy (prednisone, cyclophosphamide) over 6 months were applied. The ulceration was covered by the skin transplant. The complete remission of the skin lesions was achieved after the treatment.