AI Article Synopsis

  • Eosinophilic granulomatosis with polyangiitis (EGPA) is a complex condition that complicates diagnosis due to its diverse symptoms, as illustrated by a 59-year-old woman with asthma and sinusitis who presented with rare skin blisters and nerve issues.
  • Medical examinations showed elevated eosinophils, a specific antibody related to neutrophils, and signs of small vessel inflammation, leading to the diagnosis of EGPA.
  • Treatment with glucocorticoids and cyclophosphamide resulted in significant improvement, highlighting the importance of recognizing unusual skin lesions for early diagnosis and intervention to prevent serious complications.

Article Abstract

Eosinophilic granulomatosis with polyangiitis poses a significant diagnostic challenge due to its varied clinical presentation. Here, we present a case of a 59-year-old female with a history of asthma and sinusitis, who manifested with an extremely rare presentation of drastic tense blisters and haemorrhagic bullae alongside purpuric lesions and peripheral neuropathy. Examinations revealed eosinophilia, positive antineutrophil cytoplasmic antibody, and characteristic pathological findings with small-vessel vasculitis in the purpura. Treatment with glucocorticoids and cyclophosphamide led to rapid improvement in peripheral eosinophilia, skin manifestations, and motor neuron deficits. Although rare, our case underscores that bullous skin lesions should be recognised as a potential cutaneous hallmark of eosinophilic granulomatosis with polyangiitis to aid timely diagnosis, since prompt treatment initiation is crucial given the potential irreversible organ damage and poor prognosis of eosinophilic granulomatosis with polyangiitis.

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http://dx.doi.org/10.1093/mrcr/rxae056DOI Listing

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