case_images: PMC8825631_01
case_images: (a) Erythematous plaques with central ulceration on both legs. (b) Skin biopsy of the border of an ulcer. In the deep reticular dermis, there is a medium artery with prominent fibrinoid necrosis and inflammation, consistent with a necrotizing arteritis (hematoxylin-eosin stain; magnification x100).
case_images: 10.1177_2050313X20953110-fig1.jpg
case_images: PMC8825631_01_10.1177_2050313X20953110-fig1.jpg
case_images: fig1-2050313X20953110
case_images: Her cutaneous examination revealed multiple indurated plaques with central ulceration on both legs (Figure 1(a)). A biopsy at the border of the ulcer revealed a necrotizing medium vessel arteritis present in the dermis most suspicious of PAN (Figure 1(b)).
case_images: (a) Multiple yellowish papules on the posterior neck. (b) Skin biopsy of the yellowish papules on the posterior neck shows pseudoxanthoma elasticum-like calcification of the elastic fibers (Von Kossa stain; magnification x40).
case_images: 10.1177_2050313X20953110-fig2.jpg
case_images: PMC8825631_01_10.1177_2050313X20953110-fig2.jpg
case_images: fig2-2050313X20953110
case_images: Coincidentally, she was also noted to have multiple yellowish papules diffusely scattered on the posterior neck (Figure 2(a)). Von Kossa stain highlighted the clumped elastic fibers (Figure 2(b)).