case_images: PMC10559690_01
case_images: Clinical appearance of the cutaneous lesions characterized by erythematous palpable purpura and joint nodules on the dorsum of the patient's hands.
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case_images: Some of the lesions were superficially eroded and partially crusted (Figure 1).
case_images: Slit-lamp photograph showing nasal conjunctival tissue were growing well in the left eye (A) and conjunctival hyperemia, marginal corneal guttering from 11 o'clock to 1 o'clock with corneal ulceration in the right eye (B). Two-month after surgery, the edges of the ulcer showed dense stromal inflammatory cell infiltrations (C). Three-month after surgery, the patient's ocular condition remained stable (D).
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case_images: On follow-up examination 1 week later, the corneal perforation resolved, leaving a central scar with vascularized pseudopterygium that limited his vision to hand motion (Figure 2A). Examination of the anterior segment in the right eye showed conjunctival hyperemia, and marginal corneal guttering from 11 to 1 o'clock position, with corneal ulceration (Figure 2B). After 2 months of follow-up, the margins of the ulcer showed a dense infiltration of stromal inflammatory cells. (Figure 2C) Treatment with tobramycin and dexamethasone ointment once daily was added to the ocular medications. After 3 months of follow-up, visual acuity was 0.6 and conjunctival tissue was growing well and the corneal ulcer healed well in the right eye (Figure 2D).
case_images: Skin biopsy showed massive neutrophilic infiltrate in soft tissue mainly consisted of polymorphonuclear leukocytes, leukocytoclasis, nuclear dust around the blood vessels, and perivascular fibroblastic proliferation.
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case_images: A massive neutrophilic infiltrate in soft tissue mainly consisted of polymorphonuclear leukocytes, leukocytoclasis, nuclear dust around the blood vessels, and perivascular fibroblastic proliferation was discovered by histopathology (Figure 3).