Leukocytoclastic vasculitis with Koebner phenomenon associat
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This is an unusual case of leukocytoclastic vasculitis (LCV) demonstrating the Koebner phenomenon. A patient with Ehlers Danlos syndrome had cutaneous lesions exclusively on skin of the lower legs that was traumatized by shaving. Biopsy of the lesions found LCV.

A 51-year-old woman with a history of Ehlers Danlos syndrome, hypermobile type (diagnosed by a medical geneticist using the 2017 international classification criteria of generalized joint hypermobility, systemic manifestations of generalized connective tissue disorder, positive family history, multiple musculoskeletal complications, and absence of unusual skin fragility or other connective tissue disorders), postural orthostatic tachycardia syndrome, and fibromyalgia presented to the dermatology clinic for evaluation of an asymptomatic eruption on her lower legs that developed several hours after shaving. This eruption occurred twice in 4 months, each time preceded by shaving her lower legs. She did not shave her legs between episodes.

She had fatigue, weight gain, and symptoms of Raynaud disease. Her medications included ivabradine, tramadol, metaxalone, levothyroxine, and ranitidine. Her ivabradine dose was increased around the time the rashes began; otherwise, there were no recent medication changes or vaccinations. She denied use of nonsteroidal antiinflammatory drugs. She denied recent infections, sick contacts, recent travel, hematuria, abdominal pain, photosensitivity, or oral ulcers. She was up to date on age-appropriate malignancy screening. Family history was significant for a sister with Ehlers Danlos syndrome who had biopsyconfirmed vasculitis

Source: JAAD case reports

Read more: https://www.jaadcasereports.org/article/S2352-5126(19)30231-0/pdf
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