Antiphospholipid Syndrome with Cutaneous Necrotic Lesion of the Lower Limbs

Abstract

To the Editor: A 71-year-old woman presented with a 7-day history of a tender rash and necrosis on both shins. Six months prior to admission, she first noticed intermittent occurrence of purpura on her legs. She had been taking non-steroidal antiinflammatory drugs (NSAID) for her joint pain for 2 months and was not taking any anticoagulants. She was a nonsmoker with no history of miscarriages or allergies. Her history was unremarkable and no family history of autoimmune diseases, cancer, diabetes, or coagulopathies was elicited. On examination, she was afebrile with no cardiovascular, respiratory, or abdominal findings. On the lower limbs, there was bilateral involvement with skin necrosis on the medial distal third, more pronounced on the left, which was surrounded by purpura and ecchymosis. In addition, there were erythema and purpura, more confluent on the dorsum of the feet, but also scattered on both lower limbs (Figure 1). Routine investigations including full blood count, urea and electrolytes, and … Address correspondence to Prof. Zheng; E-mail: jie-zheng2001{at}126.com