Abstract
A 16-year-old girlhadan 8-weekhistoryofnodules and ulcerson both legs. Examination revealed manynodules with ulceration, mainlyonthe flexor aspect ofher leftleg (Fig. I). Other lesions werepurpura, blisters, and livedo reticularis bilaterally. The patient had nosystemic manifestations. Laboratory data indicating abnormality included an erythrocyte sedimentation rate of 44 mm/hr, hypergammaglobulinemia of 29.4% with a serum IgG of 2804 mg/dl (normal 780 to 1450 mg/dl). The rheumatoid factorwas42UIml (normal<15UIml), and C-reactive proteinwas2.9mg/dl (normal<0.7 mg/dl). Fluorescent antinuclear antibodies andanti-UIRNP antibodies were positive in titers of 1:2560 and 1:20, respectively.
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