Ann Dermatol.  2009 May;21(2):213-216. 10.5021/ad.2009.21.2.213.

A Case of Churg-Strauss Syndrome

• Choi JH
• Ahn IS
• Lee HB
• Park CW
• Lee CH
• Ahn HK

• KMID: 2219401
• DOI: http://doi.org/10.5021/ad.2009.21.2.213

Abstract

Churg-Strauss syndrome (CSS) or allergic granulomatosis angiitis is a rare primary vasculitic disease. CSS can be diagnosed by the presence of any four or more of the six criteria, which include asthma, eosinophilia greater than 10%, paranasal sinusitis, pulmonary infiltration, histological proof of vasculitis and mono- or poly-neuropathy. We report here on a 45-year-old male who developed erythematous macules, papules and hemorrhagic vesicles on both right extremities along with a tingling sensation and sacral pain. He has been suffering from recurrent allergic rhinitis and bronchial asthma for 6 months. The laboratory findings showed severe eosinophilia (22.3%), hyper-IgE and positivity for p-ANCA. On the histological examination of the hemorrhagic vesicle on the right lower leg, leukocytoclsatic vasulitis and many neutrophils and eosinophils around the cutaneous vessels were observed in the dermis.

Keyword

Churg-Strauss syndrome (CSS)

MeSH Terms

Antibodies, Antineutrophil Cytoplasmic
Asthma
Churg-Strauss Syndrome
Dermis
Eosinophilia
Eosinophils
Extremities
Humans
Leg
Male
Middle Aged
Neutrophils
Rhinitis
Rhinitis, Allergic, Perennial
Sensation
Sinusitis
Stress, Psychological
Vasculitis
Antibodies, Antineutrophil Cytoplasmic
Churg-Strauss Syndrome

Figure

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  Fig. 1 Erythematous macules with central hemorrhagic vesicles on the right lower leg.

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  Fig. 2 (A) Biopsy of a hemorrhagic vesicle on the right lower leg shows sub-epidermal bulla and a perivascular leukocytoclstic infiltration with much nuclear dust in the upper dermis (H&E stain, ×200). (B) Many inflammatory cells are infiltrated in the middle & lower dermis, and especially around the perivascular area (H&E stain, ×100). (C) The perivascular infiltration consists of many neutrophils, lymphocytes, histiocytes, neutrophil fragments and eosinophils (H&E stain, ×400).

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