Propylthiouracil-induced cutaneous vasculitis. Case presentation and review of the literature
D. B. Vasily and W. B. Tyler
A patient had cutaneous vasculitis, leukopenia, and splenomegaly caused by
the antithyroid drug, propylthiouracil. Histopathologic changes of acute
vasculitis of the superficial and deep dermal blood vessels accompanied by
fibrin thrombi formation were found in biopsy specimens of the cutaneous
lesions. Direct immunofluorescence studies demonstrated IgM and C3 of the
vessel walls suggesting immune complex deposition. The literature disclosed
five cases with similar features associated with propylthiouracil therapy.
Characteristic cutaneous findings include a recurrent, self-limited,
symmetrical purpuric eruption that can involve the face or earlobes.
Clinicians should recognize these changes as a cutaneous sign of a
vasculitis associated with propylthiouracil therapy.
