Churg-Strauss syndrome and hemorrhagic vasculitis

Abstract

Churg-Strauss syndrome (CSS) is a rare syndrome characterized by sinusitis, asthma and peripheral eosinophilia. This vasculitic syndrome affects medium and small-sized vessels, the lung being the most commonly affected organ, followed by the skin. The authors report a case of a 59-year-old male with a past history of asthma and allergic rhinitis. He presented necrohemorragic lesions in the distal phalanx of the 2(nd), 3(rd) and 4(th) fingers of the left-hand and petechial lesions in the plant of both feet, accompanied by asthenia, anorexia and weight loss. The analytical study revealed leukocytosis with eosinophilia, elevated inflammatory parameters and p-ANCA positive antibodies. The diagnosis of CSS was established based on clinical and histopathological data. Cutaneous manifestations of hemorragic vasculitis are rare in CSS syndrome but can be the first manifestation of the disease. The recognition of this presentation is important for the early diagnosis and treatment of this syndrome.

Keywords: Churg-Strauss syndrome; asthma; eosinophilia; p-ANCA; polyneuropathy.; vasculitis.

Figure 1

Necrohemorragic lesions in the distal phalanx of the 2^nd, 3^rd and 4^th fingers.

Figure 2

Petechial lesions in the plant of the right foot.

Figure 3

Skin biopsy of a finger lesion, showing necrotizing vasculitis with abundant eosinophils.