# Lymphocytic Vasculopathy With Cytoplasmic Antineutrophil Cytoplasmic Antibody Positivity After Upper Respiratory Infection: A Case Report

## TL;DR

A patient developed skin discoloration after an upper respiratory infection, linked to a rare autoimmune condition called lymphocytic vasculopathy.

## Contribution

This case report describes a rare instance of c-ANCA-associated lymphocytic vasculopathy limited to the skin without systemic symptoms.

## Key findings

- The patient showed skin lesions and elevated inflammatory markers after an upper respiratory infection.
- Biopsy findings suggested lymphocytic vasculopathy, with no systemic organ involvement detected.
- Treatment with corticosteroids led to gradual resolution of the lesions without complications.

## Abstract

Cutaneous manifestations of vasculitic or vasculopathic processes can pose a diagnostic challenge, particularly when systemic symptoms are absent. We report a case of an adult patient who presented with nonpainful petechiae and blue-purple discoloration of the lower extremities three days after a self-limited upper respiratory infection. Laboratory testing revealed elevated erythrocyte sedimentation rate, white blood cell count, and C-reactive protein, as well as positive cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) titers. No other systemic findings or organ involvement were identified. A punch biopsy of the affected skin demonstrated vascular changes with a differential diagnosis that included lymphocytic vasculopathy. The patient was managed with short-course systemic corticosteroids and close observation as the lesions gradually resolved without complications. This case highlights an atypical, skin-limited c-ANCA-associated lymphocytic vasculopathy, emphasizing the importance for physicians to maintain vigilance for subtle cutaneous signs of autoimmune or inflammatory disease even in the absence of systemic involvement.