Cutaneous Wegener’s granulomatosis
Molly J. Norris, MD
Kenneth J. Tomecki, MD
Wilma F. Bergfeld, MD, FACP
William S. Wilke, MD
A 32-year-old man with documented Wegener’s granulomatosis had papules and pustules on his elbows, hands, and feet and petechiae on his palms and soles. Skin biopsy showed chronic vasculitis and epidermal necrosis. The patient’s condition improved markedly after chemotherapy with nitrogen mustard, prednisone, and cyclophosphamide. This case illustrates characteristic clinical and histopathologic findings of cutaneous Wegener’s granulomatosis based on a current literature review. Although no one skin change is pathognomonic of Wegener’s granulomatosis, certain cutaneous findings are suggestive of the disease. Clinicians should be aware of these skin changes to aid early diagnosis and treatment of a rapidly fatal but potentially treatable disease.