Published: 2 January 2026
Author(s): Romain Batton, Arnaud François, Nicolas Girszyn
Issue: January 2026
Section: Internal Medicine Flashcard

A 66-year-old man was admitted to the internal medicine department with subacute abdominal pain and diarrhoea, resulting in a weight loss of 10 kg over three weeks. Shortly thereafter, he developed bilateral arthritis of the elbows, shoulders, and knees, without fever. Cutaneous purpura appeared in pressure-dependent areas, including the lower limbs and gluteal region; the lesions were non-infiltrated, non-necrotic, and non-pruritic (Fig. 1A). His medical history was notable for treated hypothyroidism, hypertension, hypercholesterolemia, and diabetes.

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