{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T09:58:26Z","timestamp":1771667906499,"version":"3.50.1"},"reference-count":21,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,15]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>Hydralazine is a common arterial vasodilator used in the management of congestive heart failure and hypertension. It can be associated with drug-induced lupus and less commonly antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Drug-induced AAV typically has a favourable long-term prognosis. It is not commonly associated with primary skin involvement, as most cases also have notable kidney and lung disease. Cases with isolated skin findings are rare. We present a rare case of a 60-year-old woman on long-term hydralazine who presented with AAV with primary skin and mucosal involvement, in the form of diffuse bullous and ulcerative lesions, which posed a diagnostic challenge. Her hospital course was marked by several complications including disseminated intravascular coagulation. She required intensive therapy with high-dose steroids, plasmapheresis and rituximab. She tolerated immunosuppression well and with multidisciplinary supportive care, she recovered well and was able to be discharged from the hospital.<\/jats:p>","DOI":"10.1136\/bcr-2020-238609","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T12:40:50Z","timestamp":1620736850000},"page":"e238609","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Severe cutaneous presentation of hydralazine-induced ANCA vasculitis without renal or pulmonary involvement, complicated by DIC"],"prefix":"10.1136","volume":"14","author":[{"given":"Mae Xintong","family":"Huo","sequence":"first","affiliation":[{"name":"Internal Medicine, Albany Medical Center, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alzira Rocheteau M","family":"Avelino","sequence":"additional","affiliation":[{"name":"Internal Medicine, Albany Medical Center, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gurpreet","family":"Singh","sequence":"additional","affiliation":[{"name":"Internal Medicine, Albany Medical Center, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"2025082708391908000_14.5.e238609.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.280.6208.156"},{"key":"2025082708391908000_14.5.e238609.2","unstructured":"Bolognia J , Schaffer JV , Cerroni L . 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