A 59-year-old lady with underlying hypothyroidism presented with acute contact dermatitis progressed to cellulitis with superimposed bacterial infection and acute kidney injury. She responded to initial management with antibiotics, but a week later, she had cutaneous and systemic vasculitis. Her skin biopsy consistent with immune-mediated leuko-cytoclastic vasculitis and her blood test was positive for cytoplasmic-anti-neutrophil cytoplasmic antibody (c-ANCA). A diagnosis of ANCA-associated vasculitis was made and she was treated with immunosuppressant with plasmapheresis and hemodialysis support for her kidney failure. Despite aggressive measures, the patient succumbed to her illness. This case report demonstrates that soft tissue infection could trigger the development of ANCA-associated vasculitis whilst a background of hypothyroidism serves as a predisposing factor as both condition were reported separately in a couple of case studies before.

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Seorang wanita usia 59 tahun dengan hipotiroidisme dermatitis kontak akut berkembang menjadi selulitis dengan infeksi bakteri superimposed dan cedera ginjal akut. Dia merespons penatalaksanaan awal dengan antibiotik, namun seminggu kemudian mengalami vaskulitis kulit dan sistemik. Biopsi kulit konsisten dengan vaskulitis leuko-sitoklastik yang dimediasi imun dan hasil tes darah positif antibodi sitoplasma-anti-neutrofil sitoplasma (c-ANCA). Diagnosis vaskulitis terkait ANCA ditegakkan. Wanita tersebut dirawat dengan imunosupresan plasmaferesis dan dukungan hemodialisis untuk gagal ginjalnya. Laporan kasus ini menunjukkan bahwa infeksi jaringan lunak dapat memicu perkembangan vaskulitis terkait ANCA, latar belakang hipotiroidisme berfungsi sebagai faktor predisposisi karena kedua kondisi tersebut dilaporkan secara terpisah dalam beberapa studi kasus sebelumnya.