American Board of Internal Medicine (ABIM) Certification Practice Exam

What is one of the skin manifestations in Churg-Strauss syndrome?

1. Psoriasis

2. Skin nodules or purpura

3. Erythema multiforme

4. Basal cell carcinoma

The correct answer is: Skin nodules or purpura

Churg-Strauss syndrome, also known as eosinophilic granulomatosis with polyangiitis, is characterized by a range of symptoms associated with systemic vasculitis, particularly affecting small to medium-sized blood vessels. One notable skin manifestation of this condition is the presence of skin nodules or purpura. Purpura are small purple spots on the skin caused by bleeding underneath the skin, which can occur as a result of inflammation of blood vessels in the skin, a hallmark of the vasculitic process associated with Churg-Strauss. Skin nodules may also arise due to the infiltration of eosinophils and the formation of granulomas, which are collections of immune cells that occur in response to inflammation. The appearance of these lesions can serve as an important clinical feature that points towards diagnosing Churg-Strauss syndrome, especially in a patient presenting with other systemic symptoms such as asthma, sinusitis, and peripheral eosinophilia. In contrast, options like psoriasis, erythema multiforme, and basal cell carcinoma are not typically associated with Churg-Strauss syndrome. Psoriasis is a chronic autoimmune condition characterized by scaling and redness, and it is not a manifestation of vasculitis.