24th July 2023

A 47-year-old man with a background of hepatitis C presents with painful hands and a rash

A 47-year-old man with a background of hepatitis C presents with painful hands and a rash. He complains of pain in the proximal interphalangeal joints of his hand, and there are many purpuric lesions on the skin spread diffusely over his body, with some beginning to ulcerate. Rheumatoid factor is tested and comes back as positive. The patient’s blood samples are tested at 4°C, from which the diagnosis is confirmed.

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