Cutaneous purpura of Sjögren syndrome successfully treated with hydroxychloroquine

Sjogren syndrome is a systemic autoimmune disease characterized by dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia). Common cutaneous manifestations of Sjogren syndrome include xerosis, annular erythema, hypergammaglobulinemic purpura, and immunologic inflammatory conditions such as vasculitis (leukocytoclastic and urticarial).1 The clinical manifestations of vasculitis depend on the degree of skin and blood vessel involvement and can range from petechiae to palpable purpura and widespread ecchymoses.2 The findings often occur on the leg.3 Here we present a case of Sjogren syndrome in which the primary cutaneous manifestations were ulcerated ecchymotic plaques that did not respond to high-dose prednisone but had an excellent response to hydroxychloroquine.