<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Archiving and Interchange DTD v1.3 20210610//EN" "JATS-archivearticle1-3.dtd">
<article xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="case-report" dtd-version="1.3" xml:lang="en">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JPSIM</journal-id>
      <journal-title-group>
        <journal-title>Journal of Pakistan Society of Internal Medicine</journal-title>
        <abbrev-title>J Pak Soc Intern Med</abbrev-title>
      </journal-title-group>
      <issn publication-format="print">2709-8729</issn>
      <issn publication-format="electronic">2710-0804</issn>
      <publisher>
        <publisher-name>Pakistan Society of Internal Medicine</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.70302/jpsim.v5i1.2417</article-id>
      <article-id pub-id-type="publisher-id">jpsim.v5i1.2417</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Case Report</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Cutaneous Small Vessel Vasculitis: A Rare Manifestation of Protein Supplement Nutritional Powder</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes">
          <name>
            <surname>Nazar</surname>
            <given-names>Madeeha</given-names>
          </name>
          <email>madeehanazar@gmail.com</email>
          <xref ref-type="aff" rid="aff1"/>
          <xref ref-type="corresp" rid="cor1">*</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Khalid</surname>
            <given-names>Abdullah</given-names>
          </name>
          <xref ref-type="aff" rid="aff1"/>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <institution>Holy Family Hospital, Rawalpindi</institution>
      </aff>
      <author-notes>
        <corresp id="cor1">*Correspondence: Madeeha Nazar (madeehanazar@gmail.com)</corresp>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic" iso-8601-date="2024-02-28">
        <day>28</day>
        <month>02</month>
        <year>2024</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <year>2024</year>
      </pub-date>
      <volume>5</volume>
      <issue>1</issue>
      <fpage>436</fpage>
      <lpage>437</lpage>
      <history>
        <date date-type="received" iso-8601-date="2023-10-02">
          <day>02</day>
          <month>10</month>
          <year>2023</year>
        </date>
        <date date-type="accepted" iso-8601-date="2023-12-09">
          <day>09</day>
          <month>12</month>
          <year>2023</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Copyright © 2024 The Author(s)</copyright-statement>
        <copyright-year>2024</copyright-year>
        <copyright-holder>The Author(s)</copyright-holder>
        <ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
          <ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v5i1.2417" content-type="text/html"/>
      <self-uri xlink:href="https://psimj.com/article/jpsim.v5i1.2417.pdf" content-type="application/pdf"/>
      <abstract>
        <p>I am Describing a rare case of purpuric rash that developed in a Diabetic patient who was advised NutritionalProtein powder for her hypoalbuminemia.There was no history of any new drug intake,joint pains, nasal ulcers or hematuria. Histopathology revealed the diagnosis cutaneous small vessel vasculitis. The protein powder was stopped and as the lesions did not regress significantly patient was started steroids with complete resolution of lesions in 4 weeks.</p>
      </abstract>
      <kwd-group xml:lang="en" kwd-group-type="author-keywords">
        <title>Keywords</title>
        <kwd>: Leukocytoclastic Vasculitis</kwd>
        <kwd>Purpuric rash</kwd>
        <kwd>fibrinoid necrosis</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <!-- <body> omitted: no manuscript (.docx) on file -->
  <back>
    <ref-list>
      <title>References</title>
      <ref id="ref1">
        <label>1</label>
        <mixed-citation>Fraticelli P, Benfaremo D, Gabrielli A. Diagnosis and management of leukocytoclastic vasculitis. Intern Emerg Med. 2021;16(6):831-41.</mixed-citation>
      </ref>
      <ref id="ref2">
        <label>2</label>
        <mixed-citation>Jennette JC, Falk RJ, Alba MA. Nomenclature of Vasculitides: 2012 Revised International Chapel Hill Consensus Conference: Nomenclature of Vasculitides and Beyond. Systemic Vasculitides: Cur Status Perspect. 2016:15-28.</mixed-citation>
      </ref>
      <ref id="ref3">
        <label>3</label>
        <mixed-citation>Bouiller K, Audia S, Devilliers H, Collet E, Aubriot MH, Leguy-Seguin V et al. Etiologies and prognostic factors of leukocytoclastic vasculitis with skin involvement: a retrospective study in 112 patients. Medicine. 2016;95(28):e4238.</mixed-citation>
      </ref>
      <ref id="ref4">
        <label>4</label>
        <mixed-citation>Ortiz-Sanjuán F, Blanco R, Hernández JL, Pina T, González-Vela MC, Fernández-Llaca H et al. Drug-associated cutaneous vasculitis: study of 239 patients from a single referral center. J Rheumatol. 2014;41(11):2201-7.</mixed-citation>
      </ref>
      <ref id="ref5">
        <label>5</label>
        <mixed-citation>Blanco R, Martínez-Taboada VM, Rodríguez-Valverde V, García-Fuentes M. Cutaneous vasculitis in children and adults: associated diseases and etiologic factors in 303 patients. Medicine. 1998;77(6):403-18.</mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>
