A 70-year-old woman in America broke out in a large, web-like purple rash, after cold weather triggered a rare blood disease.
The woman, from upstate New York, visited the doctor after feeling dizzy for a week, having also developed the strange rash that had spread across her entire body.
Details of her case were published in a report in the New England Journal of Medicine, which explained her symptoms started after the onset of a viral respiratory tract infection two weeks earlier.
After being examined, doctors found the woman had a 'generalized, macular, non-blanching rash in a reticular pattern with purplish discolouration consistent with livedo reticularis'.
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According to Speciality Medical Dialogues, livedo reticularis is a skin condition thought to be caused by spasms of the blood vessels and poor circulation near the surface of the skin.
It makes the skin look mottled and purplish, resembling a net-like pattern with distinct borders.
Interested to find out the cause, Dr Konika Sharma and Dr Anush Patel from the Bassett Medical Center in Cooperstown, New York, took blood samples.
While blood is usually a deep red, they found the woman's was almost clear. Her red blood cells, which carry oxygen, had clumped together (spontaneous agglutination).
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The patient was diagnosed cold agglutinin disease, a rare autoimmune disease that affects people when their blood is exposed to cold temperatures, meaning proteins that normally attack bacteria attach themselves to red blood cells, clumping them together.
The woman's condition had been triggered by the cold weather in upstate New York, where temperatures had dropped to −9°C.
She was kept in hospital for a week, being given blood transfusions while being kept warm. After her treatment, the ratio of red blood cells to total blood volume more than doubled.
While she still had the rash when she was discharged, her anaemia and dizziness subsided within the week.
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The NEJM report said: "A diagnosis of cold agglutinin disease, a form of acquired autoimmune hemolytic anemia, was made, a condition that may have been exacerbated by the patient's recent viral infection along with the cold weather in upstate New York, where the temperature was 15°F (−9°C) at the time of her presentation.
"The patient was warmed and treated with blood transfusions and rituximab for one week.
"At the time of hospital discharge, she had a hematocrit of 30% and a reduction in dizziness, but the rash persisted."
Featured Image Credit: NEJM