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leukocytoclastic vasculitis

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The text is the summary of recent articles on leukocytoclastic vasculitis at 75 thresold from National Library of Medicine (NLM). This information is subject to NCBI's Disclaimer and Copyright notice.

The choroid was thickened by prominent non-granulomatous Chronic Inflammation accompanied by a glomeruloid proliferation of small vessels [1]. The Inflammatory Infiltrate was almost exclusively confined to the choroid and consisted of predominantly T-cells [2]. Although it has been suggested that HORV is a form of leukocytoclastic retinal Vasculitis, the histological findings herein indicate that the pathophysiology is more complex [3]. She was treated with 6 months of intravenous Cyclophosphamide, followed by 2 doses of intravenous Rituximab (1g each), thereafter maintained on mycophenolate mofetil and glucocorticoid-based therapy [4]. Hypocomplementemic urticarial vasculitis syndrome with crescentic glomerulonephritis is a rare disease with only 5 other reported cases in literature [5].

Several studies investigating the histopathologic findings of eschars in tsutsugamushi disease reported leukocytoclastic vasculitis and Neutrophil Infiltration as the major findings [6]. Fourteen months later, he developed active retinal Vasculitis in right eye and Recurrent Nodules on forearm [7]. Skin Biopsy revealed neutrophilic infiltrates in and around Dermal vessels with destruction of vessel walls leading to Scattered Neutrophils, lymphocytes and histiocytes between collagen bundles, suggestive of leukocytoclastic vasculitis [8]. He showed concurrent cardiopulmonary involvement without involvement of the gastrointestinal system and Kidneys, which are commonly affected in IgA vasculitis patients [9]. Although some vasculitides are present in both Children and adults, some important differences exist in clinical presentation, etiology, management, and prognosis in childhood Vasculitis versus Adult Vasculitis [10].

Cutaneous vasculitis is rare in Children, and most childhood vasculitides, of which Henoch-Sch├Ânlein purpura is the most common, histologically are small vessel leukocytoclastic Vasculitis [11]. Childhood cutaneous Vasculitis is most often self-limited with a good prognosis, and treatment is mainly supportive [12]. It is the commonest Vasculitis in childhood and etiology is not completely known [13]. Neurological manifestations of IgAV are very rare and usually seen in patients with severe Hypertension or as an uncommon feature such as peripheral Neuropathy [14]. In all presented cases, Persistent cutaneous manifestations and abdominal Pain were resistant to Antibiotics and corticosteroids, but resolved during 48 h after the introduction of Dapsone [15].

The diagnostic features include histopathological findings of Dermal neutrophilic infiltration without leukocytoclastic vasculitis or peripheral blood leukocytosis [16]. Skin Biopsy revealed leukocytoclastic vasculitis with IgA deposits [17]. T helper Cells and granzyme B seem to be involved in the inflammatory cutaneous process of CLV [18]. We present a case of acute Renal Failure due to acute tubulointerstitial nephritis associated with a Diffuse leukocytoclastic vasculitic skin Eruption following intravenous vancomycin treatment [19]. CASE REPORT A 79-year-old Caucasian male patient was treated with intravenous vancomycin for MRSA bacteremia [20].

Tubulointerstitial nephritis is also a rare association with vancomycin treatment [21]. The study group consisted of 10 patients with Idiopathic myointimal Hyperplasia of mesenteric veins who underwent Surgical resection of the affected colon, 7 of whom had available prior endoscopic biopsies [22]. The control group included 10 patients each with radiation, nonocclusive ischemia, Crohn disease, diverticulitis, and Mucosal amyloidosis, and 5 cases of small vessel (leukocytoclastic) Vasculitis [23]. Fibrin thrombi were observed in only one case each of ischemic colitis and Small Vessel Vasculitis, and none of the other abovementioned features were seen in any of the controls [24]. The patient was diagnosed as HSP Vasculitis according to EULAR criteria and treated with intravenous hydration and ibuprofen [25].

However, many cases of cutaneous and Systemic Vasculitis related to TNF-╬▒ inhibitors have been reported in the literature [26]. Here, the authors report the first case of a 61-year-old Japanese Woman who developed leukocytoclastic vasculitis with cutaneous perivascular hemophagocytosis, which was related to elevated cytokines and Immune complexes after initiating adalimumab for rheumatoid arthritis without evidence of hemophagocytic syndrome and rarely encountered in the skin [27]. Topical Dapsone may provide similar efficacy with far fewer adverse effects [28]. She was diagnosed to have pyoderma gangrenosum and leukocytoclastic Vasculitis [29]. According to the Chapel Hill classification from 2012, Systemic Granulomatous Vasculitis is equated with giant cell arteritis [30].

More commonly Granulomatous infiltrates in combination with Vasculitis can be observed, whereby various infectious diseases, Sarcoidosis and Nodular vasculitis should be considered [31]. It can cause agranulocytosis and cutaneous Vasculitis that can possibly lead to cutaneous necrosis [32]. In all reported cases of levamisole-induced Vasculitis, it has been described as a clinical syndrome characterized by a constellation of typical clinical features and a positive serum serology for ANCA levels, especially very high-titer p-ANCA levels, in the background of cocaine abuse [33]. Ultimately, a final diagnosis was made by Skin Biopsy, which revealed findings suggestive of leukocytoclastic vasculitis [34]. CONCLUSIONS Cutaneous leukocytoclastic vasculitis can be caused by levamisole, which is used as an adulterant in cocaine [35].

The use of compression bandages and hosiery after interventional and Surgical procedures for varicose veins is based on experience but not on randomized controlled trials [36]. Our study highlights the multitude of causes of leukocytoclastic Vasculitis [37].

References: 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ,

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I have varied research interests ranging from eHealth, Health Information Exchange, Clinical Trials and Research, Contact Dermatitis, Bioinformatics, and Cosmetic Dermatology. I have work experience in Canada as an eHealth analyst, and in Dubai and India as a Specialist Dermatologist.


Bell Raj Eapen
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