DermKnowledgeBASE: leukocytoclastic vasculitis

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.

However, many cases of cutaneous and Systemic Vasculitis related to TNF-α inhibitors have been reported in the literature [1]. 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 [2]. Soon after, it was linked to several gastrointestinal and extra-gastrointestinal diseases (hematological, cardiovascular, neurological, pulmonary and ocular diseases, obesity, diabetes mellitus, Growth Retardation and extragastric MALT lymphoma) [3]. The clinical symptoms of LCV associated with SS comprise Palpable or nonpalpable purpura and urticarial Vasculitis [4]. Leukocytoclastic vasculitis often spontaneously resolves within weeks and requires only symptomatic treatment [5].

She was diagnosed to have pyoderma gangrenosum and leukocytoclastic Vasculitis [6]. RV remains a serious extra-articular manifestation of RA that needs to be promptly recognized and treated [7]. According to the Chapel Hill classification from 2012, Systemic Granulomatous Vasculitis is equated with giant cell arteritis [8]. More commonly Granulomatous infiltrates in combination with Vasculitis can be observed, whereby various infectious diseases, Sarcoidosis and Nodular vasculitis should be considered [9]. It can cause agranulocytosis and cutaneous Vasculitis that can possibly lead to cutaneous necrosis [10].

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 [11]. Ultimately, a final diagnosis was made by Skin Biopsy, which revealed findings suggestive of leukocytoclastic vasculitis [12]. CONCLUSIONS Cutaneous leukocytoclastic vasculitis can be caused by levamisole, which is used as an adulterant in cocaine [13]. 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 [14]. Our study highlights the multitude of causes of leukocytoclastic Vasculitis [15].

Of the patients with secondary Vasculitis, the most common causes were infections and drugs [16]. Skin biopsy was performed in six patients revealing leukocytoclastic vasculitis [17]. It is increasingly important that dermatologists recognize adverse cutaneous manifestations of imatinib and are aware of their management and outcomes to avoid unnecessarily discontinuing a potentially lifesaving medication [18]. Adverse cutaneous manifestations in response to imat-inib are not infrequent and can include dry skin, Alopecia, facial Edema, and photosensitivity rash [19]. Other less common manifestations include exfoliative dermatitis, nail disorders, psoriasis, folliculitis, hypotrichosis, urticaria, petechiae, Stevens-Johnson syndrome, erythema multiforme, Sweet syndrome, and leukocytoclastic Vasculitis [20].

Noninfectious as well as infectious diseases have been described as dermatologic manifestations of diabetes mellitus [21]. According to the 2012 Chapel Hill Consensus Conference nomenclature, patients presenting symptoms of LCV confined only to the skin should be defined as suffering from a single-organ cutaneous small vessel vasculitis (SoCSVV) [22]. Despite thorough investigation, no other cause of Vasculitis could be found [23]. Complete regression of the skin lesions was achieved with scabies treatment only, without any specific treatment for the Vasculitis [24]. A 45-year-old male Caucasian patient developed agranulocytosis caused by Dapsone (diamino-diphenyl sulfone), which he was prescribed for leukocytoclastic Vasculitis [25].

After changing the injection sites and using the combined treatment of prednisone and colchicine, the previous Lesion healed and no other cutaneous Lesion occurred [26]. acute hemorrhagic Edema of infancy (AHEI) is a Benign type of small-vessel leukocytoclastic vasculitis that presents with Progressive purpura and has an excellent prognosis [27]. Skin Biopsy revealed marked Neutrophilic and leukocytoclastic vasculitis [28]. Biological tests and computed tomographic scan allowed to rule out another cause of pancreatitis and iga vasculitis was diagnosed as its etiology [29]. Here, we report a rare case of leukocytoclastic vasculitis without Immune complexes or cryoglobulinemia in a patient with infective Endocarditis, congenital Heart disease, and a prior mechanical valve replacement [30].

The patient completely recovered following antibiotic therapy, and skin lesions disappeared without Immune suppression, which suggested infection-mediated Vasculitis [31]. Skin Biopsy revealed leukocytoclastic Vasculitis with IgA deposits in Dermal vessels [32]. Accordingly, IgA vasculitis (Henoch-Schönlein purpura) was diagnosed [33]. A skin biopsy of an area of erythema showed Multiple non-caseating epithelioid cell granulomas in the Dermis and Subcutaneous fat and Granulomatous Vasculitis with fibrinoid degeneration in the Subcutaneous fat [34]. There are two types of vasculitis in sarcoidosis: leukocytoclastic and Granulomatous Vasculitis [35].

Upper endoscopy revealed Multiple lesions consistent with Vasculitis and histological examination of the Skin Biopsy disclosed a leukocytoclastic vasculitis [36]. The simultaneous presence of history of asthma, sinusitis, hypereosinophilia, and Vasculitis led to the diagnosis of EGPA [37]. To date, no significant skin side effects have been reported other than 4 cases of non-specific skin Lesion and 2 cases of leukocytoclastic vasculitis (LCV), which is a Small Vessel Inflammatory disease that presents as palpable purpura in lower Extremities [38]. Cutaneous Small Vessel Vasculitis is confined to the skin, involves mainly postcapillary venules, and has the hallmark manifestation of Palpable purpura [39]. Henoch-Schönlein purpura is an immune complex-mediated Systemic Vasculitis of the small vessels with manifestations from the skin, Joints, Kidneys, and gastrointestinal system [40].

Cryoglobulinemic Vasculitis is induced by the deposition of cold-precipitated Immune complexes in the small vessels [41]. Urticarial vasculitis comprises a spectrum of conditions with the characteristic course of chronic urticaria, with wheals that persist longer than 24 hours, leave hyperpigmentation, and have leukocytoclastic vasculitis on histologic examination [42]. polyarteritis nodosa is a rare multisystem, segmental necrotizing vasculitis of mainly the medium-sized vessels [43]. Surgical Excision of the Inflammatory Mass promptly triggered Tumor Recurrence, whereas antineutrophil therapy (dapsone coupled with Hydroxyurea, and prednisone) lead to tumor regression [44]. Histopathologic examination revealed an eosinophilic-rich small-vessel Neutrophilic Vasculitis associated with storiform and angiocentric fibrosis (GF-like) [45].

The pathogenesis of the fibrotic Nodules and plaques of CLFLCV is suspected to be due to recurring bouts of immune-complex vasculitis, creating a cycle of vessel damage followed by reparative granulation tissue [46]. Poor lymphatic drainage may be the underlying factor initiating and maintaining Recurrent, Localized episodes of immune-complex Vasculitis and progressive Fibrosis [47]. We report four such interesting patients who presented to us initially with common dermatoses such as leukocytoclastic Vasculitis, pyoderma gangrenosum, and vesiculobullous disorders and were subsequently diagnosed to have MM [48].

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 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ,

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About Me

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
Hamilton, ON