- A case of leukocytoclastic vasculitis caused by novel anticoagulant rivaroxaban. [Journal Article]
- DODermatol Online J 2017 Nov 15; 23(11)
- Cutaneous leukocytoclastic vasculitis (LCV) is type of small vessel vasculitis that commonly presents as palpable purpura involving the lower extremities and buttocks. Approximately half of cases are...
Cutaneous leukocytoclastic vasculitis (LCV) is type of small vessel vasculitis that commonly presents as palpable purpura involving the lower extremities and buttocks. Approximately half of cases are idiopathic, but the disease may be triggered by infection, drug reaction, inflammatory disease, or other causes. We report a case of leukocytoclastic vasculitis secondary to the novel anticoagulant rivaroxaban (Xarelto®).
- Propylthiouracil-induced ANCA-negative cutaneous small vessel vasculitis. [Journal Article]
- JCJ Community Hosp Intern Med Perspect 2018; 8(1):35-37
- Propylthiouracil (PTU) is a commonly used medication for the treatment of hyperthyroidism. PTU is known to cause different adverse reactions including autoimmune syndromes. PTU-induced autoimmune syn...
Propylthiouracil (PTU) is a commonly used medication for the treatment of hyperthyroidism. PTU is known to cause different adverse reactions including autoimmune syndromes. PTU-induced autoimmune syndromes can be classified into drug-induced lupus or drug-induced vasculitis. Differential diagnoses could be very challenging. PTU-induced vasculitis is more common than PTU-induced lupus, and has a higher risk of morbidity and mortality. Usually it is limited to the skin in a form of cutaneous leukocytoclastic vasculitis, but may also affect organs including kidneys and lungs. Discontinuation of PTU should be a first step in the treatment and could lead to complete resolution of symptoms. Typically, lesions resolve spontaneously within 2-4 weeks, but chronic or recurrent disease may occur in up to 10% of patients. In cases without improvement after drug discontinuation, cases refractory to glucocorticosteroids, with necrotizing skin lesions or extracutaneous organ involvement referral to rheumatologist for more aggressive immunosuppressive treatment is indicated. Optimal duration of immunosuppressive therapy is unknown, but it is reasonable to gradually taper mediations and monitor clinical response. Frequent monitoring for side effects is mandatory for patients on PTU therapy. Treatment should be stopped immediately, if patient develops any of autoimmune syndromes. An accurate and prompt diagnosis is essential, because it determines further management. We report a rare case of antineutrophil cytoplasm antibody-negative cutaneous small vessel vasculitis as a result of longstanding exposure to PTU.
- Focus on the Involvement of the Nose and Paranasal Sinuses in Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Nasal Cytology Reveals Infiltration of Eosinophils as a Very Common Feature. [Journal Article]
- IAInt Arch Allergy Immunol 2018 Jan 23; 175(1-2):61-69
- CONCLUSIONS: Even when the rheumatological assessment scored EGPA "under control" according to the Birmingham Vasculitis Activity Score and Vasculitis Damage Index, sinonasal diseases and related nasal inflammatory processes were not controlled. Therefore, there is a need for clinical monitoring and targeted treatment to control the inflammatory processes and improve the QoL of EGPA patients.
- Pazopanib-Induced Cutaneous Leukocytoclastic Vasculitis: An Exclusion Diagnosis of a Multidisciplinary Approach. [Journal Article]
- CRCase Rep Oncol 2017 Sep-Dec; 10(3):1041-1049
- In phase II/III trials, cutaneous side effects of pazopanib were reported in less than 20% of patients, with only 1-3% being grade 3/4. We present a case of a 66-year-old man with a previous history ...
In phase II/III trials, cutaneous side effects of pazopanib were reported in less than 20% of patients, with only 1-3% being grade 3/4. We present a case of a 66-year-old man with a previous history of left nephrectomy for a stage II clear cell renal carcinoma. Approximately 18 months later, recurrent disease in the lungs, mediastinum, and left psoas and bulky abdominal/pelvic nodal metastasis were documented. He was initially treated with pazopanib 800 mg q.d. and 1 week after starting this therapy, the patient presented with palpable purpura on his ankles. These lesions regressed within 2 weeks off pazopanib, but had recurred 4 weeks after he resumed medication at 400 mg q.d. Biopsy of the lesions revealed leukocytoclastic vasculitis. Despite tumour response to therapy, pazopanib was discontinued with total resolution of this skin toxicity within 2 weeks of his cutaneous toxicity. To the best of our knowledge, we report a rare yet significant cutaneous adverse reaction to pazopanib.
- Cutaneous and systemic vasculitides in dermatology: a histological perspective. [Journal Article]
- GIG Ital Dermatol Venereol 2018 Jan 24
- Cutaneous vasculitides encompass a wide and heterogeneous group of diseases affecting skin blood vessels that are clinically characterized by polymorphic skin lesions, including in particular palpabl...
Cutaneous vasculitides encompass a wide and heterogeneous group of diseases affecting skin blood vessels that are clinically characterized by polymorphic skin lesions, including in particular palpable purpura as well as urticarial and necrotic-ulcerative lesions, with possible, albeit rare, extracutaneous involvement. Cutaneous leukocytoclastic angiitis and urticarial vasculitis, which are the two prototypic and most common variants of this group, are usually idiopathic but may also be induced by different triggers, notably drugs and infections, or may manifest in association with systemic disorders, particularly lupus erythematosus. Vasculitis skin lesions can also occur during the chronic-relapsing course of systemic vasculitides, such as granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis, with which cutaneous vasculitides can share clinical and histological features. In order to make the diagnosis of a specific form of vasculitis, the cutaneous picture and clinical history of the patient have to be correlated with the histological pattern, direct immunofluorescence findings, laboratory data and possible presence of extracutaneous manifestations. Histology is pivotal for the diagnosis of vasculitis and timing of the biopsy is relevant to correctly evaluate the characteristics of the inflammatory infiltrate. In this review, we will focus in particular on the histological features of cutaneous vasculitides in order to differentiate them from the systemic forms and to avoid misdiagnosis when skin involvement is the presenting sign of a multisystem vasculitis.
- Cutaneous hemophagocytosis: Clinicopathologic features of 21 cases. [Journal Article]
- JAJ Am Acad Dermatol 2018; 78(2):377-382
- CONCLUSIONS: This was a single-center, retrospective study.Isolated CH in conditions other than CTCL and cRDD is a histopathologic finding related mostly to leukocytoclastic vasculitis. Extensive investigations should be performed only if patients have other signs or symptoms of HLHS.
- Retinal vasculitis associated with cutaneous leukocytoclastic vasculitis. [Journal Article]
- IOInt Ophthalmol 2017 Dec 18
- CONCLUSIONS: We have reported the first case of clinically manifest retinal vasculitis, associated with a common form of cutaneous vasculitis.
- Leukocytoclastic vasculitis complicating cisplatin + radiation treatment for laryngeal cancer: a case report. [Case Reports]
- BCBMC Cancer 2017 12 06; 17(1):831
- CONCLUSIONS: Cisplatin can induce leukocytoclastic vasculitis and clinicians should be aware of this potential effect for better case management and diagnosis.
- Vasculitis: Kids are not just little people. [Journal Article]
- CDClin Dermatol 2017 Nov - Dec; 35(6):530-540
- Cutaneous vasculitis, inflammatory destruction of blood vessels, can present with a wide range of clinical and pathologic findings across a number of heterogeneous conditions. Although some vasculiti...
Cutaneous vasculitis, inflammatory destruction of blood vessels, can present with a wide range of clinical and pathologic findings across a number of heterogeneous conditions. 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. Cutaneous vasculitis is rare in children, and most childhood vasculitides, of which Henoch-Schönlein purpura is the most common, histologically are small vessel leukocytoclastic vasculitis. In children, infectious etiologies are more common than in adults. Childhood cutaneous vasculitis is most often self-limited with a good prognosis, and treatment is mainly supportive. © 2017 Elsevier Inc. All rights reserved.
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- Pristinamycin-induced leukocytoclastic vasculitis: First report of a case in Tunisia. [Letter]
- TTherapie 2017 Nov 07