- Non-hemorrhage-related adverse effects of rivaroxaban. [Journal Article]
- AMArch Med Sci Atheroscler Dis 2017; 2:e108-e112
- The direct oral anticoagulant rivaroxaban is useful in various indications that include venous deep vein thrombosis prophylaxis/treatment after knee/hip replacement surgery and prevention of stroke i...
The direct oral anticoagulant rivaroxaban is useful in various indications that include venous deep vein thrombosis prophylaxis/treatment after knee/hip replacement surgery and prevention of stroke in patients with non-valvular atrial fibrillation. Its mechanism of action has been mostly associated with hemorrhage-related adverse effects; thus a number of non-hemorrhage-related adverse effects of the drug have received less attention or go unrecognized. These adverse effects mainly include liver injury, hypersensitivity reactions, leukocytoclastic vasculitis and hair loss. Clinicians should be aware of these rare adverse reactions and advise their patients to contact them as soon as they observe any unexpected clinical response.
- Leukocytoclastic vasculitis complicating cisplatin + radiation treatment for laryngeal cancer: a case report. [Journal Article]
- BCBMC Cancer 2017 Dec 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.
- Outline of guidelines for the management of vasculitis and vascular disorders in Japan, 2016 revised edition. [Journal Article]
- JDJ Dermatol 2018; 45(2):122-127
- The proposal by the 1994 International Chapel Hill Consensus Conference on the Nomenclature of Systemic Vasculitides (CHCC1994) and by the CHCC2012 markedly influenced the classification and way of c...
The proposal by the 1994 International Chapel Hill Consensus Conference on the Nomenclature of Systemic Vasculitides (CHCC1994) and by the CHCC2012 markedly influenced the classification and way of considering cutaneous vasculitis. In the proposal by the CHCC1994, hypersensitivity angiitis was defined as an equivalent pathological condition to microscopic polyangiitis or cutaneous leukocytoclastic angiitis (CLA), and it was not adopted as a disease name. However, CLA which was positioned as a type of small-vessel vasculitis is only a pathological name. In the proposal by the CHCC2012, a new category of single-organ vasculitis included CLA and cutaneous arteritis. Vasculitis allergica cutis (Ruiter) corresponded to CLA and cutaneous polyarteritis nodosa corresponded to cutaneous arteritis. The Japanese Dermatological Association (JDA) prepared guidelines for the management of vasculitis and vascular disorders in 2008 based on the proposal by the CHCC1994 and their original viewpoint of dermatology. The JDA subsequently revised the 2008 edition guidelines in 2016 following publication of the proposal of the CHCC2012 in Japanese. We presented the outline of the 2016 edition guidelines and propose a treatment algorithm for primary vasculitides based on the evaluation of the cutaneous symptoms for cases suspected as primary cutaneous vasculitides, which integrates the 2008 JDA guideline and CHCC2012 classification. This is the secondary English version of the original Japanese manuscript for the guideline for management of vasculitis and vascular disorders published in the Japanese Journal of Dermatology 127(3); 299-415, 2017.
- Vancomycin-Induced Leukocytoclastic Vasculitis and Acute Renal Failure Due to Tubulointerstitial Nephritis. [Case Reports]
- AJAm J Case Rep 2017 Sep 25; 18:1024-1027
- CONCLUSIONS: Although skin reactions associated with drug therapy are common, vancomycin-associated dermal vasculitis is rare. Tubulointerstitial nephritis is also a rare association with vancomycin treatment. This case report has highlighted that patients being treated with intravenous vancomycin should be carefully observed for acute skin rashes and deterioration in renal function, which can be managed by ceasing treatment with vancomycin, steroid challenge, and preventing future exposure to similar antimicrobial agents.
- A Woman With Purple Macules on the Legs. [Case Reports]
- JAMAJAMA 2017 Aug 08; 318(6):569-570
- Henoch-Schonlein purpura associated with primary active Epstein-Barr virus infection: a case report. [Case Reports]
- PAPan Afr Med J 2017; 27:29
- Henoch-Schönlein purpura (HSP) is the most common form of childhood vasculitis. Various viral and bacterial infections, drugs, vaccines, food allergy and even insect bites have been considered as tri...
Henoch-Schönlein purpura (HSP) is the most common form of childhood vasculitis. Various viral and bacterial infections, drugs, vaccines, food allergy and even insect bites have been considered as triggering factors in pathogenesis of HSP. Epstein-Barr virus (EBV) infection, which is associated with HSP, have been rarely reported. Herein we present HSP patient possibly caused by EBV infection. A 8-year old boy was admitted to our department with fever, rashes on legs and arms and intermittent mild abdominal pain. Multiple purpuric rashes were on his extremities, abdomen and buttock. Laboratory investigations revealed that monospot test was positive, EBV serology tests; Anti-EA-D Ig G: 3+, Anti-VCA gp125 Ig G: 3+, Anti-VCA p19 Ig M: 2+, Anti EBNA-1 Ig M: negative, Anti EBNA-1 Ig M: negative, Anti EBNA-1 Ig G: negative. The patient was interpreted as the primary active acute EBV infection. A skin biopsy showed leucocytoclastic vasculitis. The other viral and bacterial investigations were negative. The patient was diagnosed as HSP vasculitis according to EULAR criteria and treated with intravenous hydration and ibuprofen. He was discharged after 15 days with normal laboratory findings and physical examination. We think that EBV infection may be stimulant factor for autoimmune reactions and may cause HSP vasculitis. Hence, it may be useful to investigate the EBV infection in etiology of HSP cases.
- Leukocytoclastic vasculitis resolution with topical dapsone. [Journal Article]
- CCutis 2017; 99(6):426-428
- Leukocytoclastic vasculitis (LCV) is a disease characterized by inflammation of small vessels presenting with petechiae and palpable purpura. Leukocytoclastic vasculitis often spontaneously resolves ...
Leukocytoclastic vasculitis (LCV) is a disease characterized by inflammation of small vessels presenting with petechiae and palpable purpura. Leukocytoclastic vasculitis often spontaneously resolves within weeks and requires only symptomatic treatment. Chronic or severe disease can require systemic treatment with agents such as colchicine, dapsone, or corticosteroids, which are effective but carry a risk for serious adverse events. These side effects and/or medical contraindications preclude some patients from taking systemic medications for LCV. We present a case of biopsy-proven LCV in a 60-year-old woman that resolved after treatment with topical dapsone. Systemic dapsone is effective at treating LCV but requires screening for glucose-6-phosphate dehydrogenase deficiency and routine monitoring of blood counts, and its possible adverse effects include neuropathy, blood dyscrasia, and hypersensitivity syndrome. Topical dapsone may provide similar efficacy with far fewer adverse effects. Given this drug's favorable side-effect profile compared to the currently available alternatives, we believe it is a reasonable option in selected patients.
- Levamisole-Induced Leukocytoclastic Vasculitis with Negative Serology in a Cocaine User. [Case Reports]
- AJAm J Case Rep 2017 Jun 08; 18:641-643
- CONCLUSIONS: Cutaneous leukocytoclastic vasculitis can be caused by levamisole, which is used as an adulterant in cocaine. Most cases are associated with positive ANCA levels; however, a negative serology is also a possibility.
- [Cutaneous leukocytoclastic vasculitis: about 85 cases]. [Journal Article]
- PAPan Afr Med J 2017; 26:138
- Clinical manifestation, etiology and outcome of leukocytoclastic vasculitis are little studied. The aim of our study was to examine epidemiological, clinical etiological, and evolutionary characteris...
Clinical manifestation, etiology and outcome of leukocytoclastic vasculitis are little studied. The aim of our study was to examine epidemiological, clinical etiological, and evolutionary characteristics of this entity. We conducted a cross-sectional data collection from medical records of 85 patients with leukocytoclastic vasculitis in the Department of Dermatology at the Farhat Hached University Hospital, Sousse between January 2000 and December 2013. Epidemiological, clinical, paraclinical, etiological data sheets had been completed for each patient. The average age of patients was 47.65 years, ranging between 10 and 78 years. Fifty-three women and 32 men were registered (sex ratio = 0.6). Cutaneous manifestations were dominated by vascular purpura (88.2%). The most common causes of leukocytoclastic vasculitis were systemic diseases (51%), infection (20%) and neutrophilic dermatoses (14.5%). Other causes were drugs (9.1%) and hematologic malignancies (5.4%). The cause of leukocytoclastic vasculitis was not detected in 30 patients (35, 3%). Two predictive factors associated with the acute outcome were retained: the presence of a recent infection (p= 0.014) and drug intake before the rash (p= 0.013). Chronic evolution was positively correlated with antinuclear antibodies (p= 0.009) and cryoglobulinemia (p=0.025). Our study highlights the multitude of causes of leukocytoclastic vasculitis. The search for an underlying disease is an imperative in order to ensure better therapeutic management.
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- Levetiracetam-induced leukocytoclastic vasculitis. [Case Reports]
- IJIndian J Pharmacol 2017 Jan-Feb; 49(1):124-126
- Drug-induced leukocytoclastic vasculitis is a small-vessel vasculitis that most commonly manifests with palpable purpuric lesions on gravity-dependent areas. Vasculitis occurs within weeks after init...
Drug-induced leukocytoclastic vasculitis is a small-vessel vasculitis that most commonly manifests with palpable purpuric lesions on gravity-dependent areas. Vasculitis occurs within weeks after initial administration of medication and demonstrates clearance upon withdrawal of medication. Levetiracetam, a pyrrolidone derivative, is used as an adjunctive therapy in patients with refractory focal epilepsy, myoclonic epilepsy, and primary generalized tonic-clonic seizures. We present a case of a 14-year-old female, who developed cutaneous small-vessel vasculitis within 8 days of initiation of levetiracetam. Vasculitis was successfully managed by discontinuation of medication and systemic corticosteroids. This adverse reaction, to the best of our knowledge, has not been previously reported in literature.