Alcohol-induced vasculitis: Case report and commentary

Abuabara, Katrina; Samimi, Sara; Chu, Emily Y.; Bluebond, Neil D.; James, William D.; Merkel, Peter A.

doi:10.1016/j.jaad.2013.10.014

Cited by 4 publications

(14 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among them, three were related to HSP [8–10], one was associated with Sjögren’s syndrome [11], another one appeared simultaneously with an aspirin-induced platelet dysfunction [12], and a further one was suggested to result from thrombotic thrombocytopenic purpura due to alcohol binge drinking [13]. …”

Section: Introductionmentioning

confidence: 99%

Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

2016

View full text Add to dashboard Cite

BackgroundIt is unusual for purpura to emerge as a result of drinking alcohol. Such a peculiarity was observed in a 55-year-old man with a 30-year history of heavy alcohol use.Case presentationThe Caucasian patient was studied for 11 years during several detoxification treatments. During the last 2 years of that period, purpuric rashes were newly observed. The asymptomatic purpura was limited to both lower limbs, self-limiting with abstinence, and reoccurring swiftly with alcohol relapse. This sequence was observed six times, suggesting a causative role of alcohol or its metabolites. A skin biopsy revealed histological features of purpura pigmentosa progressiva (termed Schamberg’s disease). Additionally, alcoholic fatty liver disease markedly elevated serum immunoglobulins (immunoglobulin A and immunoglobulin E), activated T-lymphocytes, and increased C-reactive protein. In addition, moderate combined (cellular and humoral) immunodeficiency was found. Unlike the patient’s immunoglobulin A level, his serum immunoglobulin E level fell in the first days of abstinence, which corresponded to the time of purpura decline. Systemic vasculitis and clotting disorders were excluded. The benign character of the purpura was supported by missing circulating immune complexes or complement activation. An alcohol provocation test with vinegar was followed by the development of fresh “cayenne pepper” spots characteristic of Schamberg’s disease.ConclusionsThis case report demonstrates that Schamberg’s disease can be strongly related to alcohol intake, in our patient most likely as a late complication of severe alcoholism with alcoholic liver disease. Immunologic disturbances thereby acquired could have constituted a basis for a hypersensitivity-like reaction after ingestion of alcohol. Schamberg’s disease induction by vinegar may point to an involvement of acetate, a metabolite of ethanol.

show abstract

Section: Introductionmentioning

confidence: 99%

Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

2016

View full text Add to dashboard Cite

show abstract

“…Possible infectious triggers in adults include, but are not limited to, Streptococcus, Mycobacterium , hepatitis B and C, Staphylococcus aureus, Chlamydia, Neisseria, and HIV [10]. In adults, alcohol-associated IgA vasculitis is a known but rare trigger; the mechanism by which alcohol may induce purpura is unclear [3, 5]. Three other biopsy-confirmed cases of alcohol-associated vasculitis have been reported in the literature and are summarized in Table 1 [3-5].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…In adults, alcohol-associated IgA vasculitis is a known but rare trigger; the mechanism by which alcohol may induce purpura is unclear [3, 5]. Three other biopsy-confirmed cases of alcohol-associated vasculitis have been reported in the literature and are summarized in Table 1 [3-5]. A unique aspect of our case is that our patient’s alcohol-associated vasculitis seems to flare with a specific type of alcohol; namely, beers brewed with hops, flowers of the hop plant Humulus lupulus that add bitterness and floral or fruity flavors to beer.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…In the presence of arthralgias, type II cryoglobulinemia may also be considered in the clinical differential diagnosis. All previously reported cases of alcohol-related IgA vasculitis, with the exception of the 26-year-old woman, underwent comprehensive laboratory evaluation that was negative for underlying disease [3]. Additionally, other alcohol-associated dermatoses, including Schamberg’s disease (progressive pigmented purpura) and idiopathic thrombocytopenic purpura, may be worth consideration and further evaluation as warranted.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…It is often idiopathic but can be triggered by infection, drugs, and systemic disease [2]. A known, but rare, trigger for IgA vasculitis is alcohol consumption [3-5]. We describe the case of a 43-year-old man with recurrent IgA vasculitis following alcohol consumption and review the literature of alcohol-associated IgA vasculitis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Alcohol-Associated Immunoglobulin A Vasculitis: A Case Report and Review of the Literature

et al. 2020

View full text Add to dashboard Cite

Immunoglobulin A (IgA)-mediated leukocytoclastic vasculitis is a cutaneous small-vessel vasculitis characterized by skin findings of palpable purpura. It may occur secondary to infections, neoplasms, drugs, and systemic conditions, although it is most commonly idiopathic. A known, but rare, trigger for IgA vasculitis is alcohol consumption. We present a case of a man with IgA vasculitis associated with alcohol use and review the literature on alcohol-associated vasculitis. Although rarely reported, alcohol-associated IgA vasculitis is an important entity to consider for appropriate diagnosis and management of such patients.

show abstract

Cutaneous IgA-vasculitis flare-ups associated with intake of red and white wine

Kluger

2021

Annales de Dermatologie et de Vénéréologie

View full text Add to dashboard Cite

Alcohol-induced vasculitis: Case report and commentary

Cited by 4 publications

References 5 publications

Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

Recurrent purpura due to alcohol-related Schamberg’s disease and its association with serum immunoglobulins: a longitudinal observation of a heavy drinker

Alcohol-Associated Immunoglobulin A Vasculitis: A Case Report and Review of the Literature

Cutaneous IgA-vasculitis flare-ups associated with intake of red and white wine

Contact Info

Product

Resources

About