Cutaneous vasculitis associated with fluoroquinolones

Abstract

Cutaneous vasculitis is a clinical entity with a broad differential diagnosis, including an adverse drug reaction. It is defined as inflammation of skin blood vessel walls. During a 7-year-period, we observed three patients who developed isolated cutaneous vasculitis during antibiotic therapy of bacterial infection. All were treated with a fluoroquinolone (ciprofloxacin or levofloxacin) combined with rifampin (two cases) or flucloxacillin (three cases), respectively. In all three cases the lesions gradually resolved after treatment with the inciting fluoroquinolone had been stopped. In one patient, leukocytoclastic small-vessel vasculitis was histologically confirmed. Fluoroquinolone-associated cutaneous vasculitis consists of an isolated self-limiting disorder that is part of a systemic vasculitis, or even life-threatening disease. Clinicians should be aware of this serious adverse event because any continuation of treatment may be fatal.

Leukocytoclastic Vasculitis with Systemic Involvement Associated with Ciprofloxacin Therapy: Case Report and Review of the Literature

“…The time between first exposure to the drug and the onset of the first clinical findings range from three days to five weeks. This reaction appears to be reported in first-time users of the drug as well as with patients who took ciprofloxacin beforehand with no history of drug-induced vasculitis [3-12]. …”

“…From 1989 to date, we found only 13 case reports of LCV related to ciprofloxacin use (Table 2) [3-12]. …”

“…Of these, two cases reported LCV with renal involvement and only Storsley, et al confirmed renal vasculitis with biopsy [7, 9]. To the extent of our knowledge, the literature does not mention any case of ciprofloxacin-related vasculitis with gastrointestinal involvement [3-12]. Even though renal vasculitis with ciprofloxacin-induced LCV is rare, and gastrointestinal involvement has not been documented, drug-induced LCV is known to involve several systems, including the lungs and gastrointestinal tract [17-21].…”

Leukocytoclastic Vasculitis: Retrospective Analysis of 60 Patients

“…Lökositoklastik vaskülite yol açan ilaçlar arasında beta laktam grubu antibiyotikler, penisilinler, sülfonamidler, NSAİİ'ler, allopürinol, tiyazidler, insülin, retinoidler, kinolon grubu antibiyotikler, hidantoinler yer almaktadır (1,12,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Bizim çalışmamızda 15 hastada sadece ilaç, beş hastada ise ilaç ve enfeksiyon birlikteliği lökositoklastik vaskülit nedeni olarak tespit edildi.…”

Drug-induced leukocytoclastic vasculitis: tigecycline a rare cause

“…14 Tigecycline is a tetracycline derivative commonly used to treat complicated skin and soft tissue infections. Reports of tetracycline derivative (e.g., minocycline) induced autoimmunity include druginduced lupus, cutaneous polyarteritis nodosa, and anti-nuclear cytoplasmic antibody (ANCA)-associated vasculitis.…”