Incidence of Leukocytoclastic Vasculitis, 1996 to 2010: A Population-Based Study in Olmsted County, Minnesota

Abstract

Objective To determine the population-based incidence of leukocytoclastic vasculitis (LCV). Patients and Methods Retrospective population-based study of all Olmsted County, Minnesota, residents with a skin biopsy–proven diagnosis of LCV from January 1, 1996, through December 31, 2010. Results A total of 84 patients (mean age at diagnosis, 48.3 years) with newly diagnosed, skin biopsy–proven LCV (43 women, 41 men) were identified. The incidence rate (age and sex adjusted to the 2000 US white population) was 4.5 per 100,000 person-years (95% confidence interval, 3.5–5.4). The incidence of LCV increased significantly with age at diagnosis (P<.001) and did not differ between female and male patients. Subtypes of LCV were cutaneous small-vessel vasculitis (CSVV), 38 patients (45%); IgA vasculitis, 25 (30%); urticarial vasculitis, 10 (12%); cryoglobulinemic vasculitis, 3 (4%); and antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis, 8 (10%). LCV was idiopathic in 29 of 38 CSVV patients (76%) and 24 of 25 IgA vasculitis patients (96%). Thirty-nine of 84 patients (46%) had systemic involvement, with the renal system most commonly involved (17/39; 44%). Twenty-four of 80 patients (30%) with follow-up data available had recurrent disease. Compared with the Minnesota white population, observed survival in the incident LCV cohort was significantly poorer than expected (P<.001), including the subset of patients with idiopathic CSVV (P=.03). Conclusion The incidence of LCV was higher than that in previously published studies. Idiopathic LCV was more common in our population-based cohort than previously described. Overall survival was significantly poorer and should be explored further in future studies.

Leukocytoclastic vasculitis in children: clinical characteristics, subtypes, causes and direct immunofluorescence findings of 56 biopsy‐confirmed cases

“…CSVV was the second most common subtype in our cohort. This compares with findings in adults that have found idiopathic CSVV to be the most common subtype of LCV (with IgA vasculitis being the second most common in adults) . In addition, a cause of the underlying cutaneous vasculitis was found much more commonly in children when compared to adults.…”

“…In addition, a cause of the underlying cutaneous vasculitis was found much more commonly in children when compared to adults. Cases of LCV were idiopathic in 19 patients (11 in IgA vasculitis (40%) and eight in CSVV (42%)), whereas in adults idiopathic cases accounted for 76% of CSVV and 96% of IgA vasculitis . These findings demonstrate the important point that the aetiologies of cutaneous vasculitis in children and adults are significantly different.…”

“…The demographic features, clinical appearance and aetiologies of cutaneous LCV are poorly characterized in the paediatric age group. A recent study of the incidence of LCV in adult patients found idiopathic cutaneous small‐vessel vasculitis and IgA vasculitis to be the most common subtypes of LCV . Other LCV subtypes identified in the aforementioned study were ANCA‐associated vasculitis, cryoglobulinemic vasculitis and urticarial vasculitis.…”

“…LCV was divided into the following categories, similar to categories used in the recent study of incidence of LCV in adults by Arora, et al …”

Leukocytoclastic vasculitis associated with rivaroxaban

“…published a 28‐year‐old male, who developed LCV 7 and 10 days after initiating the treatment, respectively . Although rivaroxaban‐induced LCV is the most likely diagnosis in our case, the 3‐month induction period also makes it possible that the association might be coincidental and that this case of LCV was idiopathic and self‐limiting …”