Leukocytoclastic Vasculitis and Polyarthritis Associated with Mycoplasma pneumoniae Infection

Abstract

References[3] and tinea cruris [4]. In a survey of the prevalence of dermatophytes in New Zealand, E. floccosum was the second commonest 1. Demidovich CW, Kornfeld BW, Gentry RH, Fitzpatrick JE. Deep dermatocause of tinea cruris and comprised 112 (15%) of all 746 dermatophyte infection with chronic draining nodules in an immunocompromised phytes isolated [5]. patient. Cutis 1995; 55:237 -40. Ketoconazole is effective treatment for topical dermatophytosis 2. Allen DE, Snyderman R, Meadows L, Pinneil SR. Generalized Miand some systemic fungal diseases [6]. The drug's disadvantages, crosporum audouinii infection and depressed cellular immunity associwhich include hepatotoxicity, inhibition of cyclosporine metaboated with a missing plasma factor required for lymphocyte blastogenesis. lism by cytochrome P-450, and inhibition of testosterone and corti-Am Clinical Infectious Diseases 1997;25:155 externalized catheter versus a subcutaneously implanted device in cancer ᭧ 1997 by The University of Chicago. All rights reserved.

Unusual Eruptions Associated with <b><i>Mycoplasma pneumoniae</i></b> Respiratory Infections: Review of the Literature

“…Less commonly, they present with targetoid lesions and nonpitting edema in the context of acute hemorrhagic edema of young children, which is considered the infantile variant of Henoch-Schönlein syndrome, or with urticarial plaques in the context of urticarial vasculitis. Our review disclosed 21 cases of leukocytoclastic vasculitides associated with M. pneumoniae infection: 18 cases of Henoch-Schönlein syndrome, 1 case of acute hemorrhagic edema and 2 cases of urticarial vasculitis [42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62]. …”

“…Using the described strategy, 94 reports were retained for the final analysis [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97]: 1 in German [23], 1 in Italian […”

Mycoplasma pneumoniae–induced Stevens-Johnson syndrome without skin lesions: Fact or fiction?

“…41 Leukocytoclastic vasculitis has been reported in patients with M pneumonia infections, suggesting that immune complexes play a role in some patients. 28,29 Patients with Henoch-Schoenlein purpura and urticarial vasculitis caused by M pneumoniae likely have circulating immune complexes. This mechanism is not likely active for patients with mucous membrane-limited disease, because one would expect widespread skin and extracutaneous manifestations.…”

“…Autoimmunity has Table I. Cutaneous manifestations of Mycoplasma pneumoniae infection Exanthematous eruptions [4][5][6][7] Erythema nodosum 8 Urticaria 9 Stevens-Johnson syndrome 10,27 Pityriasis rosea 5,[11][12][13] Toxic epidermal necrolysis [14][15][16] Kawasaki disease [17][18][19] Leukocytoclastic vasculitis 28,29 Subcorneal pustular dermatosis [20][21][22] Thrombotic thrombocytopenic purpura 23 Henoch-Schoenlein purpura 24 Urticarial vasculitis 25 Raynauds phenomenon 26 been seen in M pneumoniae-related GuillainBarré syndrome, where autoantibodies against galactocerebroside, the main cerebral myelin component, have been detected. 42 Disorders with prominent mucous membrane involvement, such as cicatricial pemphigoid, support the notion that a similar mechanism is possible in patients with M pneumoniae-related mucositis.…”

Mycoplasma pneumoniae as an Under- Recognized Agent of Vasculitic Disorders

“…Interestingly, cutaneous vasculitis due to M. pneumoniae was always accompanied by involvement of other organs; specifically, retinal vasculitis [Greco et al, 2007], polyarthritis [Perez et al, 1997], encephalitis [Perez & Montes, 2002], and acute respiratory distress syndrome, erythema multiforme, and pancreatitis [ Van Bever et al, 1992]. This suggests either that skin biopsy, which is essential for the diagnosis of cutaneous vasculitis, is not likely to be performed unless other systemic diseases are present, or that cutaneous vasculitis occurs inherently as a part of systemic inflammation.…”