Retrospective analysis of adult patients with cutaneous leukocytoclastic vasculitis

Tai, Yee J; Chong, Alvin H; Williams, Richard A.; Cumming, Simon; Kelly, Robert

doi:10.1111/j.1440-0960.2006.00239.x

Cited by 45 publications

(77 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Equally important is the absence of any underlying cause or association that could be identified for this group of patients, consistent with recent reports in which about 40-60% of all cases of cutaneous vasculitis are idiopathic [5][6][7][8][9][10][11][12] . The low incidence of HSP in this study is reflective of the fact that HSP mainly involves children [5] in accordance with other studies [1,5,7] . Drugs and infections contributed to cutaneous vasculitis in 31.6% of our patients, which is consistent with a previous report by Carlson et al [5] .…”

Section: Discussionsupporting

confidence: 90%

“…Tai et al [7] reported an incidence of 61.3%, which is higher compared to the present study. This might be explained by the fact that different researchers may use varying definitions of the vasculitic syndromes for classifying patients in different categories, such as the American College of Rheumatology criteria and the Chapel Hill Congress Conference definitions, which identify different patients [5,6,[8][9][10][11] .…”

Section: Discussioncontrasting

confidence: 78%

See 1 more Smart Citation

Spectrum of Cutaneous Vasculitis in Adult Patients from the Farwaniya Region of Kuwait

Al-Mutairi¹

2008

Med Princ Pract

View full text Add to dashboard Cite

Objective: To determine the clinical profile, etiologic factors, disease associations, and the laboratory profile of adult patients with cutaneous leukocytoclastic vasculitis (LV) presenting to the Dermatology Department at Farwaniya Hospital, Kuwait. Subjects and Methods: The medical records of 57 adult patients (>18 years) with biopsy-proven cutaneous LV from January 2004 to June 2006 at Farwaniya Hospital were reviewed. Results: Of the 57 patients studied, 21 (36.8%) were classified as having primary cutaneous small vessel vasculitis. The most common type of skin lesions found was palpable purpura seen in 29 (50.9%) patients. No possible cause for the cutaneous vasculitis could be identified in 21 patients. Extracutaneous involvement was seen in 32 (56.1%) patients of which 29 had joint involvement. The most frequent laboratory abnormality was an elevated erythrocyte sedimentation rate (ESR). Altered laboratory evaluation in the form of leukocytosis, raised antistreptolysin O titers and urine abnormalities were found in association with systemic vasculitis. IgA deposits were present in 33 patients. Risk factors for chronicity of cutaneous LV were female sex, advanced age, unidentified etiology, absence of fever and presence of joint involvement. Conclusion: The commonest type of LV in Kuwait is primary cutaneous small vessel vasculitis. The most frequent laboratory abnormality associated with LV was increased ESR.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 78%

Spectrum of Cutaneous Vasculitis in Adult Patients from the Farwaniya Region of Kuwait

Al-Mutairi¹

2008

Med Princ Pract

View full text Add to dashboard Cite

show abstract

“…It has been estimated that in 45% to 55% of cases of LCV a cause remains unknown. 10,15 Other common causes of LCV include infection, ACTD, drug reactions, and malignancy. Our study had more cases that were idiopathic compared with the literature, and no cases were associated with malignancy.…”

Section: Discussionmentioning

confidence: 99%

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

Arora

Wetter

Gonzalez-Santiago

et al. 2014

Mayo Clinic Proceedings

View full text Add to dashboard Cite

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.

show abstract

“…Leukocytoclastic vasculitis can be associated with malignancy or collagen vascular disease, but about half of cases are idiopathic. 2 Henoch-Schönlein purpura is a well-known form of leukocytoclastic vasculitis, but is more common in children, and generally evoked by viral illness. HenochSchönlein purpura may be associated with joint or kidney involvement and malignancy in older men, so an accurate diagnosis is critical.…”

Section: Discussionmentioning

confidence: 99%

Perplexing bruises on the forearms

Overcash

2015

Journal of the American Academy of Physician Assistants

View full text Add to dashboard Cite

CASEA 76-year-old man was referred to the dermatology clinic by primary care because of "frightful" bruising on both forearms, which had worsened over the past few years. He has a 50-pack-year history of smoking, and underwent coronary artery bypass grafting surgery 12 years ago after a myocardial infarction. He denied any new medications, history of liver disease, or signifi cant trauma. His family history was negative for clotting disorders. He takes simvastatin, allopurinol, low-dose aspirin, metoprolol, and occasionally naproxen. He had unsuccessfully attempted to treat the forearm bruises with self-prescribed diabetic skin lotion, antifungal creams, emu oil, and fabric bleach. He was particularly concerned that he might have Ebola, but he had not traveled to West Africa and had no constitutional symptoms. He asked if Agent Orange may have caused his bruising, commenting that he had seen similar skin on other Vietnam veterans.Physical examination revealed numerous actinic keratoses on the temples, ears, and bald scalp. His dorsal forearms were covered with overlapping 1-to 4-cm ecchymoses, brown discoloration, and streaky white scars (Figure 1). The volar forearms and areas covered by short sleeves and his watchband were spared. He had mild stasis dermatitis, and his toenails were thick and yellowed, but no other bruises were found. A 3-mm tender nodule suspicious for squamous cell carcinoma was found on the dorsal left hand. THE MOST LIKELY DIAGNOSIS IS• acquired von Willebrand disease • actinic purpura • antiplatelet drug reaction • metastatic squamous cell carcinoma • leukocytoclastic vasculitis DISCUSSIONThe patient's age, skin type, and the distribution of the bruises all support a diagnosis of actinic purpura. This condition, also known as senile purpura or solar purpura, is frequently encountered in a dermatology practice. Given this patient's typical physical appearance and history, biopsy and serologic testing were not indicated. Serologic studies would be unremarkable, and histopathology would show reduced dermal collagen, a fl attened and thin epidermis, and abnormal elastin. Similar fi ndings occur in patients with corticosteroid atrophy, whether from topical or systemic therapy, so this should be ruled out. In either case, the vessel walls are normal, but the lack of protective collagen leads to easily damaged veins, and minor trauma leads to rupture and extravasation of erythrocytes. The most convincing fi nding in this patient, as with most, is the photodistribution of the ecchymoses: sun-protected areas are without bruising. Stellate pseudoscars (Figures 2 and 3) are another typical fi nding, intermixed with other signs of photodamage. Hemosiderin deposition gives the dermis a characteristic brown color. The skin is rough in texture, and often covered in actinic and seborrheic keratoses. The loss of collagen and poor elasticity are apparent with palpation of crinkly, dry, thin skin. In contrast, the areas protected from UV radiation still appear in the patient's normal skin color and are smoo...

show abstract

Retrospective analysis of adult patients with cutaneous leukocytoclastic vasculitis

Cited by 45 publications

References 24 publications

Spectrum of Cutaneous Vasculitis in Adult Patients from the Farwaniya Region of Kuwait

Spectrum of Cutaneous Vasculitis in Adult Patients from the Farwaniya Region of Kuwait

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

Perplexing bruises on the forearms

Contact Info

Product

Resources

About