Livedoid Vasculopathy: diagnosis and treatment in pregnant women

Bezerra, Alexandre Sacchetti; Andrade, Accácio de Almeida Abussamra Junqueira de; Polimanti, Afonso César; Fürst, Rafael Vilhena de Carvalho; Criado, Paulo Ricardo; Corrêa, João Antônio

doi:10.1590/1677-5449.190093

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…A incidência de vasculite leucocitoclástica na população é baixa, e embora se manifeste principalmente na pele, também pode ocorrer acometimento extracutâneo, mas casos de vasculite associada ao uso da oxacilina são raros, havendo apenas três casos relatados na literatura científica 2,4-5 . A etiologia da vasculite leucocitoclástica é, na maioria das vezes, idiopática, embora em algumas situações esteja associada ao uso de certos fármacos, doenças autoimunes, infecções, entre outros 2,7 . O provável mecanismo fisiopatológico relacionado é o desencadeamento de uma reação de hipersensibilidade do tipo III 5 .…”

Section: Discussionunclassified

A rare case of oxacillin-induced leukocytoclastic vasculitis

Rodrigues,

Paiva,

Martins

2023

Medicina (Ribeirão Preto)

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Leukocytoclastic vasculitis is a pathology whose mechanisms are associated with the process of vascular inflammation. It is estimated that up to 24% of the cases of vasculitis are drug-related, with beta-lactam antimicrobials being one of the pharmacological groups commonly associated with this adverse outcome. Oxacillin, a semisyntheticpenicillin, has a beta-lactam ring that confers biological activity and is most frequently associated with reports of leukocytoclastic vasculitis. However, similar cases related to this antimicrobial are rare, with only three cases identified in the literature. Against this background, we report a fourth case of leukocytoclastic vasculitis in a 56-yearold man, on oxacillin treatment, who developed the vasculitis on the 3rd day of antimicrobial use. In addition to oxacillin suspension, he was treated with 125 mg/day of intravenous methylprednisolone for seven days, followed by 20 mg/day of oral prednisone for four days, resulting in satisfactory remission of the skin lesions and no new adverse outcomes. This case provides further evidence supporting the potential causal relationship between the use of oxacillin and the development of leukocytoclastic vasculitis, albeit a rare occurrence. The positive response to therapeutic interventions, such as oxacillin suspension and corticosteroid treatment, underscores the effectiveness of these approaches in addressing this complication.

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Section: Discussionunclassified

A rare case of oxacillin-induced leukocytoclastic vasculitis

Rodrigues,

Paiva,

Martins

2023

Medicina (Ribeirão Preto)

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“…4 In addition to vascular involvement, patients with LV also have nervous system involvement, possibly caused by deposits of fibrin and thrombin in the vasa nervorum. 5 Neurological involvement in LV is rare and presents usually as mononeuritis multiplex, months to years after the onset of cutaneous lesions. 6 LV is associated with a variety of underlying conditions, and no single etiology has been identified.…”

Section: Discussionmentioning

confidence: 99%

Dermoscopy of livedoid vasculopathy in skin of color treated successfully with colchicine: a case report

Ankad

Nagur²,

Nikam³

2022

Int J Res Dermatol

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Livedoid vasculopathy (LV) is recurrent and episodic thrombotic dermatosis characterized by pain and ulcerations. It requires early diagnosis, and treatment with combination of drugs. Dermoscopy is a non-invasive technique which enables clinician to visualize subsurface structures of the skin. Here, dermoscopy of LV in skin of color which was treated with colchicine is reported.

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“…At the start, the lesions present as localized erythema and macular purpura or urticarial papules that progress to palpable purpura, usually bilateral and symmetrical and frequently involving the lower limbs [16]. Although vasculitis induced by anti-TNF therapy primarily affects the skin, related multiorgan involvement has been reported in a quarter of all patients [3,9].…”

Section: Introductionmentioning

confidence: 99%

Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study

Parra

Chebli

et al. 2023

JCM

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Background: Vasculitis is an uncommon complication of biologics used to treat inflammatory bowel disease (IBD). This study describes a case series of vasculitis induced by anti-tumor necrosis factor (TNF) therapy in IBD patients. Methods: Retrospective assessments were performed using the medical records of adult IBD patients who underwent outpatient clinical follow-ups between January 2010 and December 2019 in order to identify patients with vasculitis caused by anti-TNF therapy. Results: There were 2442 patients altogether. Of these, 862 (35%) took anti-TNF medication. Five patients (0.6% of the overall patients; n = 3 (60%) Crohn’s disease; n = 2 (40%), ulcerative colitis) were identified as having leukocytoclastic vasculitis (LCV) due to anti-TNF therapy; these patients were white, female, and non-smokers. The mean age of LCV diagnosis was 32.2 years, and the mean IBD duration was 7.2 years. The mean time between the start of biologic therapy and LCV onset was 30.8 months. Most of the patients were using adalimumab (80%; n = 4). All the patients were in remission at the time of the LCV diagnosis, and the vasculitis affected the skin in all cases. Anti-TNF therapy was discontinued in the five abovementioned patients, and the response of LCV to the oral steroids was significantly positive. Remarkably, all five patients experienced complete remission from LCV within 4–12 weeks after starting prednisone therapy, and none of them had LCV recurrence in the follow-up period (a mean duration of 28 months). Conclusions: LCV is an unusual complication of anti-TNF therapy in the IBD setting. In this context, clinicians should have a high degree of suspicion of LCV in patients who develop an unexplained cutaneous rash.

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Livedoid Vasculopathy: diagnosis and treatment in pregnant women

Cited by 6 publications

References 13 publications

A rare case of oxacillin-induced leukocytoclastic vasculitis

A rare case of oxacillin-induced leukocytoclastic vasculitis

Dermoscopy of livedoid vasculopathy in skin of color treated successfully with colchicine: a case report

Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study

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