Interferon-gamma-induced local leukocytoclastic vasculitis at the subcutaneous injection site

Abstract

Cutaneous reactions associated with interferons (IFNs) treatment are either localized or generalized. The most common presentation of localized reactions at IFNs injection site is usually an erythematous patch or plaque. Local leukocytoclastic vasculitis presenting with cutaneous necrosis is extremely rare. We report a 19-year-old man with hepatitis B who had local leukocytoclastic vasculitis induced by interferon-gama injection at the injection site. After changing the injection sites and using the combined treatment of prednisone and colchicine, the previous lesion healed and no other cutaneous lesion occurred. We also made a mini review of such cases.

Leukocytoclastic Vasculitis Associated with Interferon â-1b Treatment in a Patient with Multipl Sclerosis

“…Interferons have classes such as alpha, beta, gamma, omega and tau. 2,4 IFN alpha and beta are used worldwide in the treatment of many diseases, including MS. Generally all IFN beta forms are well tolerated. However, they also have some side effect risks.…”

“…4 The most common complications of these side effects are flu-like syndrome and injection site reactions. 1,2,4 Injection site reactions are usually mild, manageable and self-limiting. However, in rare cases, more severe reactions may develop, such as necrotic ulcerations that sometimes limit treatment.…”

“…The vasculitis did not recur after the injection site was changed, the steroid and colchicine were stopped. 2 In addition, there are four cases in the literature with IFN-induced leukocytoclastic vasculitis at the injection site. Three of them using IFN alpha and the other using IFN beta.…”

“…The most common side effects of this treatment are; injection site reaction and flu-like syndrome. 1,2 Autoimmunity can be seen as a long-term side effect of this therapy that can cause significant clinical consequences and even interferon treatment interruption. 3 Many reports of cutaneous side effects (such as erythema, swelling, ulceration, and panniculitis) have been published.…”

Leukocytoclastic vasculitis caused by hepatitis C virus in a liver transplant recipient: A case report

“…The most common clinical presentation is a palpable purpura in the lower extremities[8,9], although cutaneous manifestations can also include petechiae, nodules or ulcers. Ultimately, skin biopsy is necessary for diagnostic confirmation[10,11].…”