A case of glyburide-induced leukocytoclastic vasculitis

Abstract

Introduction: Medication-induced leukocytoclastic vasculitis is a small-vessel vasculitis that most commonly manifests with palpable purpuric lesions on gravity dependent areas. Development of the vasculitis occurs within weeks after the initial administration of the medication, with clearance upon withdrawal of the medication. Glyburide, a sulfonylurea medication, is used to treat non-insulin dependent diabetes mellitus. We report a rare case of glyburide-associated leukocytoclastic vasculitis. Observation:We report a 71-year-old man with type 2 diabetes mellitus who presented with palpable purpura on the lower extremities. Cutaneous biopsy revealed superficial small vessel vasculitis with IgA perivascular deposits. Further questioning revealed three prior episodes of palpable purpura after restarting the glyburide medication, with clearance upon discontinuation. We diagnosed drug-induced vasculitis related to the glyburide. Conclusions:This case highlights a rarely reported cutaneous adverse reaction to the commonly used diabetic medication, glyburide. Physicians should consider cutaneous vasculitis as a potential side effect of glyburide.Abbreviations: LCV (Leukocytoclastic vasculitis), c-ANCA (centrally accentuated anti-neutrophilic cytoplasmic antibody), p-ANCA (Perinuclear anti-neutrophilic cytoplasmic antibody), anti-TNF-alpha (anti-tumor necrosis factor alpha)

Cutaneous Reactions to Antidiabetic Agents: A Narrative Review

“…However, different from metformin, the largest grouping within this category is a variety of loosely classified exanthematous reactions, including cases of TEN [27], psoriasiform rash [28], exanthematous pustulosis [29], pigmented purpuric dermatosis [30], and erythroderma [31], and lichenoid reactions [31][32][33][34][35]. Other types of immunologic reactions fell within the vasculitic group [36,37] and blistering reaction pattern (erythema multiforme) [38].…”