Cutaneous vasculitis: a review

Abstract

As the skin is commonly involved in systemic vasculitic disorders as well as those hypersensitivity states whose expression is largely skin‐confined, cutaneous vasculitic lesions offer a window to diagnosis and a ready source of accessible tissue for biopsy. In this review, we discuss the pathologic manifestations of chronic vasculitic syndromes such as granuloma faciale and erythema elevatum diutinum; IgA‐associated vasculitis including Henoch‐Schonlein purpura; vasculitis seen in the setting of cryoglobulinemia and hypergammaglobulinemia of Waldenstrom, hereditary deficiencies of complement, and IgA deficiency; those leukocytoclastic vasculitides resulting from hypersensitivity reactions to drug, chemical and foodstuff ingestion; and those vasculitides seen in patients with systemic diseases such as polyarteritis nodosa, rheumatoid arthritis, mixed connective tissue disease, systemic lupus erythematosus, Sjogren's syndrome, relapsing polychondritis, Behcet's disease, Wegener's granulomatosis, and allergic granulomatosis of Churg and Strauss.

Cutaneous vasculitis associated with fluoroquinolones

“…Histologically, the most common cutaneous manifestation of this clinical entity is leukocytoclastic vasculitis, which preferentially affects small vessels of the lower extremities and is clinically characterized by palpable purpuric lesions, sometimes with slight focal necrosis and ulceration [2]. No obvious triggering event has been detected to date in primary vasculitis; in contrast, the etiology of secondary vasculitis is known [3] and includes inflammatory reaction to drugs, infection, neoplasia, or autoimmune disease. Isolated cutaneous leukocytoclastic vasculitis is often associated with a drug hypersensitivity response, and the clinical symptoms improve when the drug is stopped [4].…”

Necrotizing Cutaneous Vasculitis in a Patient With Infective Endocarditis and Severe Rheumatoid Arthritis

“…No drug intake was registered. In patients with septic vasculitis, the demonstrative severe pandermal LCV with neutrophiland bacteria-containing (one of the implicated microbial pathogens is staphyloccoccus) thrombi, extravascular neutrophilia with microabscesses and neutrophilic exocytosis, and papillary dermal edema [9] were not present in our case. The longstanding history and destructive RA with very high seropositivity achieved the diagnosis of romatoid vasculitis in our patient.…”

“…The classification of vasculitic syndromes are based on clinical, pathologic, and immunologic features [4], and diagnostic imaging studies [9]. It is well-known that patients with RA exhibit various cutaneous conditions including rheumatoid vasculitis [10].…”

Vasculitis séptica por Listeria monocytogenes

“…Clínicamente se presenta como un púrpura retiforme de tipo inflamatorio, con bulas, úlceras y necrosis. Histopatológicamente, se observa un infiltrado neutrofílico en los vasos pequeños y medianos de la dermis profunda e hipodermis, con leucocitoclasia 1 asociado a la presencia de abundantes microorganismos en las células endoteliales, constituyendo una vasculitis necrosante con trombosis vascular 4,5 . Se diferencia de la vasculitis leucocitoclástica secundaria a infecciones porque la VS carece de depósitos de complejos inmunes y porque en la vasculitis leucocitoclástica no se observan microorganismos en los vasos.…”

“…En la literatura médica se han descrito otros agentes asociados a este cuadro como Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Pseudomonas spp. y Rickettsias spp., entre otros [1][2][3][4][5] . Sin embargo, no existen casos reportados de VS por L. monocytogenes.…”