Leucocytoclastic vasculitis induced by prolonged exercise

Abstract

SummaryMany people develop skin symptoms after long-distance walks, but little is known aetiology of these. In this study we took 11 biopsies from 10 long-distance walkers who walked 80 km. All biopsies originated from purpuric lesions on the lower legs, which had appeared during walking. In all 1 1 specimens, signs of a leucocytoclastic vasculitis were present with leucocytoclasis, exocytosis of erythrocytes and a granulocyte/mononuclear perivascular infiltrate. Immunofluores cence investigations showed deposition of C3c in many specimens and immunoglobulin M in some. The occurrence of a leucocytoclastic vasculitis after prolonged exercise may be explained by the existence of an exercise altered cutaneous microcirculation, complement activation and an altered immune function.

Exercise-Induced Purpura

“…Histology of the flare, performed in the hour following the end of a marathon in 10 runners, demonstrated leukocytoclastic vasculitis, with C3 and IgM deposits [5]. Moderate leukocytoclastic vasculitis was also observed in biopsies performed 2 days after the onset of the eruption in 5 of our patients [6, 7, 8], as in 2 other cases [13, 14].…”

“…Only few publications and communications have been devoted to this disorder, whether occurring in runners at the arrival of a marathon [3, 4, 5]or in observations after walking, especially in hot weather [6, 7, 8, 9, 10], jogging [11], step aerobics [12], body building [13]or even after minor exercise in a woman suffering from hyperglobulinemia [14]. Some other cases may be related to EIP, such as purpura of the chest and back after vigorous basketball training [15].…”

Cellular and Molecular Dynamics in Exercise-Induced Urticarial Vasculitis Lesions

“…1,2 However, because skin biopsy specimens of urticarial vasculitis are routinely prepared from the fully developed lesions and the early lesions have not been examined histologically, the key biological events leading to the development of leukocytoclastic vasculitis remain unknown. This is probably due to the paucity of patients in whom characteristic lesions of urticarial vasculitis can be reproduced by physical challenge, 3 despite sporadic case reports of urticarial vasculitis induced by administration of drugs 4 and by exposure to a cold stimulus. 5 The importance of the timing when taking biopsy specimens in a dynamic process such as vasculitis has been emphasized by several investigators.…”

Prognostic Factors in Leukocytoclastic Vasculitis

“…(Exercise aggravated the cutaneous vasculitis in 30.4% of our patients. 26 ) Less than 2% of patients died of systemic vasculitis. As previously stated, the infiltrate was mainly constituted by neutrophils, and the proportion of mononuclear cells significantly correlated with duration of the lesion studied by biopsy (PϽ.001).…”