Leukocytoclastic vasculitis

Abstract

Patients with leukocytoclastic vasculitis have purpuric, palpable lesions, most commonly on the lower part of the legs. Systemic involvement, particularly of the kidneys, is found frequently. Characteristic pathological features include necrosis of small vessels within the dermis, infiltration by polymorphonuclear leukocytes within and around the vessel walls, hemorrhage, and occasionally thrombosis. Immunofluorescence study frequently shows granular deposits of immunoglobulins and complement in vessel walls. Etiologic agents that have been implicated include infection, foreign proteins, chemicals, drugs, and a variety of diseases. The mechanism causing tissue damage is thought to be mediated by immune complexes, although specific antigens have only occasionally been unequivocally identified. Treatment includes bedrest, corticosteroids, and sometimes, cytotoxic agents.

Leukocyte procoagulant activity: enhancement of production in vitro by IgG and antigen-antibody complexes.

“…A direct correlation has been found between plasma fibrinopeptide A concentration and disease activity in systemic lupus erythematosus (6). In connective tissue diseases, in acute spontaneous vasculitides (7,8), and in several types of immunologically-mediated nephritis (9,11), fibrin-fibrinogen related antigen has been identified at sites of tissue damage. Fibrinfibrinogen related antigen accompanies immunoglobulin and complement deposits in vascular walls and intercellular spaces.…”

Leukocytoclastic Vasculitis Drug Reaction to Certolizumab Pegol

“…While the initial presentation is often cutaneous, LCV may cause a variety of other problems including myopathy, gastrointestinal bleeding, and renal insuffi ciency (3,4). It can also result in permanent scarring (5).…”

“…It can also result in permanent scarring (5). Common presentations of LCV include palpable purpura, urticaria, ulcers, or nodules (3,6). Th ese lesions may be exquisitely painful or pruritic, and lower leg edema and myalgias are frequently present (3).…”

“…Common presentations of LCV include palpable purpura, urticaria, ulcers, or nodules (3,6). Th ese lesions may be exquisitely painful or pruritic, and lower leg edema and myalgias are frequently present (3). Histopathologically, LCV is described as fi brinoid necrosis of dermal small vessels, hemorrhage, thrombosis, and perivascular polymorphonuclear leukocytes (3,6).…”

“…Th ese lesions may be exquisitely painful or pruritic, and lower leg edema and myalgias are frequently present (3). Histopathologically, LCV is described as fi brinoid necrosis of dermal small vessels, hemorrhage, thrombosis, and perivascular polymorphonuclear leukocytes (3,6). However, the histologic variability of LCV has been reported to morph over the course of 24 to 48 hours from a neutrophilic-predominant…”