Leukocytoclastic Vasculitis in a Patient With Rheumatoid Arthritis

Abstract

Leukocytoclastic vasculitis is a small vessel vasculitis that is usually confined to the skin with rare extracutaneous manifestation. While this condition can be idiopathic, it has been linked with systemic autoimmune conditions, malignancies, infections, and drugs. In this paper, we present a case of a patient who presented with leukocytoclastic vasculitis many years after her diagnosis of rheumatoid arthritis. It is important that physicians investigate leukocytoclastic vasculitis, as the condition, while often idiopathic, can be a presentation of something more sinister such as malignancy or systemic autoimmune condition.

Urticarial Vasculitis Induced by Adalimumab Biosimilar in an Elderly Female With Hidradenitis Suppurativa: A Case Report

“…Extra-cutaneous symptoms, which include severe angioedema, cough, shortness of breath, sore throat, and dysphagia, occur rarely [ 4 ]. LCV may develop secondary to a side effect of medication such as NSAIDs, phenytoin, and anti-TNF-a, as well as infections, neoplasms, and systemic inflammatory disorders [ 5 ]. A definitive diagnosis is made with a skin biopsy, which typically shows perivascular and vascular leukocytic infiltrates in addition to fibrinoid necrosis [ 4 ].…”

“…The mainstay of treatment is discontinuing the offending agent and controlling the underlying illness; rare occasions call for the use of high-dose steroids or immunosuppressive drugs [ 5 ]. In fact, our patient responded well to the TNF antagonist's discontinuation and the start of 60 mg tapered prednisone and doxycycline 100 milligrams BID for three months as an anti-inflammatory agent.…”