Clin Exp Dermatol 2017 Jun 22. Epub 2017 Jun 22.

Unidad de Gestión Clínica Dermatología y Venereología, Hospital Universitario Puerta del Mar, Cádiz, Spain.

The vesiculobullous variant of erythema elevatum diutinum (EED) is a very rare variant of EED. We describe a 16-year-old boy who presented with symmetrical nodular lesions accompanied by vesicles on the dorsa of his hands. Biopsy findings were consistent with EED. Read More

Clin Exp Dermatol 2017 Jul 17;42(5):573-575. Epub 2017 May 17.

Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Am J Transl Res 2017 15;9(4):1956-1959. Epub 2017 Apr 15.

Department of Dermatopathology, Shanghai Skin Disease Hospital, School of Medicine, Tongji UniversityShanghai, China.

Erythema elevatum diutinum (EED) is a rare chronic inflammatory dermatosis and a part of the spectrum of cutaneous leukocytoclasticvasculitis. The most common site of involvement is extensor surface of the extremities, with a predilection for the skin overlying joints, particularly hands, feet, elbows and knees, as well as buttocks and Achilles tendons. Here we report a case of EED with atypical presentation involving palms and soles. Read More

JAAD Case Rep 2017 May 14;3(3):212-214. Epub 2017 Apr 14.

Department of Dermatology, Whipps Cross University Hospital, Barts Health, London, United Kingdom.

Clin Exp Dermatol 2017 Apr 10. Epub 2017 Apr 10.

Department of Dermatology, Our Lady's Children's Hospital, Crumlin, Dublin, 12, Ireland.

Am J Med Sci 2017 Feb 20;353(2):189. Epub 2016 May 20.

Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, New York.

Cardiovasc Pathol 2017 Mar - Apr;27:68-70. Epub 2017 Jan 24.

Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

Immunological vascular phenomena can be the initial manifestation of bacterial infection and endocarditis. Here, we report a rare case of leukocytoclastic vasculitis without immune complexes or cryoglobulinemia in a patient with infective endocarditis, congenital heart disease, and a prior mechanical valve replacement. The patient completely recovered following antibiotic therapy, and skin lesions disappeared without immune suppression, which suggested infection-mediated vasculitis. Read More

Am J Dermatopathol 2017 Feb;39(2):111

*School of Medicine, Oregon Health and Science University, Portland, OR; and †Department of Dermatology, Oregon Health and Science University, Portland, OR.

Perm J 2017 18;21. Epub 2016 Nov 18.

Consultant in Medicine at The Dunedin Hospital; an Honorary Clinical Senior Lecturer at the University of Otago School of Medicine in Dunedin, New Zealand; Clinical Assistant Professor of Medicine at Stanford University School of Medicine; and a Hospitalist at the Santa Clara Medical Center in CA.

Introduction: Pyridostigmine is an acetylcholinesterase inhibitor commonly used in the treatment of myasthenia gravis. We describe a patient who developed a rash after recently being started on pyridostigmine and give a general review of leukocytoclastic vasculitis.

Case Presentation: A 91-year-old man was diagnosed with ocular myasthenia gravis. Read More

J Stroke Cerebrovasc Dis 2017 Mar 5;26(3):e47-e49. Epub 2017 Jan 5.

Stroke Unit, Mediterraneo Hospital, Athens, Greece.

Eosinophilic granulomatosis with polyangiitis (EGPA, previously named Churg-Strauss syndrome) is a form of necrotizing vasculitis occurring in patients with asthma and eosinophilia. Ischemic stroke is a relatively rare complication of the disease. We report a case of a 63-year-old woman with multiple embolic infarcts, hypereosinophilia (for >7 years), and skin rash. Read More

JAAD Case Rep 2017 Jan 21;3(1):1-3. Epub 2016 Dec 21.

Department of Dermatology, University of Colorado Anschutz Medical College, Aurora, Colorado.

Am J Dermatopathol 2017 Jun;39(6):479-484

*Department of Pathology, Albany Medical College, Albany, NY; and †Departamento de Dermatología, Area de Dermatopatología, Hospital Luis Vernaza, Guayaquil, Ecuador.

One of the pathogenic causes of cutaneous inflammatory pseudotumors is chronic localized fibrosing leukocytoclastic vasculitis (CLFLCV), a vasculitic reaction pattern seen in granuloma faciale (GF), a localized vasculitis, and erythema elevatum diutinum (EED), a generalized vasculitis. Patients with myelodysplastic syndromes (MDSs) are at risk for a diverse spectrum of cutaneous neutrophilic dermatoses such as EED. Herein, we report a 74-year-old man who presented with a large ulcerative, fungating tumor affecting the right flexor ankle caused by CLFLCV. Read More

Tumori 2016 Nov 11;102(Suppl. 2). Epub 2016 Nov 11.

Institute of Hematology L. and A. Seràgnoli, University of Bologna, Bologna - Italy.

Background: Autoimmune manifestations may occur in patients with hairy cell leukemia (HCL), and some rare cases of polyarteritis nodosa and leukocytoclastic vasculitis have been reported. However, data regarding the treatment of these cutaneous manifestations are lacking, given the rarity of the concomitance of HCL and vasculitic syndromes.

Case Presentation: We present a 37-year-old man with paraneoplastic leukocytoclastic vasculitis complicating newly diagnosed HCL. Read More

Curr Opin Rheumatol 2017 Jan;29(1):39-44

Department of Pathology, Acıbadem University, Istanbul, Turkey.

Purpose Of Review: The present review will focus on recent publications in cutaneous vasculitides.

Recent Findings: Some histopathological and clinical features, such as papillary dermal edema, perivascular C3 deposition, clinically evident edema, and lesions above the waist, may point out renal or gastrointestinal involvement in Henoch-Schönlein purpura (HSP). HSP associated with familial Mediterranean fever differs from typical isolated HSP by showing no deposits of IgA, much younger age, and location of the lesions on the face or the trunk. Read More

J Dermatol 2016 Nov 21;43(11):1377-1378. Epub 2016 Apr 21.

Department of Dermatology, Jichi Medical University, Tochigi, Japan.

Vnitr Lek Fall 2016;62(9 Suppl 2):18-22

Extrahepatic manifestations of hepatitis C virus infection (HCV) are very common. The most common of these is mixed cryoglobulinaemia. Anti-HCV antibodies and viral ribonucleic acid, HCV RNA, can be found in the cryoprecipitates, together with the rheumatoid factor. Read More

G Ital Dermatol Venereol 2016 Oct;151(5):580-2

Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan -

Indian Dermatol Online J 2016 Jul-Aug;7(4):300-3

Deparment of Dermatology Venereology and Leprosy, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India.

Erythema elevatum diutinum (EED) is a rare form of vasculitis characterized clinically by red-violet brown papules, plaques, and nodules mainly involving the extensor surfaces; histologically by leukocytoclastic vasculitis in early lesions, and fibrosis and cholesterolosis in late lesions. EED has been associated with many systemic disorders including infections, autoimmune disorders, and both benign and malignant hematological disorders. As it is a rare form of vasculitis and only 250 cases reported till date, we report a case of EED in association with IgA monoclonal gammopathy with partial response to dapsone treatment. Read More

Medicine (Baltimore) 2016 Jul;95(28):e4238

aService de médecine interne et immunologie clinique bService de médecine interne et maladies systémiques cService de dermatologie dLaboratoire d'anatomopathologie eService de pneumologie fService de maladies infectieuses, CHU François Mitterrand, Dijon, France.

In this study, outcomes of patients with leukocytoclastic vasculitis (LCV) were analyzed focusing on clinical, histopathology and laboratory findings, relapses, and survival.Data from patients with cutaneous vasculitis diagnosed between January 1, 2000, and December 31, 2010, at Dijon University Hospital (France) were retrospectively reviewed. LCV was defined as perivascular neutrophilic infiltrate, endothelial cell nuclear swelling, extravasation of red blood cells, and/or fibrin deposition in vessels. Read More

Indian J Sex Transm Dis 2016 Jan-Jun;37(1):81-4

Department of Skin-VD, SSG Hospital, Vadodara, Gujarat, India.

A 47-year-old male with acquired immune deficiency syndrome (AIDS) presented with multiple hyperpigmented papules and nodules on both ankles, dorsum of bilateral feet and soles. It was associated with mild itching and pain. The patient was diagnosed with human immunodeficiency virus (HIV) in 2007. Read More

Intern Med 2016 15;55(10):1355-61. Epub 2016 May 15.

Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan.

A 68-year-old man was admitted because of weakness of the left leg, dysesthesiae of the extremities and bilateral lower extremity purpura. A neurological examination showed mononeuritis multiplex with laboratory evidence of hypocomplementemia, cryoglobulinemia and leukocytoclastic vasculitis in the biopsy of a skin specimen. The patient also exhibited bilateral submandibular gland swelling, elevated serum IgG4 levels and infiltration of a large number of IgG4-positive plasma cells in the submandibular glands. Read More

Am J Clin Pathol 2016 Mar 2;145(3):401-6. Epub 2016 Mar 2.

Departments of Dermatology, Pathology and Laboratory Medicine, Mayo Clinic College of Medicine, Rochester, MN.

Objectives: To elucidate whether granuloma faciale (GF) and erythema elevatum diutinum (EED), two inflammatory skin dermatoses, meet the consensus histopathologic diagnostic criteria for immunoglobulin G4-related disease (IgG4-RD).

Methods: With institutional review board approval, we assessed the clinical, microscopic, and immunophenotypic features of skin specimens of patients with GF and EED. We compared these findings with previously published consensus diagnostic criteria for IgG4-RD. Read More

Indian J Lepr 2015 Jul-Sep;87(3):161-4

Dapsone, a potent anti-inflammatory compound, is mainly used in the treatment of leprosy, dermatitis herpetiformis, erythema elevatum diutinum and other dermatoses. Cutaneous adverse reactions range from acneiform eruptions to toxic epidermal necrolysis. A 30-year-old, married women who was treated with paucibacillary multi drug therapy, developed itchy skin lesions over the both forearms, 'V ' area of the neck and upper back after one week of the drug administration which worsened on exposure to sunlights. Read More

Medicine (Baltimore) 2016 Mar;95(11):e2957

From the Department of Internal Medicine, Caen University Hospital, Caen (HDB, NMS, BB, AA); Department of Internal Medicine, Brest University Hospital (CDM); Department of Internal Medicine, Nantes University Hospital (AN); Department of Internal Medicine, Assistance Publique Hôpitaux de Paris, Saint-Louis Hospital, Paris, France (MDM); Department of Rheumatology, Assistance Publique Hôpitaux de Paris, Bichat University Hospital, Paris, France (OM); Department of Internal Medicine, Lille University Hospital, France (DL); Mount Sinai Hospital, University Health Network, and University of Toronto, Toronto, Ontario, Canada (CP); and Department of Internal Medicine, Assistancec Publique Hôpitaux de Paris, Cochin Hospital, Paris, France (LG, XP).

A few reports suggest combination of ANCA-associated vasculitis (AAV) and neutrophilic dermatoses (ND). We aimed to describe the main characteristics of patients presenting with both AAV and ND in a French cohort and through a systematic literature review, and to discuss the possible common pathogenic process involved. We conducted a retrospective study of patients with both conditions. Read More

J Mal Vasc 2016 May 9;41(3):220-3. Epub 2016 Mar 9.

Service de médecine interne gériatrie, hôpital de Champmaillot CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France; Inserm U1093 : cognition, action et plasticité sensorimotrice (CAPS), université de Bourgogne Franche-Comté, BP 27877, 21078 Dijon cedex, France. Electronic address:

Even though digoxin causes many side effects, few cases of skin involvement are recorded in the French Pharmacovigilance Database. We report a case of leukocytoclastic vasculitis (LV) very probably due to digoxin. A 91-year-old woman, hospitalized following a fall, presented cardiac decompensation in a context of rapid atrial fibrillation requiring treatment with digoxin. Read More

J Am Acad Dermatol 2016 Jun 8;74(6):1153-9. Epub 2016 Mar 8.

Dermatology Department, Hôpital Edouard Herriot, Université Claude Bernard Lyon I, Lyon, France.

Background: Paradoxical hidradenitis suppurativa (HS) induced by biologic agents (BA) is scarcely reported.

Objective: We sought to describe the clinical characteristics and outcome of patients developing paradoxical HS under BA.

Methods: This was a multicenter nationwide retrospective study asking physicians to report all cases of HS, confirmed by a dermatologist, occurring during treatment of an inflammatory disease by a BA. Read More

BMJ Case Rep 2016 Jan 20;2016. Epub 2016 Jan 20.

Department of Surgery, Medway Maritime Hospital, Gillingham, Kent, UK.

Leukocytoclastic vasculitis (LV) is a small vessel vasculitis associated with infections, connective tissue disease, malignancies and, rarely, gastrointestinal conditions. An association between LV and acute diverticulitis has not previously been reported. LV may be localised to the skin as a purpuric rash or might manifest with systemic involvement, such as of the joints, gastrointestinal tract or kidneys. Read More

JAMA Dermatol 2016 Mar;152(3):331-2

Department of Dermatology, Howard University Hospital, Washington, DC.

J Bronchology Interv Pulmonol 2016 Jan;23(1):54-8

*Middle East Technical University Medical Center †Pulmonary Diseases Department, Başkent University School of Medicine, Ankara, Turkey.

Medwave 2015 Oct 30;15(9):e6297. Epub 2015 Oct 30.

Departamento de Fisiología, Facultad de Medicina, Universidad Nacional de Trujillo, Trujillo, Perú

Henoch Schonlein purpura (HSP) is a common childhood vasculitis, characterized by a non-thrombocytopenic palpable purpura and systemic features. It can be triggered by conditions like infections and insect bites. We present the case of a six-year-old girl with palpable maculopapular lesions on the lower limbs, itching, mild pain, swelling of feet, limitation of limb mobility, and a history of bee sting. Read More

Eur J Pediatr 2016 Apr 25;175(4):557-61. Epub 2015 Nov 25.

University Children's Hospital Berne, University of Berne, Berne, Switzerland.

Unlabelled: Acute hemorrhagic edema of young children is a rare leukocytoclastic vasculitis that has been reported exclusively in small retrospective cases series, case reports, or quizzes. Considering that retrospective experience deserves confirmation in at least one observational prospective study, we present our experience with 16 children (12 boys and 4 girls, 5-28 months of age) affected by acute hemorrhagic edema. The patients were in good general conditions and with a low-grade or even absent fever. Read More

J Drugs Dermatol 2015 Oct;14(10):1090-2

Acta Derm Venereol 2016 May;96(4):568-9

Department of Dermatology, Kinki University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan.

An Bras Dermatol 2015 Jul-Aug;90(4):561-3

Universidade de Taubaté, Taubaté, SP, BR.

Erythema elevatum diutinum is a rare chronic leukocytoclastic vasculitis of unknown etiology. It is believed to be due to deposition of immune complexes in the vessels. Clinically it is manifested as erythematous violaceous papules and nodules, isolated or confluent with hardened consistency, symmetrical, usually located on the extensor surface of the extremities, particularly over the joints. Read More

Hautarzt 2015 Aug;66(8):589-98

Abteilung für Translationale Dermatoinfektiologie, Medizinische Fakultät, Universität Münster und Universitätsklinikum Münster, Röntgenstraße 21, 48149, Münster, Deutschland,

The skin is one of the organs most frequently involved in vasculitides. Cutaneous vasculitis may present (1) part of a systemic vasculitis (e.g. Read More

Ann Pathol 2015 Aug 15;35(4):281-93. Epub 2015 Jul 15.

Département de pathologie, hôpital Henri-Mondor, Assistance publique-Hôpitaux de Paris (AP-HP), faculté de médecine, université Paris-Est-Créteil, 94010 Créteil cedex, France.

Skin manifestations associated with monoclonal gammapathy are common and can present with various clinical and pathological aspects. They can be the first events leading to the diagnosis of monoclonal gammapathy. They may be present either as specific lesions, including lymphoplasmacytic or pure plasma cell neoplastic infiltrates and monoclonal immunoglobulin deposits, or as non-specific dermatitis, such as leukocytoclastic vasculitis, neutrophilic dermatoses, mucinoses or xanthomatosis, giving little clues for the diagnosis of the underlying disease. Read More

Acta Gastroenterol Belg 2015 Jun;78(2):250-1

Leucocytoclastic vasculitis (LCV) is commonly presented as a skin disease by affecting the small vessels of targeted area. Containing loops of vessels with end- capillaries makes the small intestine villus potantially target area of LcV, when obstructed with immune complexes. Read More

Eur J Rheumatol 2015 Jun 31;2(2):73-75. Epub 2015 Mar 31.

Department of Rheumatology, Çukurova University Faculty of Medicine, Adana, Turkey.

A 43-year-old woman presented to our hospital with the complaint of a reddish-purple rash on the extensor sides of her forearms. She had been diagnosed with ankylosing spondylitis 7 years ago. On physical examination, reddish-purple nodules were detected on the pretibial areas of both legs and extensor sides of both hands and forearms. Read More

Cardiovasc J Afr 2015 Mar-Apr;26(2):70-81

Department of Cardiology, University of KwaZulu-Natal, Durban, South Africa.

An established relationship exists between human immunodeficiency virus (HIV) and the vascular system, which is characterised by clinical expressions of aneurysmal and occlusive disease that emanate from a common pathological process. The exact pathogenesis is currently unknown; attempts to implicate opportunistic pathogens have been futile. Theories converge on leucocytoclastic vasculitis with the vaso vasora as the vasculopathic epicentre. Read More

Am J Med Sci 2015 Dec;350(6):500

Med Clin (Barc) 2015 Sep 2;145(5):e9. Epub 2015 Apr 2.

Departamento de Dermatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Eur J Dermatol 2015 Jan-Feb;25(1):96-7

Clin Exp Dermatol 2015 Oct 7;40(7):761-4. Epub 2015 Mar 7.

Department of Dermatology, St George's Hospital, London, UK.

We report the case of a 27-year-old woman presenting with unilateral painless nodules of the left hand following trauma. Initially diagnosed as nontuberculous mycobacterium infection and treated with prolonged courses of antibiotics with little improvement, the condition was subsequently diagnosed histologically as erythema elevatum diutinum (EED). The lesion was treated with surgical excision, and the patient remained lesion-free at the 1-year follow-up. Read More

G Ital Dermatol Venereol 2015 Feb 16;150(1):87-94. Epub 2015 Jan 16.

Dermatology Unit, Department of Medical, Surgical Diagnostic and Pediatric Science, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy -

Granuloma faciale (GF) is a rare cutaneous condition of unknown origin, that usually presents as one or more brown-purple papules, plaques and/or nodules, localized mostly on the face, although extrafacial lesions can also occur. Eosinophilic angiocentric fibrosis (EAF) is regarded as the mucosal counterpart of GF. Histologically, it has been described as a persistent leukocytoclastic vasculitis, with a dense polymorphous inflammatory infiltrate in the superficial and mid dermis, typically sparing the subpapillary dermis, the so called grenz zone. Read More

G Ital Dermatol Venereol 2015 Feb 14;150(1):41-50. Epub 2015 Jan 14.

Department of Medico‑Surgical and Transplantation Physiopathology, Operative Unit of Dermatology,University of Milan, Italy, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy -

Urticaria is a frequent disorder classified as acute and chronic forms, which presents with wheals that can be associated with angioedema. Several entities may manifest with urticarial skin lesions, encompassing a heterogeneous group of conditions that have to be differentiated from ordinary urticaria. This review is focused on two of these urticarial syndromes: urticarial vasculitis (UV), which represents the most important differential diagnosis with common urticaria, and autoinflammatory diseases such as cryopyrin-associated periodic syndromes (CAPS) and Schnitzler's Syndrome, both rare multisystem forms that may masquerade as common urticaria. Read More

Infez Med 2014 Dec;22(4):326-30

Department of Gastroenterology, Diyarbakir Education and Research Hospital; Department of Dermatology, Faculty of Medicine, Dicle University; Department of Dermatology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.

Brucellosis is globally the most prevalent multisystem infection of zoonotic origin, while it is still one of the most important public health problems in Turkey as non-pasteurised milk and dairy products are consumed. Early diagnosis is vital to prevent the possibly lethal complications caused by the disease. However, diagnosis might be delayed as the disease does not have a single and typical manifestation and presents with various symptoms of different systems. Read More

JAMA Dermatol 2015 May;151(5):551-2

Department of Dermatology, Baylor Scott and White Healthcare, Temple, Texas.

BMJ Case Rep 2014 Dec 22;2014. Epub 2014 Dec 22.

Department of Dermatology, York Hospital, York, UK.

A 75-year-old man with ulcerative colitis (UC) and diet controlled diabetes mellitus presented with a 3-week history of slightly itchy, red plaques on both lower limbs ascending gradually to cover the trunk and arms. One week later, he developed a flare up of his UC. Routine blood tests showed modest drop in haemoglobin (122 g/L) and C reactive protein (85 mg/L). Read More

Am J Med Sci 2015 Apr;349(4):374-5

Department of Dermatology, University Hospital "José Eleuterio González," Universidad Autónoma de Nuevo León (UANL), Monterrey, Mexico.

J Am Acad Dermatol 2015 Jan;72(1):e32-3

Department of Dermatology and Dermatology Consultation Service, Columbia University Medical Center, New York, New York.