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Autops Case Rep 2019 Apr-Jun;9(2):e2018070. Epub 2019 Mar 22.

Universidade de São Paulo (USP), Hospital Universitário, Internal Medicine Division. São Paulo, SP, Brazil.

Esophageal infection by spp. is a common opportunistic entity in immunocompromised hosts; however, systemic fungal dissemination due to perforation or transmural necrosis, also known as necrotizing esophagitis (NCE), is rare. We report the case of a 61-year-old male patient with diagnosed ankylosing spondylitis, severe arteriosclerosis, and vasculitis under immunosuppressive therapy who presented NCE with fungal and bacterial septicemia diagnosed at autopsy. Read More

Proc (Bayl Univ Med Cent) 2019 Jan 27;32(1):93-95. Epub 2018 Dec 27.

Division of Rheumatology, Department of Internal Medicine, Rush University Medical CenterChicagoIllinois.

Levamisole is an adulterant found in nearly 70% of cocaine in the United States. The concomitant use of levamisole and cocaine leads to a distinct clinical syndrome that typically manifests as agranulocytosis, leukocytoclastic vasculitis, and elevated antineutrophil cytoplasmic antibody (ANCA) levels. Systemic involvement has also been rarely reported with this syndrome. Read More

Neurol Clin 2019 May 16;37(2):465-473. Epub 2019 Mar 16.

Department of Pathology, Division of Dermatology and Dermatopathology, Albany Medical College, 43 New Scotland Avenue, MC-81, Albany, NY 12208, USA.

Systemic and localized vasculitis affects the skin and subcutis, due to large vascular beds and hemodynamic factors, such as stasis in lower extremities, and environmental influences, as occur in cold exposure. Initial cutaneous manifestations of vasculitides include diverse and dynamic patterns of discoloration, swelling, hemorrhage, and necrosis. One-half of affected patients present with localized, self-limited disease to the skin without any known trigger or associated systemic disease, known as idiopathic cutaneous leukocytoclastic vasculitis. Read More

JAAD Case Rep 2019 Mar 2;5(3):288-291. Epub 2019 Mar 2.

Department of Translational Dermatoinfectiology, University of Münster, Münster, Germany.

Rev Esp Enferm Dig 2019 Mar 12;111. Epub 2019 Mar 12.

Unidad Enf. Inflam. Intest. Servicio de Digestivo., Hospital Universitario Central de Asturias.

Patients with inflammatory bowel disease are likely to receive immunomodulation treatment and therefore, should be properly vaccinated. Despite their proven safety, vaccines are not exempt from adverse reactions. The clinical case was a young female with ulcerative colitis under mesalazine treatment, who developed leukocytoclastic vasculitis following vaccination for pneumococci, varicella and hepatitis A. Read More

Int J Environ Res Public Health 2019 Mar 6;16(5). Epub 2019 Mar 6.

Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, 06129 Perugia, Italy.

Acute hemorrhagic oedema of infancy (AHEI) is a cutaneous leukocytoclastic small-vessel vasculitis presenting with localized purpuric large skin plaques that are frequently associated with fever and oedema. It must be promptly differentiated from a number of diseases with similar dermatologic manifestations with potentially severe clinical courses that require adequate monitoring and prompt therapy to avoid the risk of a negative evolution. A 15-month-old girl with a negative personal medical clinical history was admitted for the sudden appearance of petechiae on the soft palate. Read More

BMJ Case Rep 2019 Feb 28;12(2). Epub 2019 Feb 28.

Division of Rheumatology, Columbia University, New York, New York, USA.

A 62-year-old man presented with excruciating joint pains, back stiffness and numbness of his hands and feet. Over the past 18 months, he had experienced similar episodes for which the diagnoses of bilateral carpal tunnel syndrome and lateral epicondylitis had been made. Physical examination revealed polyarticular arthritis affecting the shoulders, wrists and right knee. Read More

Cureus 2018 Dec 7;10(12):e3703. Epub 2018 Dec 7.

Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, USA.

Tuberculous granulomatous vasculitis is commonly associated with meningitis and retinitis. We describe a 39-year-old male, with a history of pulmonary tuberculosis (TB) who presented with progressive weakness, pain, tingling and numbness in the bilateral lower extremities. Significant atrophy and weakness of the lower extremities were evident along with absent reflexes. Read More

Saudi J Med Med Sci 2018 May-Aug;6(2):104-107. Epub 2018 Apr 16.

Department of Dermatology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Cutaneous polyarteritis nodosa is a rare type of cutaneous vasculitis. It affects the small- and medium-sized arteries of the dermis and subcutaneous tissue without extracutaneous involvement. The diagnosis is by skin biopsy, and the characteristic finding is a leukocytoclastic vasculitis. Read More

Arch Pathol Lab Med 2019 Feb 20. Epub 2019 Feb 20.

From the Department of Dermatology, Saint Louis University, St Louis, Missouri (Dr Abate);the Departments of Dermatology (Dr Battle),and Pathology (Drs Gardner and Shalin),University of Arkansas for Medical Sciences, Little Rock; and the Department of Dermatology, University of Mississippi Medical Center, Jackson (Dr Emerson).

Context.—: Fatal dermatologic diseases and ones with high morbidity can occur in the inpatient setting. In such cases, prompt and accurate assessment of a bedside skin biopsy is required. Read More

J Am Acad Dermatol 2019 Feb 11. Epub 2019 Feb 11.

Dermatology - Department Medical Science and Public Health, University of Cagliari, Via Ospedale 54, 09124 Cagliari Italy; European Academy of Dermatology and Venereology (EADV) Task Force of Dermatopathology; SIDEMAST Dermatopathology Study Group of Italian Society of Dermatology.

Background: Clinical and pathological criteria to distinguish drug-induced subacute lupus erythematosus (DI-SCLE) from idiopathic (I-SCLE) are controversial.

Objective: Aim of the survey was a retrospective analysis of a consistent number of iatrogenous and idiopathic SCLE cases, by means of clinical and histopathological investigation.

Methods: Eleven European University Dermatology Units collected all diagnosed cases from January 2000 to December 2016. Read More

Breast J 2019 Mar 12;25(2):320-321. Epub 2019 Feb 12.

Department of Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Alberta, Canada.

Indian J Psychiatry 2019 Jan-Feb;61(1):94-96

Department of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, West Bengal, India.

Leukocytoclastic vasculitis (LCV) may be secondary to drugs, underlying infection, collagen vascular disorders, or malignancy. Drug-induced vasculitis contributes to 10% of vasculitic skin lesions cases usually developing within 7-21 days of treatment initiation. The present case highlights a report of LCV in a 59-year-old male with a history of paranoid schizophrenia on clozapine therapy. Read More

Respir Med Case Rep 2019 25;26:219-222. Epub 2019 Jan 25.

Department of Internal Medicine, Inha University College of Medicine, South Korea.

Leukocytoclastic vasculitis is a disorder characterized by neutrophilic inflammation that is predominantly limited to the superficial cutaneous postcapillary venules. This condition may be idiopathic or may have a defined cause. Rivaroxaban and dabigatran have been widely used as warfarin alternatives, because of their efficacy and safety. Read More

Semin Diagn Pathol 2019 Jan 31. Epub 2019 Jan 31.

PRW Laboratories, Charlottesville, VA, United State.

A variety of cutaneous abnormalities can be seen in patients with malignant diseases, some of which are infectious, with others representing direct involvement of the skin by the underlying disorder. Yet another group of lesions can be regarded as associated markers of the malignant process, and, as such, are termed "paraneoplastic." This review considers the latter collection of conditions, grouping them by the generic type of malignancy that is usually linked to the paraneoplasia. Read More

Rev Fac Cien Med Univ Nac Cordoba 2018 11 13;75(4):292-298. Epub 2018 Nov 13.

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The cryoglobulinemic syndrome is produced by precipitating immunoglobulins at low temperatures. Its production is associated with several causes, such as lymphoproliferative disorders, chronic infections and autoimmune disorders. However, the etiology is unknow. Read More

Rinsho Ketsueki 2019;60(1):51-56

Department of Pathology, Iwate Medical University.

A 37-year-old male with chief complaints of vomiting, abdominal pain, and diarrhea presented to our hospital in June 2017. A blood test detected increased inflammatory response, and a computed tomography scan showed that wall thickening extended from the terminal ileum to the entire large intestine. Bacterial enteritis was suspected because his household members developed infectious enteritis; however, his symptoms did not improve after antibiotic treatment. Read More

Front Pediatr 2018 22;6:413. Epub 2019 Jan 22.

Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany.

Henoch-Schönlein Purpura (HSP) or IgA vasculitis is the most common systemic vasculitis of childhood and may affect skin, joints, gastrointestinal tract, and kidneys. Skin manifestations of HSP are characteristic and include a non-thrombocytopenic palpable purpura of the lower extremities and buttocks. Rarely, HSP may initially present as or evolve into hemorrhagic vesicles and bullae. Read More

Ann Indian Acad Neurol 2019 Jan-Mar;22(1):104-108

Department of Pathology, Kasturba Medical College (Manipal University), Mangalore, Karnataka, India.

A case of Nicolau syndrome (NS) in a 36-year-old adult taking an unusual and devastating hyperacute irreversible paraplegia after an intramuscular injection of benzathine penicillin as a part of routine chemoprophylaxis of her rheumatic heart disease is reported. Although this syndrome is a considerably rare, iatrogenic and underappreciated dermatologic entity, we reiterate in this report, its extracutaneous systemic potential for a catastrophic neurovascular phenomenon and morbidity as well as its possible preventive measures. The apoplectiform onset of T10 flaccid areflexic paraplegia, with the cutaneous hallmark of "embolia cutis medicamentosa" was corroborated by magnetic resonance imaging evidence of centromedullary complete cord involvement from T10 to conus medullaris. Read More

Exp Ther Med 2019 Feb 19;17(2):1128-1131. Epub 2018 Nov 19.

CMI Dermamed, 540530 Târgu Mureş, Romania.

Erlotinib is a targeted anticancer therapy used for treating epidermal growth factor receptor (EGFR) mutation positive lung cancer in advanced stage as well as for other malignancies. The most common cutaneous side effect of erlotinib, are well documented; however the number of reports regarding cutaneous leukocytoclastic vasculitis (CLCV) are limited. We report a case, a 58-year-old, 60 kg weight, non-smoking woman suffering of lung adenocarcinoma and brain metastases treated with erlotinib monotherapy with 150 mg/day dose, who presents cutaneous leukocytoclastic vasculitis after 8 months of initiating the treatment. Read More

Dermatol Online J 2018 Oct 15;24(10). Epub 2018 Oct 15.

Department of Dermatology, The University of Texas McGovern Medical School, Houston, Texas.

Trifluridine/tipiracil has been approved for the treatment of refractory metastatic colorectal cancer. Adverse effects of this drug combination include leukopenia, neutropenia, fatigue, diarrhea, and vomiting. We present a case of trifluridine/tipiracil-induced leukocytoclastic vasculitis (LCV) with late-onset Henoch-Schönlein purpura (HSP) in a 42-year-old man with metastatic appendiceal cancer. Read More

Oman Med J 2019 Jan;34(1):66-69

Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

A 30-year-old man presented with fever, hepatosplenomegaly, and a rash over his lower limbs (palpable purpura). Evaluation revealed pancytopenia and hypergammaglobulinemia. A subsequent bone marrow examination and serology confirmed visceral leishmaniasis (kala-azar), while the biopsy of skin lesion suggested leukocytoclastic vasculitis. Read More

Asian Pac J Allergy Immunol 2019 Jan 13. Epub 2019 Jan 13.

Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Urticarial vasculitis (UV) is a rare form of cutaneous leukocytoclastic vasculitis with persistent urticarial lesions. UV may be severe and refractory to standard treatment including antihistamines, anti-inflammatories, antimalarials, corticosteroids and immunosuppressants. Omalizumab, an anti-IgE antibody, is approved for chronic spontaneous urticaria. Read More

J Med Case Rep 2019 Jan 16;13(1):13. Epub 2019 Jan 16.

Department of Gastroenterological Chemotherapy, The Cancer Institute Hospital, Jaese Foundation for Cancer Research, Tokyo, Japan.

Background: Panitumumab is the first human combinatorial antibody for the treatment of metastatic colorectal carcinoma. Dermatologic toxicity of all grades occurs in more than 90% of patients. However, there are few reports of purpura induced by anti-epidermal growth factor receptor antibody. Read More

J Cutan Pathol 2019 May 7;46(5):393-395. Epub 2019 Feb 7.

Department of Dermatology and Venerology, First Hospital of Jilin University, Changchun, Jilin, China.

J Investig Med High Impact Case Rep 2018 Jan-Dec;6:2324709618820873. Epub 2018 Dec 21.

St. Joseph Hospital, Bangor, ME, USA.

Vancomycin causes different types of hypersensitivity reactions, ranging from localized skin reactions to generalized cardiovascular collapse. However, cases of vancomycin-induced leukocytoclastic vasculitis are rare. In this article, we present a case where the patient developed palpable purpura on his bilateral lower limbs following treatment with vancomycin. Read More

Fetal Pediatr Pathol 2019 Jan 2:1-6. Epub 2019 Jan 2.

b Department of Pathology , Tehran University of Medical Sciences , Tehran , Iran.

Objective: Henoch-Schonlein purpura (HSP) is a common vasculitis in children that can present with multi-organ involvement. The aim of this study is to investigate the correlation between direct immunofluorescence (DIF) results and the systemic involvements of the HSP in pediatric patients.

Material And Methods: Those HSP patients with leukocytoclastic vasculitis on their biopsies who also had documented immunoglobulin/complement deposition by DIF were included in our study. Read More

Reumatismo 2018 Dec 20;70(4):259-263. Epub 2018 Dec 20.

Rheumatology Department, Faruk Medical City.

Cutaneous vasculitis may behave as a paraneoplastic syndrome. Paraneoplastic vasculitis as a phenomenon of colonic adenocarcinoma has been described in the literature. To the best of my knowledge, this is the first case report of urticarial vasculitis being an initial presentation of signet-ring cell carcinoma of the colon. Read More

Cutis 2018 Nov;102(5):359-362

Department of Dermatology, Geisinger Health System, Danville, Pennsylvania, USA.

We report the case of a 10-month-old previously healthy boy who presented with acute rash, edema, and low-grade fever in the setting of recent diarrhea. We differentiate between acute hemorrhagic edema of infancy (AHEI) and Henoch-Schönlein purpura (HSP). Read More

J Investig Allergol Clin Immunol 2018 Dec;28(6):417-418

Servicio de Enfermedades del Sistema Inmune-Alergia, Hospital Universitario Príncipe de Asturias, Departamento de Medicina y Especialidades Médicas; Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.

Int J Low Extrem Wounds 2018 Dec 3;17(4):218-226. Epub 2018 Dec 3.

1 Women's College Hospital, Toronto, Ontario, Canada.

Cutaneous and other vasculitides are specific inflammations of the blood vessel wall that can take place in any organ system of the body including the skin. Vasculitis has been traditionally divided according to the size of the vessel involved (small, medium, and large). Vasculitis is more of a reaction pattern rather than a specific disease entity. Read More

Asian Pac J Allergy Immunol 2018 Oct 15. Epub 2018 Oct 15.

Department of Pediatrics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.

Vancomycin (VCM) has been reported to elicit adverse cutaneous drug reactions. However, VCM-associated purpuric drug eruption has not been reported yet, except leukocytoclastic vasculitis. A 16-year-old Japanese girl was admitted with a respiratory infection. Read More

Curr Rheumatol Rep 2018 Nov 17;20(12):87. Epub 2018 Nov 17.

LSU Health Science Center, New Orleans, LA, USA.

Purpose Of Review: Autoinflammatory diseases (AIDs) constitute several disorders that share similar characteristics, clinical features, disease course, and prognosis. They are characterized by the presence of recurrent episodes of unprovoked inflammation due to dysregulated innate immune system in the absence of autoantibodies or infections. AIDs include periodic fever syndromes and other less commonly growing list of syndromes. Read More

Endocr Metab Immune Disord Drug Targets 2019 ;19(2):221-225

Microbiology and Virology Unit, Policlinico University Hospital of Bari, Italy.

Background And Objective: Leukocytoclastic vasculitis (LCV) is a small vessel vasculitis that can be limited to the skin but may also affect other organs. Often, its cause is unknown. LCV has previously been reported to occur with the reactivation of human herpesvirus 6 (HHV-6). Read More

J Med Case Rep 2018 Oct 31;12(1):320. Epub 2018 Oct 31.

Division of Hematology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.

Background: Multiple myeloma is a very heterogeneous disease comprising a number of genetic entities that differ from each other in their evolution, mode of presentation, response to therapy, and prognosis. Due to its more chronic nature and cumulative toxicities that patients develop from multiple lines of treatments, a number of symptoms are associated with multiple myeloma. However, the mechanisms responsible for the relationship between these symptoms and multiple myeloma currently remain unclear. Read More

Lupus 2018 Dec 30;27(14):2220-2227. Epub 2018 Oct 30.

1 Department of Dermatology, Kansai Medical University, Hirakata, Japan.

Background: Palisaded neutrophilic and granulomatous dermatitis (PNGD) is a commonly occurring condition related to systemic autoimmune disease. It is characterized histopathologically by a distinct pattern of granulomatous inflammation in the presence or absence of leukocytoclastic vasculitis. The properties of granulomatous cells in PNGD are still uncertain. Read More

Cutis 2018 Sep;102(3):169;170;175;176

Department of Dermatology, Vanderbilt University, Nashville, Tennessee, USA.

Reports of levamisole-induced vasculopathy (LIV) secondary to use of levamisole-contaminated cocaine largely have been limited to the skin. We report the case of a 35-year-old woman with painful purpuric lesions affecting the cheeks, nose, ears, arms, and legs of several days' duration. She recently had used crack cocaine. Read More

Rev Assoc Med Bras (1992) 2018 Jul;64(7):590-594

Internal Medicine Department - III, District Hospital of Santarem, Portugal.

The authors report a case of a 69-year-old man with idiopathic leukocytoclastic cutaneous vasculitis. For three years, the lesions recurred with progressive worsening and were associated with systemic manifestations of low-grade fever, weight loss and raised inflammatory markers. The patient latter presented a 6th cranial nerve involvement, raising the concern of a possible systemic vasculitis, which was latter evidenced by the development of deep vein thrombosis and angina pectoris. Read More

J Cutan Pathol 2019 Feb 3;46(2):97-101. Epub 2018 Dec 3.

Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.

Background: Erythema elevatum diutinum (EED) is a rare vasculitis with variable clinical presentation which diagnosis can be challenging. Herein we want to describe the clinicopathological spectrum of findings in five cases of EED.

Methods: We retrospectively analyzed five cases in a single institution collected over a period of 27 years. Read More

BMC Dermatol 2018 10 25;18(1). Epub 2018 Oct 25.

Respiralab, Respiralab Research Group, Guayaquil, Ecuador.

Background: Despite the current knowledge of UV, there is a lack of consensus among diagnostic criteria and management. In general, antihistamine therapy is regularly used for the symptomatic management of pruritus but does not control inflammation or alter the course of the disease. Monoclonal antibodies such as omalizumab (anti-IgE) have been proposed as a potential treatment for urticarial vasculitis. Read More

Hautarzt 2018 Oct;69(10):878

Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland.

J Allergy Clin Immunol 2019 Feb 27;143(2):458-466. Epub 2018 Sep 27.

Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology and Allergy, Allergie-Centrum-Charité, Berlin, Germany. Electronic address:

Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by the severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic review of the efficacy of current UV treatment options. Read More

Hautarzt 2018 Oct;69(Suppl 1):31-33

Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, 80337, München, Deutschland.

Int J Dermatol 2018 Dec 25;57(12):1411-1416. Epub 2018 Sep 25.

Department of Dermatology, University of Texas Medical Branch, Galveston, TX, USA.

Levamisole-contaminated cocaine toxicity is a serious emerging public health concern, and providers should be aware of its presentation and management. Most cases of levamisole-induced vasculitis/vasculopathy (LIV) are associated with high antineutrophil cytoplasmic antibodies (ANCA). We describe a unique case of a cocaine user who presented with an acute purpuric eruption and negative ANCA laboratory findings. Read More

J Hand Surg Am 2018 Sep 18. Epub 2018 Sep 18.

Department of Orthopaedics, Louisiana State University Health Sciences Center, New Orleans, LA.

Erythema elevatum diutinum (EED) is a rare skin disease caused an Arthrus-type immunological reaction to antigen with immune complex deposition in the cutaneous microvasculature, which leads to tissue damage secondary to the effects of complement and leukocytes. It presents as brown or red cutaneous nodules, papules, or plaques, often on the extensor surfaces of the hands, knees, or elbows. Onset usually occurs in the fourth to sixth decades but possibly younger in patients with human immunodeficiency virus. Read More

JAAD Case Rep 2018 Sep 18;4(8):824-826. Epub 2018 Sep 18.

Dermatology Department, Hôtel-Dieu University Hospital, Nantes, France.

J Pediatr Endocrinol Metab 2018 Oct;31(10):1165-1168

Ghent University, Department of Pediatrics and Medical Genetics, Ghent, Belgium.

Background The association of hyperthyroidism with renal disease is very rare and the importance of timely clinical recognition cannot be overemphasized. Case presentation An 11-year-old girl presented with gastrointestinal symptoms while hypertension, edema and abdominal pain were noticed on clinical examination. Laboratory investigation revealed: hemoglobin 9. Read More

Pediatr Rheumatol Online J 2018 Sep 4;16(1):54. Epub 2018 Sep 4.

Department of Pediatric Rheumatology, Children's Hospital Colorado, 13123 East 16th Avenue, B311, Aurora, CO, 80045, USA.

Background: Henoch-Schonlein Purpura (HSP) is one of the most common vasculitides of childhood, with 10-20 cases per 100,000 children. It frequently occurs following an infectious trigger and involves IgA and C3 deposition in small vessel walls. HSP is characterized by palpable purpura plus IgA deposition on biopsy, arthritis/arthralgia, renal involvement (hematuria and/or proteinuria), and/or abdominal pain. Read More

Therapie 2018 Jul 24. Epub 2018 Jul 24.

Département de pharmacologie, faculté de médecine de Sousse, université de Sousse, avenue Md Karoui, 4002 Sousse, Tunisie.

Introduction: Drug-induced vasculitis is reported in almost 10-20 % of vasculitis. Several drugs may be incriminated in their occurrence. Our study aimed to study the epidemiological, clinical, histopathological and evolutionary characteristics of drug-indced vasculitis from a series of cases and to specify the different drugs involved. Read More

Clin Case Rep 2018 Aug 4;6(8):1422-1425. Epub 2018 Jun 4.

Department of Pediatrics Niigata City General Hospital Niigata City Japan.

We present a child with bullous IgA vasculitis. Because skin biopsy showed epidermal vesicles with neutrophil infiltration and leukocytoclastic vasculitis in all layers of the dermis, with IgA deposits and tissue eosinophilia, extensive dermal infiltration of neutrophils may have led to both blistering eruptions and tissue eosinophilia in our patient. Read More