Am J Dermatopathol 2017 Jul 14. Epub 2017 Jul 14.

Departments of *Dermatology, and †General Medicine/Primary Care Center, Aichi Medical University School of Medicine.

Tumor necrosis factor (TNF)-α inhibitors target TNF-α to effectively treat autoimmune inflammatory conditions, such as rheumatoid arthritis. However, many cases of cutaneous and systemic vasculitis related to TNF-α inhibitors have been reported in the literature. Here, the authors report the first case of a 61-year-old Japanese woman who developed leukocytoclastic vasculitis with cutaneous perivascular hemophagocytosis, which was related to elevated cytokines and immune complexes after initiating adalimumab for rheumatoid arthritis without evidence of hemophagocytic syndrome and rarely encountered in the skin. Read More

J Biol Regul Homeost Agents 2017 07 13;31(2 Suppl. 2). Epub 2017 Jul 13.

Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Helicobacter pylori is a gram-negative, flagellate, microaerophilic bacterium identified for the first time about 30 years ago, as a pathogenic factor of gastritis and peptic ulcer. Soon after, it was linked to several gastrointestinal and extra-gastrointestinal diseases (hematological, cardiovascular, neurological, pulmonary and ocular diseases, obesity, diabetes mellitus, growth retardation and extragastric MALT lymphoma). Association and possible cause-effect correlation with H. Read More

JAAD Case Rep 2017 Jul 22;3(4):291-293. Epub 2017 Jun 22.

Department of Dermatology, Mayo Clinic Arizona, Scottsdale, Arizona.

Zhongguo Dang Dai Er Ke Za Zhi 2017 Jul;19(7):837-840

Department of Pediatrics, Lianyungang Hospital Affiliated to Xuzhou Medical University, Lianyungang, Jiangsu 222000, China.

Immunoglobulin A (IgA) vasculitis is the most common leukocytoclastic small-vessel vasculitis in children and mainly involves the small vessels in the skin, joints, digestive tract, and kidneys. Its pathogenesis is still unclear. Currently, it is believed that environmental factors can cause autoimmune dysfunction and lead to the deposition of IgA-containing immune complexes on the wall of arterioles on the basis of genetic factors. Read More

Case Rep Dermatol 2017 May-Aug;9(2):40-43. Epub 2017 Jun 14.

Department of Dermatology, Tokyo Medical University, Tokyo, Japan.

The etiology of purpura in Sjögren syndrome (SS) includes cryoglobulinemia, hypergammaglobulinemia, and leukocytoclastic vasculitis (LCV). The clinical symptoms of LCV associated with SS comprise palpable or nonpalpable purpura and urticarial vasculitis. Here, we report a case of LCV presenting as erythema gyratum repens (EGR)-like purpura in a 62-year-old woman with rheumatoid arthritis and SS. Read More

Cutis 2017 Jun;99(6):426-428

Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.

Leukocytoclastic vasculitis (LCV) is a disease characterized by inflammation of small vessels presenting with petechiae and palpable purpura. Leukocytoclastic vasculitis often spontaneously resolves within weeks and requires only symptomatic treatment. Chronic or severe disease can require systemic treatment with agents such as colchicine, dapsone, or corticosteroids, which are effective but carry a risk for serious adverse events. Read More

Wounds 2017 Jun;29(6):E43-E47

Department of Dermatology, SMS Medical College and Hospital, Jaipur, Rajasthan, India.

Background: Skin ulcers, especially of the lower extremities, encompass a myriad of causes that a clinician must analyze. Case Re- port. A 45-year-old hypothyroid woman presented with a 6-year history of recurrent widespread eruptions of rashes and ulcers on her skin. Read More

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

Curr Rheumatol Rep 2017 Jul;19(7):39

Division of Rheumatology, Department of Medicine, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.

Purpose Of Review: Rheumatoid vasculitis (RV) is an unusual complication of long-standing rheumatoid arthritis, which is characterized by the development of necrotizing or leukocytoclastic vasculitis involving small or medium-sized vessels. In this review, we aim to provide an update on the epidemiology, pathogenesis, clinical presentation, and management of this challenging extra-articular manifestation.

Recent Findings: RV is heterogenous in its clinical presentation depending on the organ and size of blood vessels involved. Read More

Curr Rheumatol Rep 2017 Jun;19(6):36

Hospital Pablo Tobon Uribe, Calle 78 B # 69-240 consultorio 153, Medellin, Colombia.

Purpose Of Review: To understand the clinical spectrum of cocaine-levamisole-induced vasculitis. Worldwide recreational drug consumption is high among the adult population from various social strata. The use of cocaine with levamisole, a frequently added antiparasitic diluent, favors the manifestations of vasculitic lesions, especially in the skin. Read More

Hautarzt 2017 Jul;68(7):553-559

Konsultations- und Referenzzentrum für Vaskulitis-Diagnostik, MVZ am Marienkrankenhaus gGmbH, Hamburg, Deutschland.

A particular diagnostic situation in the classification of a granulomatous dermatitis results when no circumscribed granulomas but instead a diffuse interstitial histiocytic inflammatory infiltrate, a granulomatous vasculitis or a neoplastic lymphocytic infiltrate is found. Interstitial granulomatous dermatitis was originally described in patients with arthritis. Later, it was recognized that there are also associations with other usually immunological diseases. Read More

Am J Case Rep 2017 Jun 8;18:641-643. Epub 2017 Jun 8.

Department of Medicine, NYC Health + Hospital/Harlem, Columbia University, New York, NY, USA.

BACKGROUND Levamisole is a common adulterant of cocaine. It can cause agranulocytosis and cutaneous vasculitis that can possibly lead to cutaneous necrosis. In all reported cases of levamisole-induced vasculitis, it has been described as a clinical syndrome characterized by a constellation of typical clinical features and a positive serum serology for ANCA levels, especially very high-titer p-ANCA levels, in the background of cocaine abuse. Read More

Clin Case Rep 2017 Jun 12;5(6):1051-1053. Epub 2017 May 12.

Department of PathologyAbington Memorial Hospital/Abington Jefferson Health1200 Old York RoadAbington19001PA.

Leukocytoclastic vasculitis (LCV) is a cutaneous small vessel vasculitis characterized by cutaneous manifestations in the form of palpable purpura, and rarely bullae, vesicles, and ulcerations. Although rare, cephalosporins such as cefazolin, should be recognized to have a potential to trigger LCV. Read More

Hautarzt 2017 Jun 2. Epub 2017 Jun 2.

Klinik- und Poliklinik für Haut- und Geschlechtskrankheiten, Universitätsmedizin Greifswald, F.-Sauerbruchstr., 17475, Greifswald, Deutschland.

Background: Medical compression therapy is widely used to treat phlebologic diseases. Compression bandages as well as compression stockings are used. Compression has been identified to be an effective conservative therapy for the healing of venous ulcers and other indications. Read More

Pan Afr Med J 2017 14;26:138. Epub 2017 Mar 14.

Université du Centre, Tunisie.

Clinical manifestation, etiology and outcome of leukocytoclastic vasculitis are little studied. The aim of our study was to examine epidemiological, clinical etiological, and evolutionary characteristics of this entity. We conducted a cross-sectional data collection from medical records of 85 patients with leukocytoclastic vasculitis in the Department of Dermatology at the Farhat Hached University Hospital, Sousse between January 2000 and December 2013. 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.

Postepy Dermatol Alergol 2017 Apr 13;34(2):104-109. Epub 2017 Apr 13.

Department of Dermatovenereology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey.

Introduction: Vasculitides are a heterogeneous group of diseases characterized by inflammation of the blood vessel walls. Etiological factors include infections, drugs, connective tissue diseases, and malignancies.

Aim: To examine the demographic characteristics, etiological factors, and treatment options in 75 patients with leukocytoclastic vasculitis. Read More

World J Pediatr 2017 Apr 29. Epub 2017 Apr 29.

Departments of Pediatrics C, Schneider Children's Medical Center, Petah Tiqva, Israel.

Background: Acute hemorrhagic edema of infancy (AHEI) is a rare leukocytoclastic vasculitis of the small vessels occurring at a young age and considered as a benign self-limited disease. Due to its low prevalence, there are limited data on the presentation and complications of this disease.

Methods: All computerized files of children who were hospitalized at a tertiary pediatric center due to AHEI over a 10 year period were reviewed. Read More

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

Indian J Pharmacol 2017 Jan-Feb;49(1):124-126

Treatwell Skin Centre, Jammu, Jammu and Kashmir, India.

Drug-induced leukocytoclastic vasculitis is a small-vessel vasculitis that most commonly manifests with palpable purpuric lesions on gravity-dependent areas. Vasculitis occurs within weeks after initial administration of medication and demonstrates clearance upon withdrawal of medication. Levetiracetam, a pyrrolidone derivative, is used as an adjunctive therapy in patients with refractory focal epilepsy, myoclonic epilepsy, and primary generalized tonic-clonic seizures. 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.

Semin Diagn Pathol 2017 May 7;34(3):285-300. Epub 2017 Apr 7.

Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States.

The inflammatory and non-inflammatory disorders affecting the blood vessels are an important cause of death among patients. Additionally, some of the findings could be very subtle, while the consequences of misdiagnosis tragic. There is a limited number of factors by which the cutaneous blood vessels can be affected and the most common examples in the clinical practice will be discussed here: non-inflammatory purpuras; vascular-occlusive disorders; urticarias; vasculitides; and neutrophilic dermatoses. Read More

Tuberc Respir Dis (Seoul) 2017 Apr 31;80(2):210-211. Epub 2017 Mar 31.

Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

Proc (Bayl Univ Med Cent) 2017 Apr;30(2):213-214

University of Texas Dell Medical School, Austin, Texas (Woody); Baylor Scott & White, Marble Falls, Texas (Warren); and Westlake Dermatology, Austin, Texas (Speck, Jackson).

Tumor necrosis factor (TNF)-alpha antagonists are a common treatment modality for autoimmune disorders, but their use can be associated with many side effects, including various dermatologic conditions. Certolizumab pegol, a newer TNF antagonist that lacks the Fc portion of the IgG antibody, has recently been approved to treat psoriatic arthritis, rheumatoid arthritis, and Crohn's disease. Though other TNF antagonists have been associated with leukocytoclastic vasculitis, this finding has not yet been reported with certolizumab pegol. Read More

Cutis 2017 Mar;99(3):189-192

Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, USA.

Imatinib mesylate (imatinib) is a tyrosine kinase inhibitor initially approved by the US Food and Drug Administration in 2001 for chronic myeloid leukemia (CML). Since then, the number of indicated uses for imatinib has substantially increased. It is increasingly important that dermatologists recognize adverse cutaneous manifestations of imatinib and are aware of their management and outcomes to avoid unnecessarily discontinuing a potentially lifesaving medication. Read More

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 Clin Dermatol 2017 Aug;18(4):541-553

Department of Dermatology, University Hospital Jena, Erfurter Straße 35, 07740, Jena, Germany.

Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Read More

Medicine (Baltimore) 2017 Mar;96(12):e6376

aDepartment of Dermatology b2nd Department of Medicine, Jagiellonian University Medical College, Cracow, Poland.

Leukocytoclastic vasculitis (LCV) is a heterogenous group of disorders that may manifest as a mild disease isolated to the skin or be a part of life-threatening systemic vasculitis. According to the 2012 Chapel Hill Consensus Conference nomenclature, patients presenting symptoms of LCV confined only to the skin should be defined as suffering from a single-organ cutaneous small vessel vasculitis (SoCSVV). SoCSVV is a benign disease with a good clinical outcome but with a significant risk of relapse and skin ulcer formation. Read More

Ann Dermatol Venereol 2017 May 18;144(5):349-355. Epub 2017 Mar 18.

Service de dermatologie, hôpital Nord, chemin des Bourrely, 13015 Marseille, France.

Background: The infectious causes of cutaneous vasculitis are well known and include streptococcal infections among others. Cases resulting from parasitic infection are less frequent. Scabies, which is currently on the increase, has only been reported in a few isolated cases. Read More

Fundam Clin Pharmacol 2017 Mar 21. Epub 2017 Mar 21.

University of Zagreb School of Medicine, Šalata 3, 10 000, Zagreb, Croatia.

Dapsone-induced agranulocytosis is a rare but potentially fatal adverse drug reaction (ADR). A 45-year-old male Caucasian patient developed agranulocytosis caused by dapsone (diamino-diphenyl sulfone), which he was prescribed for leukocytoclastic vasculitis. Patient's treatment consisted of termination of dapsone, antibiotic therapy, and granulocyte colony-stimulating factor leading to prompt improvement of symptoms and normalization of laboratory blood values. Read More

An Bras Dermatol 2016 Sep-Oct;91(5 suppl 1):76-78

The Eastern Hospital of The First Affiliated Hospital, Sun Yat-sen University - Guangzhou, China.

Cutaneous reactions associated with interferons (IFNs) treatment are either localized or generalized. The most common presentation of localized reactions at IFNs injection site is usually an erythematous patch or plaque. Local leukocytoclastic vasculitis presenting with cutaneous necrosis is extremely rare. Read More

J Dermatol 2017 Mar;44(3):288-296

Department of Dermatology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.

Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory condition characterized by tissue infiltration with IgG4(+) plasma cells and an elevated serum IgG4 level. It usually occurs in middle-aged or older patients, with male predominance, and can involve multiple organs synchronously or metachronously. Patients with IgG4-RD generally respond to steroid therapy. Read More

Case Rep Pediatr 2017 24;2017:5637503. Epub 2017 Jan 24.

Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA.

Purpura, particularly when accompanied by fever, is a worrisome finding in children. Acute hemorrhagic edema of infancy (AHEI) is a benign type of small-vessel leukocytoclastic vasculitis that presents with progressive purpura and has an excellent prognosis. Patients with AHEI present with large, target-like purpuric plaques affecting the face, ear lobes, and extremities. Read More

Ann Dermatol Venereol 2017 Jun - Jul;144(6-7):423-425. Epub 2017 Feb 24.

Service de dermatologie, hôpital Bichat, université Denis-Diderot, Sorbonne Paris Cité, AP-HP, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.

Background: Acute generalized exanthematous pustulosis (AGEP) is a severe drug eruption. We report herein the first case of AGEP induced by phloroglucinol (Spasfon(®)).

Patients And Methods: A 27-year-old pregnant woman developed a febrile exanthematous pustulosis eruption three days after treatment with intravenous phloroglucinol and paracetamol for nephritic colic. Read More

Rev Med Interne 2017 Feb 16. Epub 2017 Feb 16.

Service de médecine interne et immunologie clinique, hôpital universitaire de Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France; Faculté de médecine, université Paris-Sud, 94275 Le Kremlin-Bicêtre, France; IDMIT, CEA, DSV/iMETI, division d'immunovirologie, 92260 Fontenay-aux-Roses, France; Inserm, U1184, centre d'immunologie des maladies virales et autoimmunes, 94275 Le Kremlin-Bicêtre, France.

Introduction: IgA vasculitis is a systemic small vessel leukocytoclastic vasculitis characterized by skin purpura, arthritis, abdominal pain and nephritis. Most of the abdominal complications are due to edema and hemorrhage in the small bowel wall, but rarely to acute secondary pancreatitis.

Case Report: Here, we report a 53-year-old woman who presented with acute pancreatitis and, secondarily, developed skin purpura and arthritis at the seventh day of the clinical onset. Read More

JAAD Case Rep 2017 Jan 4;3(1):70-73. Epub 2017 Feb 4.

St. Joseph Mercy Dermatology, Ann Arbor, Michigan.

J Cutan Pathol 2017 May 8;44(5):500-503. Epub 2017 Mar 8.

Colorado Springs Health Partners PC, Department of Dermatology and Dermatopathology, Colorado Springs, Colorado.

Bilateral lower extremity inflammatory lymphedema (BLEIL) is a recently described condition that presents with exquisite tenderness, erythema and edema of the lower leg, ankle and dorsal foot resembling an acute cellulitis. It was first reported in healthy, young adult military basic trainees with a normal body mass index during the first 72 hours of arrival to basic training. It occurs while standing at attention for many hours, and shows rapid resolution with elevation and rest. Read More

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

Clin Rheumatol 2017 Mar 6;36(3):729-733. Epub 2017 Feb 6.

Nephrology Center, Toranomon Hospital, 2-2-2, Toranomon, Minato, Tokyo, 105-8470, Japan.

A 41-year-old man was referred to our hospital for the evaluation of hypergammaglobulinemia (IgG 2898 mg/dL and IgA 587 mg/dL), inflammation (CRP 6.7 mg/dL and serum interleukin-6 (IL-6) 15.1 ng/L), and anemia (Hb 10. 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.

Am J Nephrol 2017 28;45(3):209-216. Epub 2017 Jan 28.

Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.

Background: Cocaine is a risk factor for acute kidney injury and chronic kidney disease with progression to end-stage renal disease. Levamisole is an adulterant that is added to cocaine to enhance its euphoric effects. Levamisole-adulterated cocaine (LAC) is associated with the distinct clinical syndromes of agranulocytosis, leukocytoclastic vasculitis, cocaine-induced midline destructive lesions (CIMDL), and ANCA-associated vasculitis (AAV) with pauci-immune necrotizing glomerulonephritis. Read More

J Cutan Pathol 2017 May 2;44(5):494-496. Epub 2017 Mar 2.

Department of Dermatology, Kansai Medical University, Osaka, Japan.

Sarcoidosis is known to be involved in diseases with vasculitis as sarcoid vasculitis. However, vasculitis in cutaneous sarcoidal lesions is extremely rare. Here we describe a case of sarcoidosis with multiple annular skin lesions with granulomatous vasculitis. Read More

Allergol Int 2017 Jul 16;66(3):497-498. Epub 2017 Jan 16.

Department of Dermatology, Nippon Medical School, Tokyo, Japan.

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

Cureus 2016 Nov 28;8(11):e900. Epub 2016 Nov 28.

Department of Internal Medicine, Hospital Centre of Algarve.

A 71-year-old woman presented with constitutional signs and lower extremity palpable purpura after being prescribed a four-day course of 500 mg of ciprofloxacin two times daily for a gastrointestinal infection. She was admitted for inpatient treatment. During the third hospital day, she presented with an episode of abundant hematemesis while her skin lesions remained unchanged. 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

BMJ Case Rep 2017 Jan 4;2017. Epub 2017 Jan 4.

Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

Dabigatran is a non-vitamin K antagonist oral anticoagulant that has been approved for atrial fibrillation and prevention of venous thromboembolism. Its use has been increasing in the USA since serum drug levels do not need monitoring. To date, no significant skin side effects have been reported other than 4 cases of non-specific skin lesion and 2 cases of leukocytoclastic vasculitis (LCV), which is a small vessel inflammatory disease that presents as palpable purpura in lower extremities. 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.

Presse Med 2016 Oct 28. Epub 2016 Oct 28.

Internal Medicine Department of Armed Forces Hospital, Brasília, DF, Brazil.