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Cutaneous Vasculitis  [PDF]
Nilsel ?lter,Esra Ad??en
Turkderm , 2010,
Abstract: Vasculitis is defined as inflammation directed at vessels, which compromises or destroys the vessel wall leading to haemorrhagic and/or ischaemic events. Although the most common clinical finding of vasculitis is palpable purpura, patients may also present with other lesions including urticaria, infiltrative erythema, petechiae, purpura, purpuric papules, haemorrhagic vesicles and bullae, nodules, livedo reticularis, deep ulcers and digital gangrene. Classification systems have been important in the study of vasculitic diseases, and the most widely accepted one is based on the size of the vessel involved. This article will focus on the most common forms of cutaneous vasculitis.
Cutaneous vasculitis with peripheral neuropathy  [cached]
Joshi R,Phadke V,Wadhwa S
Indian Journal of Dermatology, Venereology and Leprology , 1995,
Abstract: a 40-year-old male patient presented with cutaneous vasculitis affecting both lower legs without any evidence of systemic involvement and a bilateral sensory neuropathy affecting both lateral popliteal nerves. Treatment with oral prednisolone resulted in healing of the cutaneous lesions but the sensory loss persisted.
Anti-proteinase 3 antibodies in diffuse systemic sclerosis (SSc) with normotensive renal impairment: is it suggestive for an overlapping between SSc and idiopathic vasculitis?  [cached]
F. Bellisai,G. Morozzi,M.R. Bacarelli,A. Radice
Reumatismo , 2011, DOI: 10.4081/reumatismo.2001.33
Abstract: Objective. To test the prevalence of anti-neutrophil cytoplasmic antibodies (ANCA) in systemic sclerosis (SSc) and to verify a possible association of ANCA with normotensive renal involvement in SSc. Patients and methods: 51 patients affected by SSc, 35 with diffuse scleroderma (dSSc) and 16 with limited scleroderma (lSSc), were tested for ANCA by indirect immunofluorescence (IIF) on human ethanol and formalin-acetone-fixed granulocytes (before and after DNase treatment), by conventional enzyme linked immuno-sorbent assay (ELISA) and by capture-ELISA. Results. Six out of 51 selected SSc patients had ANCA by IIF (11.7%) and five presented a perinuclear/nuclear atypical ANCA pattern. In all cases we only found anti-proteinase3 (aPR3) antibodies. All ANCA positive patients had diffuse form of SSc (17.1%), all were anti-Scl70 positive (aScl70), five patients had proteinuria, three had microscopic haematuria. All ANCA positive patients were normotensive with normal renin plasma levels, the mean erythrocyte sedimentation rate (ESR) was higher in this group compared to the other SSc patients. Conclusions. Our study shows that aPR3 is not rare in dSSc. According to the clinical and serological findings and to the recent literature, we can hypothesise that when ANCA are found in SSc, an overlapping of scleroderma with systemic necrotizing vasculitis should be suspected.
Aspirin induced leukocytoclastic vasculitis, lower gastrointestinal hemorrhage and acute renal failure (mimicking systemic vasculitis)
Fahdah A. Alokaily,Mushabab Alghamdi,Ahmad S. Almalki,Hussa Alhussaini
Saudi Medical Journal , 2013,
Abstract: This is a case of a 60-year-old gentleman who presented with an extensive cutaneous vasculitic rash (leukocytoclastic) with lower gastrointestinal bleeding following a small dose of aspirin (81 mg). The aspirin was stopped immediately. Three weeks later, he had acute renal failure, which was initially thought to be secondary to systemic vasculitis, but proved to be acute renal tubular necrosis as a delayed reaction to aspirin.
Cutaneous leukocytoclastic vasculitis associated with levofloxacin therapy  [cached]
Dana Blyth,Elizabeth Markelz,Jason Okulicz
Infectious Disease Reports , 2012, DOI: 10.4081/idr.2012.e11
Abstract: Many cases of cutaneous vasculitis are druginduced with histology revealing leukocytoclastic vasculitis (LCV). We present a case of levofloxacin- associated LCV successfully treated with prednisone and cessation of the offending drug. Although case reports describe a link between LCV and older fluoroquinolones, such as ciprofloxacin and ofloxacin, recent reports have implicated the newer fluoroquinolone levofloxacin. Recognition of fluoroquinoloneinduced cutaneous vasculitis is important as continuation or re-exposure of the offending agent may have life-threatening consequences.
Gastroenterology Cases of Cutaneous Leukocytoclastic Vasculitis  [PDF]
Cumali Karatoprak,Elif Arabaci,Kemal Yildiz,Mustafa Cakirca,Mehmet Ali Cikrikcioglu,Fatih Ergun,Ahmet Danalioglu,Orhan Kocaman,Hakan Senturk
Case Reports in Medicine , 2013, DOI: 10.1155/2013/264189
Abstract: Rarely, leukocytoclastic vasculitis can result from ischemic colitis, inflammatory bowel disease, and cryoglobulinemia. There is no established standard for the treatment of leukocytoclastic vasculitis associated with gastroenterologic diseases. This paper presents three cases of leukoytoclastic vasculitis, each of which is associated with a different gastroenterologic condition: ischemic colitis, Crohn’s disease, and chronic hepatitis C. Each condition went into remission by treatment of leukocytoclastic vasculitis, regardless of the underlying disease. 1. Introduction Vasculitis is an uncommon disease caused by destruction, necrosis, and inflammation of vessel walls of all types and sizes, especially small vessels such as postcapillary venules. Among small vessel vasculitides, cutaneous leukocytoclastic vasculitis (LV) is the most common [1]. LV may be idiopathic, or caused by viral, bacterial, and parasitic infections or by vaccines, insect bites, drugs, chemicals, toxins, rheumatologic diseases, or systemic diseases such as cancer [2, 3]. Infections, drugs, and malignant diseases are the most common causes of LV [4], but even with additional testing, identification of the particular etiologic agent can be difficult. LV may, rarely, result from inflammatory bowel disease and cryoglobulinemia. The association between ischemic colitis and LV has not been reported in the literature. The rare cases of LV associated with gastroenterologic diseases have no established standard for the treatment. This paper presents three cases of cutaneous LV, each associated with a different gastroenterologic condition: ischemic colitis, Crohn’s disease, and chronic hepatitis C. The treatment of LV caused remission in all of them, regardless of the underlying disease. Case 1. A 73-year-old male patient suffering from bloody diarrhea that had begun 3 weeks before was referred to us. He also had purpura-like rash on both lower extremities. In his history, he had been diagnosed with hypertension and pulmonary thromboembolism one year before. Our physical examination revealed widespread abdominal tenderness without defender or rebound. Stool microscopy showed an abundance of leukocytes and erythrocytes; his body temperature was 37.3°C. Laboratory test results were normal except for his C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) (Table 1). The patient’s stool culture proved negative, so a colonoscopy was performed. It revealed severe colitis beginning from the distal sigmoid colon and reaching to the midtransverse colon, suggestive of ischemic colitis
Childhood cutaneous vasculitis : A comprehensive appraisal
Palit Aparna,Inamadar Arun
Indian Journal of Dermatology , 2009,
Abstract: Cutaneous vasculitides in childhood are rare and often present with clinical features distinct from adults. Diagnosis of cutaneous vasculitides in children was difficult because of lack of a satisfactory classification systems for this age group. A new international classification system for childhood vasculitis has been discussed in the following section along with important clinical features, diagnostic modalities, and recent therapeutic developments of important vasculitides in children.
Histopathological study of 60 cases of cutaneous vasculitis
Mittal R,Chopra Adarsh,Gill S,Kiranjot
Indian Journal of Dermatology, Venereology and Leprology , 1996,
Abstract: Sixty cases of cutaneous vasculitis were selected from department of Skin and STD, Government Medical College/Rajendra Hospital, Patiala. Detailed history, general physical examination, systemic examination and dermatological examination were conducted in each and every case. Routine investigations were done. Clinical diagnosis was confirmed by biopsy. Histopathologic study was conducted by using H &E stain under 100X and 400X by light microscopy.
Serum immunoglobulin estimation in 30 cases of cutaneous vasculitis  [cached]
Mittal R,Chopra Adarsh,Kaur Kiranjeet,Kiranjot
Indian Journal of Dermatology, Venereology and Leprology , 1996,
Abstract: Clinically diagnosed and histopathologically proved 30 cases of cutaneous vasculitis (CV) were collected from Dermatovenereology department. Serum immunoglobulins (Igs) estimation was done in all cases. Nineteen cases showed increased levels of Igs, 4 had decreased levels, while in 7 cases Igs levels remained normal. Seventeen had increase in IgG, 17 cases had in IgA and 10 in IgM and decrease in levels of IgM was seen in 3, and IgA in 2 cases. But the fluctuation in levels of Igs was statistically insignificant.
Infliximab for Idiopathic Deep Cutaneous Vasculitis Refractory to Cyclophosphamide  [PDF]
Marcelo Derbli Schafranski,Giuliano Doretto Campanari
International Journal of Vascular Medicine , 2010, DOI: 10.1155/2010/951850
Abstract: Cutaneous vasculitis can be classified as primary or idiopathic; or secondary, when it presents as a manifestation of connective tissue diseases, infections, drug reactions or malignancies. Although most of the idiopathic cases are self-limited and responsive to supportive measures and nonsteroidal anti-inflammatory drugs, potent immunosuppressants are sometimes required for the management of the refractory situations. Here we describe a case of a 32-year-old Caucasian female patient with history of idiopathic cutaneous deep vasculitis unresponsive to methotrexate, dapsone, and cyclophosphamide who was effectively treated with infliximab. 1. Introduction Cutaneous vasculitis, a disease with an annual incidence rate ranging from 39.6 to 59.8 per million [1], can be classified as primary or idiopathic; or secondary, when it presents as a manifestation of connective tissue diseases, infections, drug reactions or malignancies [2]. Although most of the idiopathic cases are self-limited and responsive to supportive measures (limb elevation, warming, avoid standing) and nonsteroidal anti-inflammatory drugs, potent immunosuppressants are sometimes required for the management of the refractory situations [3]. We herein describe a case of a 32-year-old Caucasian female patient with history of idiopathic cutaneous deep vasculitis unresponsive to methotrexate, dapsone, and cyclophosphamide, who was effectively treated with infliximab. 2. Case Report The patient felt well until September 2005, when palpable painful nodules and multiple ulcerated lesions developed in both legs and ankles. There was no history of arthritis, rashes, photosensitivity, other skin lesions, mouth ulcers, gastrointestinal, or urogenital symptoms. Antinuclear antibody (ANA), rheumatoid factor (RF), anti-neutrophil cytoplasmatic antibodies (ANCA), anti-RO, anti-LA, anti-HIV, HBsAg, HCV, antistreptolysin O (ASO), and cryoglobulins tested negative; complete blood count and a serum thyroid-stimulating hormone (TSH) determination were normal, as were a chest X-ray. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were markedly elevated (90?mmHg on the first hour and 45?mg/dL—normal: 0–6?mg/dL; resp.), and there was a polyclonal gammopathy on a serum protein electrophoresis test. Examination of a skin smear sample to identify Mycobacterium leprae was negative. A cutaneous biopsy revealed fibrinoid degeneration of the perivascular and vessels walls collagen, as well as mononuclear and neutrophilic infiltrates extending to the deeper dermis and the presence of leukocytoclasia,
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