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Management of leukocytoclastic vasculitis
C Sunderkötter1, G Bonsmann, A Sindrilaru
1Department of Dermatology and Allergology, University of Ulm, Germany. cord.sunderkoetter@medizin.uni-ulm.de
The Journal of Dermatological Treatment
|October 27, 2005
Summary
Leukocytoclastic vasculitis (LcV) is common skin vasculitis from immune complexes. Diagnosis involves history, biopsy, and tests; treatment varies by type and severity, often not requiring aggressive therapy.
Area of Science:
- Dermatology
- Rheumatology
- Immunology
Background:
- Leukocytoclastic vasculitis (LcV) is the most frequent form of cutaneous vasculitis.
- It typically arises from immune complex deposition within vessel walls.
- LcV presents diversely, often linked to various underlying conditions.
Purpose of the Study:
- To establish diagnostic guidelines for LcV.
- To differentiate LcV subtypes and assess systemic involvement.
- To identify potential underlying causes of LcV.
Main Methods:
- Review of diagnostic approaches for LcV.
- Emphasis on patient history, including drug intake and infections.
- Biopsy with immunofluorescence, blood counts, urinalysis, and throat swabs are key diagnostic tools.
Main Results:
- IgA-dominant LcV (Henoch-Schönlein purpura) suggests systemic involvement.
- LcV associated with IgG or IgM immune complexes generally has a better prognosis.
- Other forms include cryoglobulinemic, urticarial, ANCA-associated, and LcV linked to SCLE/SLE or sepsis.
Conclusions:
- Diagnostic work-up aims to classify LcV type and extent, guiding treatment.
- Treatment for immune complex LcV is often conservative, focusing on triggers and supportive care.
- Corticosteroids are reserved for skin necrosis; colchicine and dapsone are options for chronic cases.