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Published on: September 26, 2019
Leucocytoclastic vasculitis in severe ulcerative colitis.
Donald Martin1, Tristan Handler, Joseph McDermott
1Department of Internal Medicine, 48 MDOS/SGOMI, Unit 5210 Box 320, RAF Lakenheath, Brandon, Suffolk IP27 9PN, United Kingdom.
Ulcerative colitis can cause skin issues like leucocytoclastic vasculitis. Treatment with mesalamine and infliximab resolved lesions, which did not recur after colectomy.
Area of Science:
- Gastroenterology and Dermatology
- Immunopathology
Background:
- Ulcerative colitis (UC) is an inflammatory bowel disease.
- Extraintestinal manifestations (EIMs) are common in UC, including skin conditions like erythema nodosum and pyoderma gangrenosum.
- Leukocytoclastic vasculitis (LCV) is a rare skin manifestation of UC.
Observation:
- A 26-year-old military pilot with UC experienced recurrent LCV during a severe flare.
- Initial treatment with corticosteroids was partially effective.
- Subsequent treatment with mesalamine and infliximab resolved the LCV lesions.
Findings:
- LCV resolved with medical therapy targeting UC.
- LCV did not recur after total colectomy for medically refractory UC.
- This case suggests a potential link between UC activity and LCV.
Implications:
- LCV may be an underrecognized EIM of UC.
- Targeting underlying UC inflammation may resolve LCV.
- Further research into the immunopathophysiology linking UC and LCV is warranted.
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