Novel Inflammatory Markers Associated With Cutaneous Leukocytoclastic Vasculitis Etiology

We aimed to compare inflammatory markers and determine their potential role in distinguishing secondary leukocytoclastic vasculitis (SLV) from idiopathic leukocytoclastic vasculitis (ILV).

We included in this cross-sectional study patients with cutaneous leukocytoclastic vasculitis (CLV) diagnosed on cutaneous biopsy. We assessed clinical and laboratory data and then calculated platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP)-to-albumin ratio (CAR), and fibrinogen-to-albumin ratio (FAR). We have also defined the number of positive etiological examination (NPE) as the sum in a unique patient of the positive paraclinical examinations involved in the etiological assessment of CLV.

In total 77 patients were included, with 52 SLV group patients and 25 in the ILV group, mean age was 44+/-18 vs 49+/-21, and gender ratio was 29/23 vs 11/14. Comparison of PLR, NLR, CAR, and FAR showed significant differences in mean values between SLV and ILV groups with 199.1 (117.3-309.8) vs 126.8 (79-193) (P = 0.01) for PLR, 3.6 (1.9-5.1) vs 2.3 (1.7-3.4) (P = 0.048) for NLR, 1.9 mg.g-1 (0.4-3.6) vs 0.6 mg g-1 (0.2-1.9) (P = 0.043) for CAR, and 155.8 mg.g-1 (90.7-192.3) vs 108.7 mg.g-1 (82.2-148.1) (P = 0.034) for FAR. PLR, CAR, and FAR were positively correlated to NPE (r = 0.463, P < 0.001; r = 0.434, P < 0.001; and r = 0.411, P < 0.001, respectively), and there was no significant correlation between NLR and NPE (r = 0.165, P = 0.151).

This is the first study to investigate PLR, NLR, CAR, and FAR in CLV, and it demonstrates that elevation of these ratios is associated with SLV, which leads us to suggest to exhaustively explore patients with elevated ratios.