Leukocytoclastic angiitis induced by clindamycin

Area of Science:

• Dermatology
• Rheumatology
• Pharmacology

Background:

• Leukocytoclastic vasculitis (LCV) is a small-vessel vasculitis with various potential causes.
• Drug-induced vasculitis is an important differential diagnosis in patients presenting with LCV.

Observation:

• A 56-year-old male with diabetes experienced a skin eruption consistent with LCV.
• The patient had recently been treated with clindamycin for a diabetic foot ulcer infection.

Findings:

• The patient's LCV resolved after discontinuing clindamycin.
• The vasculitis recurred upon re-challenge with clindamycin and again resolved upon withdrawal.
• This strongly suggests clindamycin as the causative agent for the LCV.

Implications:

• Clindamycin can induce leukocytoclastic vasculitis as an idiosyncratic drug reaction.
• Clinicians should consider clindamycin and lincomycin allergy in the differential diagnosis of LCV, especially in patients using these antibiotics.
• Prompt recognition and drug withdrawal are crucial for managing drug-induced LCV.