Learn About Leukocytoclastic Vasculitis Causes, Symptoms, Diagnosis and Treatment

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What Is Leukocytoclastic Vasculitis?

Vasculitis is a general term that describes an inflammation of your blood vessels that causes changes in blood vessel walls, such as scarring, thickening, narrowing and weakening, according to MayoClinic.com. Vasculitis can present as acute or chronic and affect any age or gender. The type of vasculitis is determined by the size and type of blood vessel that is affected. Leukocytoclastic vasculitis is the inflammation of small blood vessels.

Symptoms

Symptoms common with most types of vasculitis include muscle and joint pain, fever, poor appetite and fatigue. The presence of a skin rash is the main symptom in LV. Other symptoms may include skin ulceration, burning skin lesions, itchy skin and painful skin lesions.

Diagnosis

Diagnosing hypersensitivity vasculitis includes multiple tests to rule out involvement of other organs; specifically the heart, lungs, digestive system and musculoskeletal system. Laboratory tests may include:

  • a complete blood cell count
  • urinalysis
  • blood cultures to rule out infection
  • rheumatoid factor titers and antinuclear antibody tests to look for rheumatoid arthritis, systemic lupus erythematosus and Sjogren’s syndrome.

A skin biopsy is the most definitive diagnosis for HV found only on the skin, but it does not confirm or rule out other types of systemic vasculitis.

In 1990, the American College of Rheumatology developed criteria for determining hypersensitivity vasculitis. At least three of the following five criteria must be present for a diagnosis:

  1. Over the age of 16
  2. Use of a drug prior to symptom development
  3. Slightly elevated rash that does not blanch with pressure
  4. Flat and raised lesions
  5. Biopsy showing granulocytes

Causes

Vasculitis of small vessels may be idiopathic, or of unknown origin; however, there are many known causes, such as infections, medications, connective tissue diseases and malignancy, according to the American Academy of Family Physicians. In addition, some disease processes, such as HIV and Crohn’s disease, may present symptoms of leukocytoclastic vasculitis.

Treatment

In cases of LV that involve only the skin, rash symptoms usually resolve within a few weeks to months. Comfort measures such as elevating the affected limb, protecting your skin from injury, and taking over-the-counter analgesics may be all that is necessary. If there is an underlying cause, such as an allergic reaction to medication or an infection, eliminating the trigger is usually effective in relieving the symptoms.

For symptoms that do not respond to conservative treatment, medications such as corticosteroids, nonsteroidal anti-inflammatory drugs, colchicine, Dapsone or hydroxychloroquine may be required.

Prognosis

The prognosis for vasculitis is variable and directly related to the specific form. Since LV is a benign disorder that most often affects only the skin, the prognosis is good with prompt and adequate treatment. For LV that is secondary to underlying disease processes or disorders, the prognosis depends on the response of the primary cause to treatment.

References

MayoClinic: Vasculitis https://www.mayoclinic.com/health/vasculitis/DS00513

American College of Rheumatology: Criteria for Hypersensitivity Vasculitis https://www.rheumatology.org/practice/clinical/classification/hsv.asp

American Academy of Family Physicians: Diagnosing Leukocytoclastic Vasculitis https://www.aafp.org/afp/991001ap/1421.html

DermNet NZ: Treatment of Small Vessel Vasculitis https://dermnetnz.org/vascular/vasculitis.html