Dermatológia pre prax 4/2023

Cutaneous leukocytoclastic vasculitis

Cutaneous leukocytoclastic vasculitis is the most common vasculitis affecting skin. It is typically manifested by symmetric palpable purpura on the lower extremities. The etiopathogenesis includes deposition of immune complexes in postcapillary venules of the skin. The most common antigens are infectious microorganisms, drugs, autoantigens and tumors. Vasculitis is primarily diagnosed on the basis of skin biopsy findings. Cutaneous leukocytoclastic vasculitis is limited to the skin, with little or no systemic involvement and the absence of symptoms characteristic of other systemic vasculitis. Treatment of cutaneous leukocytoclastic vasculitis primarily focuses on removal of the underlying cause. Depending on the severity of the condition and comorbidities, nonsteroidal antiphlogistics, antihistamines and corticosteroids are administered. Other therapeutic options include dapsone, hydroxychloroquine, colchicine, and pentoxifylline. In refractory cases, combination of corticosteroids with immunosuppressive agents such as azathioprine, methotrexate, cyclosporine have shown effectiveness.

Keywords: cutaneus leukocytoclastic vasculitis, hypersensitivity vasculitis, palpable purpura, deposits of immunocomplexes