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Leukocytoclastic vasculitis

Evidence: Immune-mediated

Names

LCV
Cutaneous Leukocytoclastic vasculitis
Hypersensitivity Vasculitis
Hypersensitivity Angitis
Henoch-Schonlein Purpura

Description

Leukocytoclastic vasculitis refers to the inflammation of the small blood vessels in your skin. This occurs when neutrophils (a type of immune cell) enter the walls of small blood vessels where they disintegrate, leaving behind fragments. It may be triggered by a variety of different factors; however, approximately half of the cases are idiopathic (i.e. have unknown cause). Some triggers include infections, certain drugs, collagen vascular disease, autoimmune disease, or neoplastic disease.  Drugs and infections are the most common triggers.

Symptoms of the skin usually develop about a week after the triggering event. Approximately, 90% of patients will have spontaneous healing of skin lesions within weeks to months, and about 10% will have chronic or recurrent disease.

Henoch-Schonlein Purpura is a subtype of Leukoclastic vasculitis that affects children and is usually triggered by an upper respiratory infection.

Patient Groups

Bloggers

Prevalence

US Cases per year: 4,500 [Arora 2014] Most cases resolve in a few months, chronic cases resolve in 2 to 4 years.

Typical Age of onset

Occurs in all ages and in both males and females, however it typically presents in adult-age.
Henoch-Schonlein Purpura: 6 years of age.
Baigrie D, Bansal P, Goyal A, et al. (2020)

Symptoms

  • Raised purple-red spots (palpable purpura)

  • Pain and burning 

  • Itchiness

  • Fluid-filled sacs (bullae)

  • Bumps on the skin containing pus (pustules)

  • Abnormal lumps below the skin (nodules)

  • Crusted ulcers

  • Mottled skin (livedo reticularis)

  • Generalized systemic symptoms (low-grade fever, weight loss, muscle aches, joint pain, abdominal pain, vomiting, coughing, weakness) 

  • Rash on lower legs (1 out of 3 individuals also develop rash on the trunk and upper extremities)

Baigrie D, Bansal P, Goyal A, et al. (2020)