A rare case of leukocytoclastic vasculitis (E-Poster Presentations)
Dublin Core
Title
A rare case of leukocytoclastic vasculitis (E-Poster Presentations)
Subject
leukocytoclastic vasculitis
Description
Introduction
Leukocytoclastic vasculitis is a rare small vessel vasculitis characterized by immune-complex mediated vasculitis of dermal
capillaries and venules. Its annual incidence is around 45 per million individuals. We present a rare case of leukocytoclastic
vasculitis after a viral upper respiratory infection that responded to steroids.
Case presentation
A 40-year-old female presented to the hospital with rash on her lower extremities, sporadically affecting the buttocks and
abdomen for one week after having upper respiratory symptoms for 1 week. She denied photosensitivity and had no prior history
of similar rashes. Physical examination revealed generalized joint tenderness and a painful purpural rash symmetrically on both
legs. A provisional diagnosis of cutaneous small-vessel-vasculitis secondary to viral aetiology was made. Steroid treatment was
commenced, but her skin condition worsened upon tapering the dose. Investigations ruled out connective tissue or
rheumatological disease but indicated mild IgA elevation. Initial punch biopsy suggested neutrophilic urticarial reactions and
early Sweet's syndrome. The patient developed gastrointestinal symptoms, including diarrhoea and abdominal pain, concomitant
with worsening painful cutaneous manifestations impeding ambulation. Chest and abdominal CT imaging didn’t show evidence of
systemic vasculitis and endoscopy did not reveal any neutrophilic infiltration. A multidisciplinary discussion pointed to
leukocytoclastic vasculitis, recommending a more gradual steroid tapering regimen. Some skin lesions at this time had ulcerated
and topical tacrolimus was advised.
Discussion
The patient's prodromal viral symptoms, the evolution of her classically looking rash, elevated IgA and the response to steroids
corroborated the clinical course consistent with leukocytoclastic vasculitis.
Conclusion
Clinicians should be aware that leukocytoclastic vasculitis could happen in adults although it is rare. Vasculitis should be always suspected in any patient with bilateral symmetric rash.
Leukocytoclastic vasculitis is a rare small vessel vasculitis characterized by immune-complex mediated vasculitis of dermal
capillaries and venules. Its annual incidence is around 45 per million individuals. We present a rare case of leukocytoclastic
vasculitis after a viral upper respiratory infection that responded to steroids.
Case presentation
A 40-year-old female presented to the hospital with rash on her lower extremities, sporadically affecting the buttocks and
abdomen for one week after having upper respiratory symptoms for 1 week. She denied photosensitivity and had no prior history
of similar rashes. Physical examination revealed generalized joint tenderness and a painful purpural rash symmetrically on both
legs. A provisional diagnosis of cutaneous small-vessel-vasculitis secondary to viral aetiology was made. Steroid treatment was
commenced, but her skin condition worsened upon tapering the dose. Investigations ruled out connective tissue or
rheumatological disease but indicated mild IgA elevation. Initial punch biopsy suggested neutrophilic urticarial reactions and
early Sweet's syndrome. The patient developed gastrointestinal symptoms, including diarrhoea and abdominal pain, concomitant
with worsening painful cutaneous manifestations impeding ambulation. Chest and abdominal CT imaging didn’t show evidence of
systemic vasculitis and endoscopy did not reveal any neutrophilic infiltration. A multidisciplinary discussion pointed to
leukocytoclastic vasculitis, recommending a more gradual steroid tapering regimen. Some skin lesions at this time had ulcerated
and topical tacrolimus was advised.
Discussion
The patient's prodromal viral symptoms, the evolution of her classically looking rash, elevated IgA and the response to steroids
corroborated the clinical course consistent with leukocytoclastic vasculitis.
Conclusion
Clinicians should be aware that leukocytoclastic vasculitis could happen in adults although it is rare. Vasculitis should be always suspected in any patient with bilateral symmetric rash.
Creator
Mahrukh Asad Chandna, Kubranur Durmaz, Mohamed Mortagy, Ahmed Elsandouby
Source
Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD
Publisher
From Zero to Hero Medical Education LTD
Date
10 July 2024.
Contributor
Sri Wahyuni
Format
PDF
Language
English
Type
Text
Files
Citation
Mahrukh Asad Chandna, Kubranur Durmaz, Mohamed Mortagy, Ahmed Elsandouby, “A rare case of leukocytoclastic vasculitis (E-Poster Presentations),” Repository Horizon University Indonesia, accessed April 13, 2026, https://repository.horizon.ac.id/items/show/12000.