Leukocytoclastic vasculitis. Review of 51 cases.

Abstract

Leukocytoclastic vasculitis (L.V.) is a polymorphous inflammatory dermatosis, characterized clinically by palpable purpura of the lower legs and, histologically by fibrinoid change in the small dermal vessels as well a polymorphonuclear infiltrate and nuclear dust. Fifty one cases (33 females and 18 males) of histologically confirmed L.V., seen at the Dermatologic Clinic, University Hospital of Coimbra, are reviewed. The most common type of skin lesions found were palpable purpura (80%), erythematous papules, vesicles and bullae (45%). Systemic manifestations occurred in 32 patients (63%), predominantly fever (33%), arthralgias (27%), malaise (18%) and gastro-intestinal pain (10%). The most frequent laboratory abnormality was a high E.S.R. found in 80% of the patients tested. Possible causative agents could be identified in 37 patients (73%) and included drugs in 12 patients (24%), drugs and infections in 16 (31%) and infection in 3 (6%). Three patients had malignancies and 2 had rheumatoid arthritis. The course of the disorder was acute in 25 cases (49%), recurrent in 14 (27%) and chronic in 10 (20%). The majority of patients (61%) were treated with systemic corticosteroids.