Posters
Presentation Type
Poster
Discipline Track
Patient Care
Abstract Type
Case Report
Abstract
Background: Leukocytoclastic vasculitis (LCV) is a histopathologic term for isolated cutaneous small vessel vasculitis (CSVV) without systemic involvement. LCV can be idiopathic or caused by medications, infections, vascular disorders or malignancies. The annual incidence of biopsy-proven leukocytoclastic vasculitis is approximately 45/million individuals. It presents as erythematous macules with palpable purpura bilaterally on dependent areas of the body. Unilateral and localized presentations are uncommon. Here, we present a rare case of isolated LCV on the abdomen.
Case Presentation: A 65 year old woman with a history of vitiligo and Raynaud’s Syndrome, presented with a 12 day history of a tender abdominal rash associated with fevers at home, but no other systemic symptoms. The patient was started on multiple antibiotics in the outpatient setting without any improvement. The rash continued to expand and darken prompting her ED visit. On evaluation, vital signs were unremarkable. Abdominal inspection was significant for a large violaceous, palpable rash over the lower abdomen which was tender and warm to touch. Labs showed leukocytosis of 16K, sedimentation rate 104, ANA titer 1:80 but ANCA, antiphospholipid antibodies, HIV/Hepatitis serology, blood cultures, Ds-DNA, and RF were negative. Skin punch biopsy was performed from the right lower abdomen which was consistent with leukocytoclastic vasculitis and thrombotic vasculopathy with ischemic epidermal necrosis. Immunofluorescent studies were negative.
Conclusions: Our case represents a rare presentation of LCV, localized in a non-dependent area. LCV should not be missed, as it can clinically mimic cellulitis, but would require a different management.
Academic/Professional Position
Resident
Mentor/PI Department
Internal Medicine
Recommended Citation
Hammad, Dina; Thierry, Marco; Loftis, Christine E.; and Gutierrez, Cesar, "It’s Not Always Cellulitis: An Unusual Presentation of Leukocytoclastic Vasculitis" (2023). Research Symposium. 126.
https://scholarworks.utrgv.edu/somrs/theme1/posters/126
Included in
It’s Not Always Cellulitis: An Unusual Presentation of Leukocytoclastic Vasculitis
Background: Leukocytoclastic vasculitis (LCV) is a histopathologic term for isolated cutaneous small vessel vasculitis (CSVV) without systemic involvement. LCV can be idiopathic or caused by medications, infections, vascular disorders or malignancies. The annual incidence of biopsy-proven leukocytoclastic vasculitis is approximately 45/million individuals. It presents as erythematous macules with palpable purpura bilaterally on dependent areas of the body. Unilateral and localized presentations are uncommon. Here, we present a rare case of isolated LCV on the abdomen.
Case Presentation: A 65 year old woman with a history of vitiligo and Raynaud’s Syndrome, presented with a 12 day history of a tender abdominal rash associated with fevers at home, but no other systemic symptoms. The patient was started on multiple antibiotics in the outpatient setting without any improvement. The rash continued to expand and darken prompting her ED visit. On evaluation, vital signs were unremarkable. Abdominal inspection was significant for a large violaceous, palpable rash over the lower abdomen which was tender and warm to touch. Labs showed leukocytosis of 16K, sedimentation rate 104, ANA titer 1:80 but ANCA, antiphospholipid antibodies, HIV/Hepatitis serology, blood cultures, Ds-DNA, and RF were negative. Skin punch biopsy was performed from the right lower abdomen which was consistent with leukocytoclastic vasculitis and thrombotic vasculopathy with ischemic epidermal necrosis. Immunofluorescent studies were negative.
Conclusions: Our case represents a rare presentation of LCV, localized in a non-dependent area. LCV should not be missed, as it can clinically mimic cellulitis, but would require a different management.