Leukocytoclastic vasculitis (cutaneous small-vessel vasculitis) after COVID-19 vaccination

Leukocytoclastic small-vessel vasculitis of the skin (with or without systemic involvement) is often preceded by infections such as common cold, tonsillopharyngitis, or otitis media. Our purpose was to document pediatric (≤18 years) cases preceded by a symptomatic disease caused by an atypical bacterial pathogen. We performed a literature search following the Preferred Reporting of Systematic Reviews and Meta-Analyses guidelines. We retained 19 reports including 22 cases (13 females and 9 males, 1.0 to 17, median 6.3 years of age) associated with a Mycoplasma pneumoniae infection. We did not find any case linked to Chlamydophila pneumoniae, Chlamydophila psittaci, Coxiella burnetii, Francisella tularensis, or Legionella pneumophila. Patients with a systemic vasculitis (N = 14) and with a skin-limited (N = 8) vasculitis did not significantly differ with respect to gender and age. The time to recovery was ≤12 weeks in all patients with this information. In conclusion, a cutaneous small-vessel vasculitis with or without systemic involvement may occur in childhood after an infection caused by the atypical bacterial pathogen Mycoplasma pneumoniae. The clinical picture and the course of cases preceded by recognized triggers and by this atypical pathogen are indistinguishable.

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Leukocytoclastic Vasculitis/Cutaneous Small Vessel Vasculitis

Inpatient Dermatology ◽

10.1007/978-3-319-18449-4_47 ◽

2018 ◽

pp. 233-235

Author(s):

Aileen Y. Chang

Keyword(s):

Leukocytoclastic Vasculitis ◽

Small Vessel ◽

Small Vessel Vasculitis

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Mycoplasmal upper respiratory infection presenting as leukocytoclastic vasculitis

Infectious Disease Reports ◽

10.4081/idr.2015.5605 ◽

2015 ◽

Vol 7 (1) ◽

Author(s):

Mana Rao ◽

Abhinav Agrawal ◽

Manan Parikh ◽

Rikka Banayat ◽

Maria Joana Thomas ◽

...

Keyword(s):

Respiratory Tract ◽

Leukocytoclastic Vasculitis ◽

Small Vessel ◽

Stevens Johnson Syndrome ◽

Small Vessel Vasculitis ◽

Upper Respiratory Tract ◽

Cutaneous Lesions ◽

Upper Respiratory Infection ◽

Mycoplasmal Infection ◽

Upper Respiratory

Mycoplasma is a virulent organism that is known to primarily infect the respiratory tract; however, affection of the skin, nervous system, kidneys, heart and bloodstream has been observed in various forms, which include Stevens Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, encephalitis, renal failure, conduction system abnormalities and hemolytic anemia. Small vessel vasculitis is a lesser-known complication of mycoplasma pneumonia infection. We report a case of mycoplasmal upper respiratory tract infection with striking cutaneous lesions as the presenting symptom. Mycoplasmal infection was confirmed by serology testing, skin biopsy was suggestive of leukocytoclastic vasculitis. This case brings forth an uncommon manifestation of mycoplasmal infection with extra-pulmonary affection, namely small vessel vasculitis.

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Case Report: Systemic Small-Vessel Vasculitis in an Adolescent With Active Ulcerative Colitis

Frontiers in Pediatrics ◽

10.3389/fped.2021.617312 ◽

2021 ◽

Vol 9 ◽

Author(s):

Marleen Bouhuys ◽

Wineke Armbrust ◽

Patrick F. van Rheenen

Keyword(s):

Ulcerative Colitis ◽

Abdominal Pain ◽

Gastrointestinal Tract ◽

Leukocytoclastic Vasculitis ◽

Foot Drop ◽

Small Vessel ◽

Antineutrophil Cytoplasmic Antibodies ◽

Small Vessel Vasculitis ◽

Induction Treatment ◽

High Dose

Introduction: Small-vessel vasculitis (SVV) is a rare immunological disease that affects arterioles, capillaries and venules. It causes purpura, but can also manifest in other organs, including the gastrointestinal tract. SVV and inflammatory bowel disease (IBD) co-occur more frequently than would be expected by chance.Case description: A 16-year-old girl, who had been diagnosed with ulcerative colitis (UC) 2 years earlier at a general hospital, developed purpura, progressive abdominal pain with frequent bloody diarrhea and frontotemporal headache and swelling while on azathioprine and mesalamine maintenance therapy. Serology was positive for perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) without antiprotease- or myeloperoixidase antibodies. Endoscopy revealed active left-sided UC and atypical ulcerations in the ascending colon. Biopsies of these ulcerations and of affected skin revealed leukocytoclastic vasculitis. Initially this was interpreted as an extraintestinal manifestation of UC that would subside when remission was induced, consequently infliximab was started. Over the next 3 weeks she developed severe burning pain in her right lower leg that progressed to a foot drop with numbness and the purpura progressed to bullous lesions. The diagnosis was adjusted to ANCA-associated vasculitis with involvement of skin, bowel and peripheral nerves. Infliximab was discontinued and induction treatment with high-dose prednisolone and cyclophosphamide was given until remission of SVV and UC was achieved. Subsequently, infliximab induction and maintenance was re-introduced in combination with methotrexate. Remission has been maintained successfully for over 2 years now. The foot drop only partly resolved and necessitated the use of an orthosis.Conclusion: Pediatric patients with IBD who present with purpuric skin lesions and abdominal pain should be evaluated for systemic involvement of SVV, which includes endoscopic evaluation of the gastrointestinal tract. We discuss a practical approach to the diagnosis, evaluation and management of systemic SVV with a focus on prompt recognition and early aggressive therapy to improve outcome.

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Small Vessel Vasculitis: Leukocytoclastic Vasculitis

Absolute Dermatology Review ◽

10.1007/978-3-319-03218-4_12 ◽

2016 ◽

pp. 41-48

Author(s):

Hugh Morris Gloster ◽

Lauren E. Gebauer ◽

Rachel L. Mistur

Keyword(s):

Leukocytoclastic Vasculitis ◽

Small Vessel ◽

Small Vessel Vasculitis

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The enigma of adult onset Henoch Schoenlein purpura and leucocytoclastic Vasculits: a case report

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20211718 ◽

2021 ◽

Vol 7 (3) ◽

pp. 482

Author(s):

Vasudha A. Belgaumkar ◽

Ravindranath B. Chavan ◽

Nitika S. Deshmukh ◽

Ranjitha K. Gowda

Keyword(s):

Connective Tissue ◽

Histopathological Examination ◽

Leukocytoclastic Vasculitis ◽

Connective Tissue Diseases ◽

Bed Rest ◽

Final Diagnosis ◽

Small Vessel ◽

Small Vessel Vasculitis ◽

Adult Onset ◽

Diffuse Abdominal Pain

<p class="abstract">Leukocytoclastic vasculitis (LCV), also known as hypersensitivity vasculitis is a small vessel inflammatory disease which mainly involves the postcapillary venules. It can be idiopathic or secondary to connective tissue diseases, infection, malignancy. A 39 year old male presented with a recurrent episode of multiple palpable purpurae over the legs, trunk, back and upper limbs with diffuse abdominal pain, bloody diarrhoea and arthralgia. Anti-nuclear antibodies (ANA) were positive, but ANA profile was equivocal. Histopathological examination confirmed leukocytoclastic vasculitis. A final diagnosis of Henoch Schoenlein purpura (HSP) was reached based on EULAR Criteria. He was treated with tapering doses of prednisolone, hydroxychloroquine and bed rest with limb elevation. All symptoms and lesions gradually resolved. Various sub-types of cutaneous small vessel vasculitis may mimic each other, warranting a meticulous evaluation. Adult onset HSP though rare must be considered in the differential diagnosis of LCV, which might be the presenting manifestation of an underlying connective tissue disease. Hence long-term follow-up with stringent clinical and laboratory monitoring is recommended.</p>

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Don't Discount Severity of Small-Vessel Vasculitis

Rheumatology News ◽

10.1016/s1541-9800(07)70598-7 ◽

2007 ◽

Vol 6 (11) ◽

pp. 9

Author(s):

DIANA MAHONEY

Keyword(s):

Small Vessel ◽

Small Vessel Vasculitis

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Leukocytoclastic Vasculitis Associated with HHV6-A/ciHHV6-A and HHV6-B Coinfection in an Immunocompetent Woman

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530318666181106153758 ◽

2019 ◽

Vol 19 (2) ◽

pp. 221-225 ◽

Cited By ~ 1

Author(s):

Agata Calvario ◽

Caterina Foti ◽

Maria Scarasciulli ◽

Paolo Romita ◽

Eva Eliassen ◽

...

Keyword(s):

Transcriptional Activity ◽

Skin Infection ◽

Leukocytoclastic Vasculitis ◽

Human Herpesvirus ◽

Small Vessel Vasculitis ◽

Case Description ◽

Human Herpesvirus 6 ◽

Late Antigen ◽

Herpesvirus 6 ◽

Systemic Symptoms

Background and Objective: Leukocytoclastic vasculitis (LCV) is a small vessel vasculitis that can be limited to the skin but may also affect other organs. Often, its cause is unknown. LCV has previously been reported to occur with the reactivation of human herpesvirus 6 (HHV-6). Here, we report a second instance of HHV-6 reactivation in a 43-year-old woman with idiopathic cutaneous LCV. </P><P> Case Description: In this case, the patient was immunocompetent, and testing revealed that she had inherited chromosomally integrated human herpesvirus 6 variant A (iciHHV6-A) with a parallel skin infection of HHV-6B. The integrated ciHHV-6A strain was found to be transcriptionally active in the blood, while HHV-6B late antigen was detected in a skin biopsy. The patient’s rash was not accompanied by fever nor systemic symptoms and resolved over four weeks without any therapeutic intervention.Conclusion:In light of the transcriptional activity documented in our case, further examination of a possible role for HHV-6 in the etiology of LCV is warranted.

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