Cutaneous vasculitis: Report of 117 cases

Introduction.- Cutaneous vasculitis (CV) is defined broadly as inflammation of the blood vessels of the dermis. We retrospectively analyzed a cohort of 117 patients with biopsy-proven CV. Patients.- We performed a single-centre retrospective review of 117 patients who met the histologic criteria for cutaneous vasculitis between 2003 and 2012. Results.- The mean age was 55.34 years (15-95) and 65 (55.6%) were females. The main hystopathological pattern was leukocytoclastic vasculitis (65.81%) followed by urticarial (10.25%), lymphocytic (7.6%), neutrophilic (4.2%), nodular (2.5%), granulomatous necrotizing and other type of CV (3.4%). Palpable purpura (65.81%) was the most frequent clinical lesion followed by plaques (17.09%), papules (5.9%) and others (11.11%). Systemic symptoms were observed in 47 cases (41.02%) while 70 cases (59,08%) did not have any symptom. The most common systemic symptom was fever (30.43%) followed by arthritis (18.84%), oral or genital ulcers and uveitis (10.14%), renal disease (8.60%), respiratory symptoms (5.7%) and others (26.08%). Only eight patients showed positive ANCA antibodies, being five MPO positive and three PR-3 positive. Forty-nine cases (41.8%) had idiopathic cutaneous vasculitis being the leukocytoclastic type the most frequent. Sixty-eight patients (58.11%) had an aetiological condition. Thirty-four patients (29%) had a systemic autoimmune disease, systemic vasculitis was the most common disease (18), 16 (13.6%) cases were caused by drug reaction and 16 (13.6%) were due to infections. Only two cases had a malignancy cause. Discussion.- In 58.11%of cases, CV occurred either as part of a primary systemic vasculitis or as secondary vasculitis related to an underlying disease, such as an autoimmune disease, drugs, infections or malignancy. In the remaining 41.8% of cases, CV occurred idiopatically. Leukocytoclastic vasculitis was the most frequent histological pattern observed. Conclusion.- Cutaneous vasculitis is not one specific disease but a manifestation that can be seen in a variety of settings.