Photodistributed cutaneous vasculitis: An uncommon side effect for topical ketoprofen Photodistributed cutaneous vasculitis: An uncommon side effect for topical ketoprofen

Letter to editor
Photodistributed cutaneous vasculitis: An uncommon side effect for topical ketoprofen
#TopicalKetoprofen #Leukocytoclastic #Vasculitis #Photosensitivity
www.em-consulte.com/article/1720...

ddx for #leukocytoclastic #vasculitis includes drug reaction with eosinophilia and systemic symptoms (DRESS), amyloidosis, antiphospholipid syndrome, atrial myxoma, Behcet disease, Churg-Strauss syndrome, granulomatosis with polyangiitis, HSP, urticarial vasculitis, ITP, meningococcemia.

Most idiopathic cutaneous #leukocytoclastic #vasculitis are mild & resolve w/ leg elevation, rest, compression stockings, antihistamines
-chronic/resistant 4-6wk steroid taper
-Rarely methotrexate, azathioprine, mycophenolate mofetil, dapsone, cyclophosphamide, IVIG

Classic #leukocytoclastic #vasculitis
neutrophil infiltration in small vessel walls
-Fibrinoid necrosis of the vessel walls can be apparent around vasculature
-Extravasation of red blood cells can be present in dermis as well
-drug-related: eosinophils in dermis

Systemic diseases #leukocytoclastic #vasculitis
SLE
Sjogren syndrome
inflammatory bowel disease
Behcet
rheumatoid arthritis
cryoglobulinemic vasculitis
HSP
Hypocomplementemic urticarial vasculitis
Erythema elevatum diutinum

Neoplastic or hematologic triggers of #leukocytoclastic #vasculitis include, but are not limited to

lymphomas
leukemias
visceral tumors as
intestinal adenocarcinoma &
lung cancer

#leukocytoclastic #vasculitis drug related: onset 1-3wks post
b lactams
erythromycin
clinda
vanc
sulfa
FQ
minocycline

furosemide
allopurinol
NSAIDs
amiodarone
thiazide
phenytoin
beta-blocker
TNF blocker
SSRI
metformin
warfarin
valproic acid
Cocaine
Montelukast
Rituxumab
Statin

#leukocytoclastic #vasculitis
infectious triggers include, but not limited to
Mycobacterium
Staphylococcus aureus
Chlamydia
Neisseria
HIV
hepatitis B
hepatitis C
Syphilis
CMV
VZV
Brucella
HTLV
Erythrovirus B19

#Leukocytoclastic #vasculitis idiopathic in 50% of cases
Infections & drugs most common triggers for secondary dz
-Also systemic autoimmune dz, chronic infections, malignancies
-Post-infectious most commonly seen after streptococcal upper respiratory tract infection

A Unique Case Report on Hypersensitivity Vasculitis as an Allergic Reaction to the Herpes Zoster Vaccine - Vikram Puram, Danielle Lyon, Nedaa Skeik, 2019 Hypersensitivity vasculitis (HV) or leukocytoclastic vasculitis is a rare small-vessel vasculitis that may occur as a manifestation of the body’s extreme allerg...

#Leukocytoclastic #vasculitis due to zoster vaccine Ref journals.sagepub.com/doi/abs/10.1...