Leukocytoclastic vasculitis (LCV) refers to small blood vessel inflammation. It’s also known as hypersensitivity vasculitis and hypersensitivity angiitis.
The word “leukocytoclastic” comes from “leukocytoclasia,” a process where neutrophils (immune cells) break down and release debris. “Vasculitis” means inflammation of the blood vessels.
When people use the term “leukocytoclastic vasculitis,” they’re usually talking about small blood vessel inflammation in the skin due to infiltrating, dying neutrophils.
However, the term is misleading for the following reasons:
- Leukocytoclasia occurs when neutrophils are involved in any type of inflammation — not just vasculitis.
- Similarly, small vessel vasculitis doesn’t always involve neutrophils. It may include other immune cells like lymphocytes and granulomas.
- The condition can affect the small blood vessels of any organ. It’s not specific to skin.
“Cutaneous leukocytoclastic vasculitis” is thought to be a more accurate name. This term, along with acute leukocytoclastic vasculitis, is often used interchangeably with LCV.
Read on to learn about the symptoms, causes, and treatment of leukocytoclastic vasculitis.
LCV has many possible causes. Yet, it may also be idiopathic, which means the underlying cause is unknown.
In general, it’s thought that immune system issues are involved. Potential LCV causes include:
In most cases with a known cause, LCV is caused by an allergic reaction to a drug. Usually, the condition develops 1 to 3 weeks after starting the medication.
LCV has been associated with many drugs, including:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- TNF-alpha inhibitors
- selective serotonin reuptake inhibitors (SSRIs)
- valproic acid
Sometimes, LCV might be caused by an allergy to a food or food additive.
Infections are another frequent cause of LCV. Bacterial, viral, and parasitic infections are all possible triggers.
Commonly, it’s due to a streptococcal upper respiratory tract infection. Other causes include:
- hepatitis B
- hepatitis C
- Staphylococcus aureus
- Neisseria gonorrhoeae
Various autoimmune diseases have been associated with LCV, which supports the theory that LCV is related to a problem with the immune system.
Autoimmune disorders connected to LCV include:
- rheumatoid arthritis
- lupus erythematosus
- Sjögren‘s disease
- Henoch-Schönlein purpura (most common in children)
In some cases, LCV is caused by drugs that treat IBD. The condition also typically develops years after an IBD diagnosis.
A malignancy is characterized by abnormal cell growth. The cells divide uncontrollably and invade surrounding tissues.
Less commonly, LCV may be linked to malignancies such as:
Leukocytoclastic vasculitis is an inflammation of blood vessels. It is not a form of cancer.
However, leukocytoclastic vasculitis is the form of vasculitis most frequently associated with cancer. Most commonly, it is associated with cancers that begin in the blood.
The most notable symptoms of LCV involve the skin. Usually, this includes a rash characterized by:
- palpable purpura (raised purple-red spots)
- pain and burning
- bullae (fluid-filled sacs)
- crusted ulcers
- livedo reticularis (mottled skin)
The following LCV symptoms are systemic, or more generalized:
- low grade fever
- unexplained weight loss
- muscle aches
- joint pain
- bloody urine or stool
- abdominal pain
These systemic symptoms affect about
Leukocytoclastic vasculitis primarily causes grouped rashes on the legs. The rash might also include pustules, nodules, and mottling.
Here are visual examples of LCV:
To determine what’s causing your symptoms, a healthcare professional can use several tests, which may include:
- Physical exam. During a physical exam of your skin, a healthcare professional will check for pain, swelling, and inflammation.
- Chest X-ray. This test may be used to detect pulmonary vasculitis.
- Medical history. This helps your healthcare professional figure out if something specific triggered your symptoms.
- Blood tests. Blood tests can show signs of underlying conditions. The tests may include a complete blood count, a basic metabolic panel, and liver and kidney function.
- Urinalysis. A sample of your urine might be checked for signs of disease.
- Punch biopsy. A healthcare professional takes a small skin sample with a circular tool. The sample, which includes deeper skin layers, is examined in a lab.
While a healthcare professional can diagnose LCV through a physical examination, a punch biopsy is often used to confirm the diagnosis.
Leukocytoclastic vasculitis may be treated either with home remedies like ice packs and compression stockings, or with medications.
Treatment begins with removing or treating the underlying cause of LCV. For example, if you developed LCV due to a drug, your healthcare professional will likely have you stop taking it.
It’s important to remember to speak with your healthcare professional before stopping any prescribed medications.
A mild case of LCV can be treated with home remedies, including:
However, if your LCV is chronic (long lasting) or severe, you’ll need additional treatments, which may involve:
NSAIDs can help manage skin and joint pain. They’re available over the counter (OTC), so you don’t need a prescription.
NSAIDs may cause some side effects that can be serious, including:
- holes in the intestine or stomach
The risk of this occurring is greater:
- if NSAIDs are taken over a longer period of time
- in older adults
- in people in poor overall health
- in people who consume three or more alcoholic beverages a day
Your healthcare professional may prescribe colchicine, which is made from the plant Colchicum autumnale. This oral drug works to manage neutrophils in the immune system.
While colchicine may help skin and joint symptoms, it doesn’t work for everyone. You might need to take it with other medical treatments.
In some cases, colchicine may cause side effects. Speak with a doctor if you experience severe or persistent:
- abdominal pain
- stomach cramps
If you experience any of the following symptoms, stop taking colchicine and immediately contact your doctor:
- pale or gray lips, palms, or tongue
- pain in muscles
- muscle weakness
- tingling or numb fingers or toes
- sore throat
- unusual bleeding
- unusual bruising
Dapsone is an anti-inflammatory drug used to treat chronic LCV. It helps reduce inflammation due to neutrophils.
Depending on your symptoms, your healthcare professional might prescribe dapsone along with:
Dapsone may cause some side effects. You should contact your doctor if you experience severe or persistent:
- upset stomach
You should also contact your doctor right away if you experience:
- yellowing of the eyes or skin (jaundice)
- sore throat
- unusual bruising
Like NSAIDs, oral steroids are used to manage skin rashes and joint pain. Most people respond to a short course of steroids, such as prednisone or methylprednisolone.
In most people, steroids won’t cause major side effects if they are taken at a low dose or only for a short period of time.
In some people, they may cause:
- mood changes
- problems sleeping
- increase in appetite
It is important to not stop taking steroids without first speaking with your doctor, as this can cause more side effects.
Leukocytoclastic vasculitis can range from mild to severe. Therefore, it’s recommended that you see your healthcare professional if you notice any symptoms of LCV.
Seek medical attention if you have:
The outlook of leukocytoclastic vasculitis is good. Roughly
The mortality rate of leukocytoclastic vasculitis is low, at roughly
If you receive a diagnosis of leukocytoclastic vasculitis, it means the small blood vessels in your skin are inflamed.
It may be associated with:
- an autoimmune disease
- an infection
However, there usually isn’t a known cause.
Your healthcare professional will develop a treatment plan to manage any underlying conditions. If you have skin and joint pain, they can also prescribe medication to help you feel better.