Annular Leukocytoclastic Vasculitis in a Patient with Ulcerative Colitis

다국어 초록 (Multilingual Abstract)

Leukocytoclastic vasculitis (LV) is characterized by neutrophilic invasion and fibrinoid necrosis along with endothelial enlargement in postcapillary venules. Annular appearance of LV (ALV) is rare, but it can be accompanied by several systemic diseases. One of these systemic diseases is ulcerative colitis (UC), a subgroup of inflammatory bowel disease. Only one case was previously reported in which ALV was associated with UC, and herein we present one more case. A 66-year-old woman presented with painful polycyclic erythema on both palms, which had been present for 4 days. She had suffered from UC for 5 years. The patient had no fever or other systemic symptoms, and histological examination demonstrated typical LV. 200 mg of oral dapsone was taken daily to rapidly reduce her symptoms and signs, and after 1 week all lesions resolved completely without any adverse events. ALV is not a distinct condition and it can appear in a broad range of small vessel vasculitides.
Although ALV in patients with UC is a very rare combination,clinicians need to be aware of this possible association. (Ann Dermatol 23(S3) S338∼S340, 2011)

참고문헌 (Reference)

1 Hannon CW, "Vasculitis. In Dermatology. 1st ed" Philadelphia: Elsevier 381-402, 2003

2 Basler RS, "Ulcerative colitis and the skin" 64 : 941-954, 1980

3 Basler RS, "Ulcerative colitis and the skin" 112 : 531-534, 1976

4 Burgdorf WH, "The histiocytoses. In Fitzpatrick's dermatology in general medicine. 6th ed" New York: McGraw-Hill 977-979, 2003

5 Greenstein AJ, "The extra-intestinal complications of Crohn's disease and ulcerative colitis: a study of 700 patients" 55 : 401-412, 1976

6 Cribier B, "Recurrent annular erythema with purpura: a new variant of leucocytoclastic vasculitis responsive to dapsone" 135 : 972-975, 1996

7 Claudy A, "Pathogenesis of leukocytoclastic vasculitis" 8 : 75-79, 1998

8 Iannone F, "Leucocytoclastic vasculitis as onset symptom of ulcerative colitis" 62 : 785-786, 2003

9 Friedman S, "Inflammatory bowel disease. In Harrison's principles of internal medicine. 16th ed" New York: McGraw-Hill Professional 1776-1789, 2005

10 Branford WA, "Annular vasculitis of the head and neck in a patient with sarcoidosis" 106 : 713-716, 1982

11 Kelly RI, "Annular vasculitis associated with pregnancy" 129 : 599-601, 1993

12 Meissner M, "Annular leukocytoclastic vasculitis in association with chronic hepatitis B" 21 : 135-136, 2007

13 Nousari HC, "Annular leukocytoclastic vasculitis associated with monoclonal gammopathy of unknown significance" 43 : 955-957, 2000

14 Chiu CS, "Annular leucocytoclastic vasculitis induced by chlorzoxazone" 150 : 153-, 2004

15 Aram H, "Annular erythema with histologic features of leukocytoclastic vasculitis in ulcerative colitis" 35 : 250-252, 1985