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What Is the Treatment for Leukocytoclastic Vasculitis?

Anti-inflammatory medication may be required to treat leukocytoclastic vasculitis.
Elevating the feet may help to relieve effects of leukocytoclastic vasculitis.
Individuals with leukocytoclastic vasculitis may experience itchiness of the skin.
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  • Written By: B. Chisholm
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 20 March 2014
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In up to 50% of leukocytoclastic vasculitis cases, the cause of the disease is unknown, which often makes treatment difficult. The choice of drug or treatment depends on the type, cause, and manifestations of the disease. Generally, however, this condition can be treated either by the use of drugs such as corticosteroids or anti-inflammatories, by removing the trigger, or by non-drug measures such as elevating the feet. Also known as hypersensitivity vasculitis, the disease may affect only the skin or also involve internal organs, most commonly the joints, gastrointestinal tract, and kidneys. The prognosis of the purely cutaneous version is good, but if the internal organs are affected, the disease may be serious and even fatal.

Vasculitis refers to inflammation of the blood vessels and may occur just once as an acute attack or recur chronically. The cause of leukocytoclastic vasculitis is often unknown. Various triggers have been described, including reactions to drugs such as antibiotics, acute infections, foods, and chronic diseases such as Crohn's Disease or HIV. The first step in treatment is to remove the trigger, if it is known.

This condition usually presents with a burning or itching sensation of the skin. A rash may then develop, which ranges from puerpural lesions to ulcerated lesions in severe cases. The rash may also be urticarial, or itchy. Various tests can be performed by a medical specialist to establish whether there is systemic involvement, and the treatment can then be decided accordingly.

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Non-drug measures, such as raising the feet and compression stockings, are often recommended, as the disease may cause swelling of the extremities. There is no single drug that is used to treat the disease, and drugs are used symptomatically and chosen on a case-by-case basis. Treatment of the underlying disease and removal of any triggers is also recommended. If the rash is urticarial, antihistamines may be used.

Patients who have the more severe manifestation of leukocytoclastic vasculitis, which involves the organs, may be treated with corticosteroids. They are used either alone or in combination with immunosuppressants such as cyclophosphamide, azathioprine, or mycophenolate mofetil. Rituximab, a monoclonal antibody, is used in some subsets of the disease involving antineutrophil cytoplasmic antibodies (ANCA).

Anti-inflammatories, such as colchicine or dapsone, are also used in patients with disease of the skin. Some may respond to non-steroidal anti-inflammatories. Due to the fact that this condition may present in so many different manifestations, thorough investigation of the patient is necessary to establish the correct diagnosis and subsequent treatment. It is a disease that needs to be managed by a medical professional.

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Discuss this Article

anon347915
Post 6

I just get this disease, and am looking for an advanced diagnosis to confirm the trigger. Hopefully I will not need to take steroids.

dautsun
Post 5

@sunnySkys - That's true. I think it's really great that there are treatments for this disorder. And not only are there treatments, there seems to be a big variety of things you can try, from medications to non-drug treatments like compression stockings. And from what I understand, a lot of the milder treatments work fine for some people with this illness.

My friend's grandmother has leukocytoclastic vasculitis, and she tries to limit interaction with her triggers, take antihistamines, and uses the compression stockings. These measure are enough to keep her comfortable, so she's never needed to try the stronger drugs.

And hopefully she'll never have to, because from what some of the other commenters have said, those drugs sound pretty serious!

sunnySkys
Post 4

It must be so frustrating to have a disease and not know what's causing it. However, at least there are some possible treatments for cutaneous leukocytoclastic vasculitis. It would horrible if the illness had no known cause and no known cure!

indemnifyme
Post 3

@KaBoom - Yeah, the side effects from steroids aren't very pleasant. They can cause anxiety, weight gain, and an upset stomach. And they lower your immune system, which makes you susceptible to secondary infection. I would definitely think pretty strongly before using them for vasculitis treatment too.

However, that doesn't mean I wouldn't use them! Sometimes, steroids really are the only option. I have a good friend that has an autoimmune disease, and she need the steroids for her treatment. Unfortunately, she also has to deal with the side effects.

KaBoom
Post 2

I always feel really bad for anyone with a condition that needs to be treated with corticosteroids. I've been on steroids for my asthma before, and the side effects are really, really unpleasant. If I developed vasculitis symptoms, I would probably try one of the other treatments first, and keep steroids as a last resort.

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