Cutaneous leukocytoclastic angiitis
| Classification according to ICD-10 | |
|---|---|
| M31.8 | Other specified necrotizing vasculopathies |
| ICD-10 online (WHO version 2019) | |
The cutaneous leukocytoclastic angiitis (KLA) (from Latin cutis , skin ' and ancient Greek λευκός leukós , German , white' , κύτος Cytos , German , cavity, vessel shell ' , κλᾶν klan , German , break, break' and αγγεῖον angeion , German 'Vascular, blood vessel' ) or leukocytoclastic vasculitis (LcV) (from vasculum 'small vessel' ) is an autoimmune disease that mainly causes symptoms of the skin. It is counted among the primary non- ANCA -associated vasculopathies .
It is mostly caused by the deposition of immune complexes on the vessel walls and is noticeable through small punctiform hemorrhages ( purpura ) on the skin. If IgA is bound in the immune complexes , other organs can also be involved ( Henoch-Schönlein purpura ). With IgG and IgM involvement, the disease is mostly limited to the skin.
diagnosis
In the anamnesis , questions about drug abuse and recent infections can be groundbreaking. Ask about known arthritis and arthralgias (joint pain). During the physical examination, the entire body surface must be inspected for skin necrosis . Often these are found especially on the trunk area. They are reddish-brownish colored, easily palpable elevations of the skin with a small diameter. Laboratory tests are often only marginally indicative. Usually there is an increase in non-specific inflammatory parameters ( C-reactive protein , sedimentation rate ). The only way to confirm the diagnosis is through a biopsy . Tissue is taken from a freshly infected area of skin (taking a biopsy from an older focus often does not provide any directional diagnostic information), cut into thin slices approx. 5 µm thick, colored and assessed under the microscope. As an anatomical-histological correlate of angiitis , epithelial cell granulomas , nodular accumulations of macrophages , granulocytes (white blood cells) and endothelial cells (flat cover cells of the inner wall of the vessel) can be seen in the wall layers of the arteriole .
therapy
No causal treatment is known. Uncomplicated forms are only treated symptomatically ; corticosteroids are used if there is a threat of necrosis or ulceration . Colchicine has been used successfully in the treatment of leukocytoclastic vasculitis.
swell
- ↑ C. Sunderkötter et al.: Leukocytoclastic vasculitis . In: dermatologist. (2004) 55, pp. 759-783. PMID 15257403
- ↑ Callen, JP Colchicine is effective in controlling chronic cutaneous leukocytoclastic vasculitis, J Am Acad Dermatol 1985, 13: pages 193-200
- ↑ Plotnik, S, Hupert, AS and Kantor G, Colchicine and leukocytoclstic vasculitis. Arthritis Rheum, 1989, 32, pages 1489-1490
