What is the Treatment for Leukocytoclastic Vasculitis?

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.

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.