Abstract: PUB173
Persistent Rashes: A Case of IgA Vasculitis
Session Information
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Ismail, Tariqul Omar, University of Virginia, Charlottesville, Virginia, United States
- Herrforth, Craig, University of Virginia, Charlottesville, Virginia, United States
- Khan, Sana F., University of Virginia, Charlottesville, Virginia, United States
Introduction
IgA vasculitis (IgAV) is a poorly understood systemic vasculitis in adults anddiagnosis and treatment remain challenging. We present a patient with significant skin involvement. Awareness of this presentation with appropriate management is imperative.
Case Description
A 33-year-old male with a diagnosis of presumed idiopathic leukocytoclastic vasculitis presented to the hospital with a worsening open wound on his leg. He was initially diagnosed via punch biopsy of a palpable purpura 6 months prior to current presentation. He was treated with prednisone taper and ramp up Dapsone regimen. Comprehensive autoimmune work was negative, with no concerns for multiorgan involvement.
The patient is now presented to the hospital with reports of waxing and waning symptoms, with prescribed medications being discontinued for 2 months prior to arrival. He had 2 week of history of a blister on his left leg that had developed into a large open wound. There was concern for superimposed infection, and he was initiated on intravenous antibiotics. Physical exam revealed large erosion with areas of ulceration, granulation tissue and a hemorrhagic crust.Leg ulceration was thought to be secondary to poorly controlled vasculitis, and he was restarted on Prednisone taper with ramp up Dapsone regimen. Comprehensive autoimmune panel, kidney function tests and urinalysis negative for multiorgan involvement.
Discussion
Most cases of idiopathic leukocytoclastic vasculitis are mild and resolves with supportive care. In more chronic or resistant cases, prednisone can be used for symptom alleviation. Use of steroid sparing agents (Dapsone, Methotrexate, Azathioprine, Mycophenolate Mofetil) is uncommon. Rare complications of leukocytoclastic vasculitis include ulcerating skin lesions, which may have superimposed infections. Treatment remains addressing underling vasculitis.