Leukocytoclastic vasculitis, also known as cutaneous small vessel vasculitis, embodies a challenging condition for both the physician and the patient. This condition is affecting mainly the small vessels, commonly the post-capillary venules, being characterized by presence of neutrophilic infiltration within and throughout the vessel wall with signs of leukocytoclasia, fibrinoid necrosis and local damage to the vessel wall and the surrounding tissue. Frequently, it is associated with other conditions (cryoglobulinemic vasculitis, IgA vasculitis, ANCA-associated vasculitides), infections, medication, systemic diseases (systemic lupus erythematosus, Sjögren syndrome, rheumatoid arthritis). Cutaneous leukocytoclastic vasculitis is considered a rare condition. We are presenting a 46 year old man, with history of chronic urticaria, presented in our clinic for recurrent intensely pruritic urticarian plaques, disseminated on limbs and trunk, associating bullae with serocitrin content. Petechiae and palpable purpura were observed just in a few places. Bullous lesions occurred after the patient went through COVID-19 and followed a self-treatment with paracetamol. Patch and prick tests were performed on this patient, identifying positive reactions to hydroxyisohexyl-3-cyclohexane-carboxaldehyde, fragrance mix and paracetamol. Histopathological exam evidentiated tipically aspect for leukocytoclastic vasculitis and subepidermal vesicle-bullae lesion. IgM/IgG immune complexes,C3 and fibrinogen were found positive in direct immunofluorescence exam. Through this scientific paper, we are presenting the crucial role of direct immunofluorescence exam in early diagnosis and evolution of this condition, efficacy of oral therapy with dapsone (anti-inflammatory properties, antioxidant scavenger effect, inhibitory effect on chemotaxis and function of neutrophils).

ESDR068 - Unusual cutaneous leukocytoclastic vasculitis: A case report.

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