Leukocytoclastic Vasculitis Follow-up

Updated: Oct 25, 2018
  • Author: A Brooke W Eastham, MD; Chief Editor: Herbert S Diamond, MD  more...
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Follow-up

Further Outpatient Care

The design of a follow-up program depends on the vasculitic syndrome, its chronicity, and the organ systems affected.

Once the process is inactive in a patient with leukocytoclastic vasculitis (LCV), further follow-up care may be unnecessary.

Patients with Henoch-Schönlein purpura may develop impaired renal function or hypertension; therefore, regular follow-up care, even after complete clearing of their disease, is needed.

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Further Inpatient Care

Inpatient care is needed in patients who have severe systemic vasculitic syndromes and severe organ dysfunction. Most patients with cutaneous leukocytoclastic vasculitis are treated in an outpatient setting.

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Inpatient & Outpatient Medications

Treating patients with chronic LCV is a challenge. Considerations include the following:

  • In the absence of an identifiable cause, dietary restriction may be attempted but is usually unsuccessful.

  • Colchicine at 0.6 mg twice daily and/or dapsone at 100-200 mg/d may control the disease. Combination of these two agents seems to be complementary.

  • In patients whose conditions do not respond or respond poorly, other agents, including immunosuppressive or cytotoxic agents, may be administered (eg methotrexate, mycophenolate mofetil, azathioprine).

  • Biologic therapies such as intravenous immunoglobulin and rituximab are useful in some patients.

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Transfer

Transfer to a tertiary care facility should be considered in patients with severe visceral disease. Patients with chronic LCV are often referred to a tertiary care center for specialty care.

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Prognosis

The prognosis of cutaneous vasculitis depends on the underlying syndrome or the presence of end-organ dysfunction. [43] Patients with disease that primarily affects the skin, joints, or both have a good prognosis. [44]

Patients with granulomatosis with polyangiitis (formerly known as Wegener granulomatosis), polyarteritis nodosa, eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome), or severe necrotizing vasculitis have potentially fatal disease. Treatment with corticosteroids and/or immunosuppressive or cytotoxic agents is often lifesaving.

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