Clinical features and outcome of 49 patients with drug-associated cutaneous vasculitis

WU Xiao-xia

doi:10.11786/sypfbxzz.1674-1293.20160407

Abstract：Objective To assess the clinical spectrum of patients with drug-associated cutaneous vasculitis (DACV). Methods Case records of 158 patients with DACV who had once accepted treatment in our department from 2008 to 2014 were reviewed. Results Forty-nine patients (27 male and 22 female, mean age 36.41 yrs) were diagnosed with DACV. Antibiotics (n=30, 61.2%), mainlyβ-lactams and nonsteroidal antiinflammatory drugs (NSAIDs, n=5, 10.4%), were the most common drugs. Besides skin lesions (100%), the most common clinical features were joint (51.0%) and gastrointestinal (38.7%) manifestations, nephropathy (34.7%), and fever (24.5%). The most remarkable laboratory data were increased erythrocyte sedimentation rate (40.2%), leukocytosis (24.7%), anemia (18.4%), positive antinuclear antibodies (20.4%), and positive rheumatoid factor (16.3%), presence of serum cryoglobulins (24.5%). Despite drug discontinuation and bed rest, 22 patients (44.9%) required medical treatment, mainly corticosteroids (n=14) or immunosuppressive drugs. After a median follow up of 5 months, relapses occurred in 9 patients. Conclusion DACV is generally associated with antibiotics and NSAID. Except for cutaneous lesions, DACV may be complicated by a variable degree of visceral involvement, including GI, joint, and renal manifestations. Treatment of DACV is mainly based on discontinuation of the drug and bed rest. In most cases the disease has a favorable prognosis.