engleski

Cutaneous vasculitis - screening for extracutaneous involvement to therapy decisions

Treatment of cutaneous vasculitis hasto be tailored according to disease severity rather than the type of vasculitis diagnosed in a patient. Vasculitides fall within domains of both internal medicine specialists as well as dermatologists, since they are often etiologically and diagnostically unclear conditions, their classification is seldom uniform and the full extent of extracutaneous involvement could rarely be fully determined. We describe the patient with coutaneous vasculitis and renal involvement who developed atypical debilitating abdominal symptoms. Case history: A 44-year-old man presented with palpable purpuric rash of the lower extremities and microhematuria. Skin biopsy was suggestive of leucocytoclastic vasculitis and urine culture revealed Ureaplasma urealyticum infection. After small and large bowel involvement was established by contrast CT imaging, the patient was pulsed with intravenous methylprednisolone to prevent serious and life threatening concequences. Ureaplasma infection was treated with doxycyclin. Outcome: Methylprednisolone therapy was followed by gradual improvement of the skin lesions, renal laboratory tests and general condition. Conclusion: This represents an interesting case of cutaneous vasculitis illustrating that radiological imaging, although not specific and crucial in diagnosing vasculitis, can provide invaluable information, thus helping the formation of treatment guidelines. Vasculitis may be associated with various primary diseases and causative agents. In our patient an Ureaplasma urealyticum infection, which can be found in other immunological disorders, could be the agent triggering the hypersensitivity reaction. Therefore, Ureaplasma urealyticum could be considered as a novel cause of cutaneous leucoytoclastic vasculitis.

vasculitis; coutaneous involvement

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