Leukocytoclastic Vasculitis as an Extraintestinal Manifestation of Crohn’s Disease

• Main Authors: Thiara Barcelos Rocha, Ana Lorena Sousa de Vasconcelos Garate, Rodrigo Fedatto Beraldo, Sean Hideo Shirata Lanças, Fábio Vicente Leite, Rodrigo Quera, Jaqueline Ribeiro Barros, Julio Pinheiro Baima, Rogerio Saad-Hossne, Ligia Yukie Sassaki
• Format: Article
• Language: English
• Published: Karger Publishers 2021-09-01
• Series: Case Reports in Gastroenterology
• Subjects: leukocytoclastic vasculitis; extraintestinal manifestation; crohn’s disease; inflammatory bowel disease; case report
• Online Access: https://www.karger.com/Article/FullText/519003

Cutaneous involvement is one of the most common extraintestinal manifestations of inflammatory bowel disease (IBD). More commonly, pyoderma gangrenosum and erythema nodosum are noted, but psoriasis, aphthous stomatitis, Sweet’s syndrome, and vasculitis may also occur. Leukocytoclastic vasculitis (LCV) is a rare cutaneous manifestation, characterized by the appearance of palpable purpura, urticaria, and ulcer-necrotic lesions predominantly in the lower extremities that improve with immunosuppressive therapy. In this case, we report a patient with CD and LCV. We also searched the literature on the diagnosis and treatment of LCV in patients with CD. Female, 31, presented with diarrhea containing mucus and blood, abdominal pain, arthralgia, and enanthematous plaques and ulcers with a hematinic background in the lower extremities. The results of the colonoscopy were compatible with CD and skin biopsy showed signs of LCV. Systemic autoimmune disease and primary vasculitis were ruled out. The patient received treatment with a systemic corticosteroid and the skin lesions improved. Outpatient treatment with antitumor necrosis factor therapy was initiated to promote skin healing and IBD clinical remission. As LCV is a rare manifestation of IBD, it is necessary to distinguish this dermatopathy from other systemic vasculitis. The engagement of a multidisciplinary team is essential for the correct diagnosis and management.