Vasculitis with cutaneous involvement can be idiopathic-55% neoplasms), secondary to infection (15-20%), non-flaucoma (15-15%), drugs (10%) or malignancies (< 5%).
Leukocytoclastic vasculitis (LV) is a vasculitis of the small vessel mediated by deposits of complexes (IgG and IgM) in the post-capillary vessels.
This activates the complement cascade and releases chemotactic factors and lysosomal enzymes that produce the destruction of the blood vessel wall, giving rise to palpable purpura that progresses to necrotic ulcers23 vesicles.
Treatment includes management of underlying causes and systemic corticosteroids for 10 to 14 days24.
Case 6 presented a necrotizing vasculitis with biopsy compatible with LV probably secondary to drugs.
Case 7 presents an extensive necrotizing systemic vasculitis associated with large B-cell lymphoma of the elderly associated with diffuse necrotizing Epstein virus in which necrotizing vasculitis probably represents a manifestation of cancer25.
