Leukocytoclastic vasculitis as a rare extraintestinal dermatologic manifestation of inflammatory bowel disease associated with Clostridium difficile: Case repor
DOI:
https://doi.org/10.22516/25007440.500Keywords:
Leukocytoclastic vasculitis, clostridum difficile, ulcerative colitis, inflammatory bowel disease, Extraintestinal manifestationsAbstract
Leukocytoclastic vasculitis is defined as the damage and inflammation of the vascular walls. The term refers
to vasculitis of the small vessels that anatomopathologically present leukocytoclasia and it can be seen as
an extra-intestinal manifestation of inflammatory bowel disease. In ulcerative colitis, it occurs less frequently
due to immune complexes produced in the intestinal mucosa by exposure of the submucosal lymphoid tissue
to fecal antigens, which could precipitate in the walls of the small vessels. This condition can be associated
with Clostridium difficile, which is a gram-positive, sporulated, strict anaerobic bacillus, normally found in the
environment. It causes colitis that manifests as a diarrheal disease following the ingestion of antibiotics that
alter the common bacterial flora of this organ. This is the case report of a 36-year-old patient with liquid diarrhea with mucus and scarce bleeding. Endoscopic and anatomopathological studies were performed, finding ulcerative colitis with positive coproparasite for Clostridium difficile antigen. The patient was hospitalized, and during his stay, he presented with petechiae and necrotic skin lesions on the fourth finger of the left hand. Skin biopsy showed small vessel vasculitis. This article is a practical review of the pathophysiology, histology, treatment, and diagnosis of a rare dermatologic extraintestinal manifestation, namely, leukocytoclastic vasculitis, in patients with C. difficile–associated ulcerative colitis.
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