TY - JOUR T1 - Drug-associated Cutaneous Vasculitis: Study of 239 Patients from a Single Referral Center JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.140390 SP - jrheum.140390 AU - Francisco Ortiz-Sanjuán AU - Ricardo Blanco AU - José L. Hernández AU - Trinitario Pina AU - María C. González-Vela AU - Héctor Fernández-Llaca AU - Vanesa Calvo-Río AU - Javier Loricera AU - Susana Armesto AU - Marcos A. González-López AU - Javier Rueda-Gotor AU - Miguel A. González-Gay Y1 - 2014/09/15 UR - http://www.jrheum.org/content/early/2014/09/10/jrheum.140390.abstract N2 - Objective The 2012 International Chapel Hill Consensus Conference on the Nomenclature of Vasculitides defined drug-associated immune complex vasculitis as a distinct entity included within the category of vasculitis associated with probable etiology. In the present study we assessed the clinical spectrum of patients with drug-associated cutaneous vasculitis (DACV). Methods Case records were reviewed of patients with DACV treated at a tertiary referral hospital over a 36-year period. A diagnosis of DACV was considered if the drug was taken within a week before the onset of the disease. Results From a series of 773 unselected cutaneous vasculitis cases, 239 patients (30.9%; 133 men and 106 women; mean age 36 yrs) were diagnosed with DACV. Antibiotics (n = 149; 62.3%), mainly β-lactams and nonsteroidal antiinflammatory drugs (NSAID; n = 24; 10%) were the most common drugs. Besides skin lesions (100%), the most common clinical features were joint (51%) and gastrointestinal (38.1%) manifestations, nephropathy (34.7%), and fever (23.8%). The most remarkable laboratory data were increased erythrocyte sedimentation rate (40.2%), presence of serum cryoglobulins (26%), leukocytosis (24.7%), positive antinuclear antibodies (21.1%), anemia (18.8%), and positive rheumatoid factor (17.5%). Despite drug discontinuation and bed rest, 108 patients (45.2%) required medical treatment, mainly corticosteroids (n = 71) or immunosuppressive drugs (n = 7). After a median followup of 5 months, relapses occurred in 18.4% of patients, and persistent microhematuria or renal insufficiency in 3.3% and 5%, respectively. Conclusion DACV is generally associated with antibiotics and NSAID. In most cases it has a favorable prognosis, although a small percentage of patients may develop residual renal damage. ER -