TY - JOUR T1 - Cutaneous vasculitis - a case for laparotomy? JF - The Journal of Rheumatology JO - J Rheumatol SP - 1621 LP - 1623 VL - 30 IS - 7 AU - Lisa Willcocks AU - Gladstone Chelliah AU - Rachel Brown AU - Paul Bacon Y1 - 2003/07/01 UR - http://www.jrheum.org/content/30/7/1621.abstract N2 - The diagnosis of gut vasculitis infers a poor prognosis necessitating aggressive therapy. We describe a case with predominant features of a skin-limited vasculitis but atypical debilitating abdominal symptoms. Although endoscopic biopsies were unremarkable, full thickness biopsy taken at laparotomy revealed a necrotizing vasculitis. After treatment with cyclophosphamide, the previously resistant abdominal symptoms resolved. This case illustrates the need to tailor treatment to disease severity, rather than determine it by the type of vasculitis with which the patient has been labelled. In view of the importance of gastrointestinal involvement to therapy decisions, laparotomy may be necessary to establish the presence of vasculitis. ER -