Leukocytoclastic vasculitis (LCV) is a term used in histopathology to describe a typical kind of small vessel vasculitis (SVV), which can affect the skin and internal organs. The most common clinical symptom of leukocytoclastic is palpable purpura. The diagnosis is made based on a histological examination in which neutrophils with fibrinoid necrosis and fragmented nuclei (known as “leukocytoclastic”) make up the inflammatory infiltrate. Infections, cancer, or leukocytoclastic vasculitis can all be brought on by various drugs.

Introduction:

Small blood vessels are inflamed in leukocytoclastic vasculitis, also known as hypersensitivity vasculitis. Leukocytoclastic describes the immune cell debris inside blood artery walls, including neutrophils. The illness can only affect the skin (cutaneous) or it can impact a variety of body organs, including the kidneys, heart, lungs, central nervous system, and gastrointestinal tract. Skinny leukocytoclastic vasculitis typically has a better prognosis and a self-limited course of the disease, whereas systemic involvement is typically linked to a more severe disease course. When individuals refer to “leukocytoclastic vasculitis,” they typically mean the inflammation of small blood vessels in the skin brought on by dying neutrophils that have invaded the tissue.

The phrase is deceptive, nevertheless, for a number of reasons:

• Neutrophils implicated in any kind of inflammation, not simply vasculitis, cause leukocytoclasia.
• Similar to this, neutrophils are not always present in small vessel vasculitis. Other immune cells like lymphocytes and granulomas could be present.
• The disease can impact any organ’s tiny blood arteries. It is not skin-specific.

A more appropriate name is suggested to be cutaneous leukocytoclastic vasculitis. In addition to acute leukocytoclastic vasculitis, this term is frequently used to refer to LCV.

Causes:

While infection with bacteria, viruses, or fungi can result in vasculitis, the majority of cases are brought on by an immune response.  Up to 50% of cases of leukocytoclastic vasculitis are unexplained.  The most frequent causes of secondary leukocytoclastic vasculitis include medications and infections. It can also manifest secondarily to underlying cancers, persistent infections, and systemic autoimmune disorders. The most frequent cause of post-infectious leukocytoclastic vasculitis is streptococcal upper respiratory tract infection. Besides HIV, Mycobacterium, Staphylococcus aureus, Chlamydia, and Neisseria are other infectious triggers.  Leukocytoclastic vasculitis can also be brought on by syphilis, hepatitis B, and hepatitis C chronic infections. Leukocytoclastic vasculitis has been connected to a number of medications.

Symptoms:

When blood vessels in the skin are injured, they can leak and cause palpable purpura, which is elevated, purple-red lesions. On the legs or other reliant areas of the body, multiple distinct or organized lesions are frequently discovered. Although usually asymptomatic, these lesions can itch or hurt. Large, uncomfortable blisters with ulcers are a sign of more serious vascular inflammation. On average, lesions last between one and four weeks before they disappear (frequently with some lingering scarring). Fever, muscular aches, joint pain, bleeding in the urine or stool, nausea, vomiting, coughing, numbness, and weakness are symptoms of systemic involvement.

Diagnosis:

Due to the lack of a standardized technique, the method of diagnosis is reliant on symptoms of leukocytoclastic vasculitis. If cutaneous symptoms are caused by leukocytoclastic vasculitis, a skin biopsy can be utilized to confirm this. The underlying reasons or whether systemic involvement is present, however, cannot be determined from the histology of the lesions. A thorough diagnostic work-up is required to develop a reliable diagnosis. The most frequent clinical appearance of leukocytoclastic vasculitis manifests on the skin as palpable purpura that frequently appears fast (over the course of a few hours) and tends to mostly affect the lower body, notably the lower legs. The palpable purpura caused by leukocytoclastic vasculitis may develop into a bigger rash, and the affected skin may be unpleasant and itchy or unaffected. Over the course of two to three weeks, the lesions usually turn into hyperpigmented scars.

Homeopathic Treatment:

Leukocytoclastic vasculitis can be effectively treated with homeopathy because it treats the underlying dysfunctional immune system. Being an autoimmune condition, leukocytoclastic vasculitis can be successfully treated with carefully selected, deeply acting, constitutional homeopathic medicine. An all-encompassing strategy will strengthen the immune system, which will then control the underlying illness process and lessen the signs and symptoms of leukocytoclastic vasculitis. Lycopodium, Natrum Mur, Rhus Tox, Sepia, Bovista, and Antipyrinum are a few of the medications frequently used to treat Leukocytoclastic vasculitis. However, since the etiology and presentation vary frequently and can be completely different, the treatment may change. Prednisolone and immune suppressants (methotrexate and cyclophosphamide) are the two main medications used to treat vasculitis traditionally. Both work to lessen the immune system’s reaction and, as a result, the force of its assault on the body’s tissues. The patient’s medical history affects the course of treatment for leukocytoclastic vasculitis. A single occurrence of skin lesions characterizes acute cases, which go away after the infection, medicine, or food source is eliminated. The course of treatment is more involved in cases that reoccur. These people require the identification and treatment of an underlying systemic condition. When internal organs are affected or there are significant ulcerating skin lesions, systemic corticosteroids, and immunosuppressive medications may be required. According to certain research, dapsone plus colchicine may be beneficial in treating chronic conditions.

Precautions:

Reduce your intake of starchy foods like bread, potatoes, rice, and pasta if you do not require a specific diet in favor of fresh fruit and vegetables. Processed foods and meat raised on grains should also be avoided. Oily fish like salmon, mackerel, trout, and sardines are rich in omega-3 fatty acids, which are helpful in autoimmune diseases. Omega 3 is also included in flaxseed, walnuts, and leafy green vegetables. Particularly for those individuals on steroids, a sensible food regimen should be adopted. This will assist in preventing weight gain. The patient with vasculitis is not advised to overdo it on their diet. Additionally, there is a higher chance of developing osteoporosis when taking steroids. Increased calcium intake can aid in preventing the onset of osteoporosis. It is advised to eat broccoli, yogurt, skim milk, and tinned sardines.