Abstract：
OBJECTIVE: Single-organ cutaneous small-vessel vasculitis (SoCSVV) is an inflammatory skin-limited vascular disease affecting the dermal and/or hypodermal vessel wall. Pathogenetically, idiopathic forms are described, as well as the induction from different triggers, such as infections, drugs, and vaccines. Following the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic outbreak, cases of cutaneous vasculitis induced by both COVID-19 and COVID-19 vaccinations have been reported in literature. The aim of this study is to provide the most recent evidence on new etiological factors, clinical features, and management of the SoCSVV.
METHODS: We included 42 patients (22 women, 20 men) with SoCSVV and no systemic involvement in the study. The mean age of the patients was 57.3 years. Palpable purpura was the most frequent clinical manifestation (38 cases-90.4%). All patients were diagnosed with leukocytoclastic vasculitis by skin biopsy.
RESULTS: The etiological factors were as follows: idiopathic in 9 (21%) patients, drug-related in 19 (45%) patients, COVID-19 infection-related in 5 (12%) patients, post-COVID-19 vaccination in 5 (12%) patients, paraneoplastic in 2 (5%) patients, and drug and infection and sepsis in 1 patient each. Among the drug-related cases, 16 (84%) were antibiotic-related, and most of them were beta-lactam antibiotics. Eosinophilia was present in skin biopsy in the cases related to vaccination and drugs, while intense necrosis and vascular damage in the skin were observed in the cases related to COVID-19 infection, unlike the others. A rapid resolution was observed with the cessation of drugs and short-term steroid treatment for the precipitating factors.
CONCLUSIONS: SoCSVV is usually associated with drugs, preceding infections, and vaccines. COVID-19 infection and COVID-19 vaccinations have been reported as new etiological factors. SoCSVV indicates that the disease seems to be a mild, self-limiting illness with a good clinical result.
METHODS: We included 42 patients (22 women, 20 men) with SoCSVV and no systemic involvement in the study. The mean age of the patients was 57.3 years. Palpable purpura was the most frequent clinical manifestation (38 cases-90.4%). All patients were diagnosed with leukocytoclastic vasculitis by skin biopsy.
RESULTS: The etiological factors were as follows: idiopathic in 9 (21%) patients, drug-related in 19 (45%) patients, COVID-19 infection-related in 5 (12%) patients, post-COVID-19 vaccination in 5 (12%) patients, paraneoplastic in 2 (5%) patients, and drug and infection and sepsis in 1 patient each. Among the drug-related cases, 16 (84%) were antibiotic-related, and most of them were beta-lactam antibiotics. Eosinophilia was present in skin biopsy in the cases related to vaccination and drugs, while intense necrosis and vascular damage in the skin were observed in the cases related to COVID-19 infection, unlike the others. A rapid resolution was observed with the cessation of drugs and short-term steroid treatment for the precipitating factors.
CONCLUSIONS: SoCSVV is usually associated with drugs, preceding infections, and vaccines. COVID-19 infection and COVID-19 vaccinations have been reported as new etiological factors. SoCSVV indicates that the disease seems to be a mild, self-limiting illness with a good clinical result.
摘要：
目的：单器官皮肤小血管血管炎（SoCSVV）是一种影响皮肤和/或皮下血管壁的炎症性皮肤受限血管疾病。从病因上讲，描述了特发性形式，以及不同触发因素的诱导，如感染，毒品,和疫苗。严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）大流行爆发后，文献报道了由COVID-19和COVID-19疫苗引起的皮肤血管炎病例。这项研究的目的是提供有关新病因的最新证据，临床特征,和管理SoCSVV。
方法：我们纳入了42例患者(22例女性，20名男性)患有SoCSVV，没有全身参与研究。患者的平均年龄为57.3岁。临床表现以明显性紫癜最常见(38例,占90.4%)。所有患者均通过皮肤活检诊断为白细胞碎裂性血管炎。
结果：病因如下：9例（21％）患者特发性，19名（45%）患者与药物相关，5例（12%）患者与COVID-19感染相关，5名（12%）患者接种COVID-19疫苗后，2例（5%）患者的副肿瘤，药物、感染和脓毒症各1例。在与毒品有关的案件中，16（84%）与抗生素相关，其中大多数是β-内酰胺类抗生素。在与疫苗接种和药物有关的情况下，皮肤活检中存在嗜酸性粒细胞增多，在与COVID-19感染相关的病例中观察到皮肤强烈坏死和血管损伤，不像其他人。随着药物的停止和对诱发因素的短期类固醇治疗，观察到了快速的解决。
结论：SoCSVV通常与药物有关，之前的感染，和疫苗。据报道，COVID-19感染和COVID-19疫苗接种是新的病因。SoCSVV表明该疾病似乎是轻度的，具有良好临床效果的自限性疾病。
方法：我们纳入了42例患者(22例女性，20名男性)患有SoCSVV，没有全身参与研究。患者的平均年龄为57.3岁。临床表现以明显性紫癜最常见(38例,占90.4%)。所有患者均通过皮肤活检诊断为白细胞碎裂性血管炎。
结果：病因如下：9例（21％）患者特发性，19名（45%）患者与药物相关，5例（12%）患者与COVID-19感染相关，5名（12%）患者接种COVID-19疫苗后，2例（5%）患者的副肿瘤，药物、感染和脓毒症各1例。在与毒品有关的案件中，16（84%）与抗生素相关，其中大多数是β-内酰胺类抗生素。在与疫苗接种和药物有关的情况下，皮肤活检中存在嗜酸性粒细胞增多，在与COVID-19感染相关的病例中观察到皮肤强烈坏死和血管损伤，不像其他人。随着药物的停止和对诱发因素的短期类固醇治疗，观察到了快速的解决。
结论：SoCSVV通常与药物有关，之前的感染，和疫苗。据报道，COVID-19感染和COVID-19疫苗接种是新的病因。SoCSVV表明该疾病似乎是轻度的，具有良好临床效果的自限性疾病。
