RECURRENT ANNULAR ERYTHEMA WITH PURPURA - A NEW VARIANT OF LEUKOCYTOCLASTIC VASCULITIS RESPONSIVE TO DAPSONE

Annular lesions are rarely reported in the clinical spectrum of leucoc ytoclastic vasculitis, except in the acute haemorrhagic oedema of the skin. We report three patients who suffered from an extraordinary recu rrent annular dermatitis, for 4 years in one case and for decades in t he other two. The eruption was characterized by purpuric lesions that had a centrifugal evolution, creating target- or polycyclic patches di sseminated on the limbs and trunk. The patients' general condition rem ained excellent during the attacks. All lesions spontaneously disappea red within 2 weeks, but recurred monthly. In all three cases, the hist ological changes were consistent with leucocytoclastic vasculitis. One patient had ulcerative colitis and another had a benign immunoglobuli n A (IgA) monoclonal gammopathy. These two patients showed a good resp onse to dapsone therapy. This dermatosis probably represents a new and rare variant of leucocytoclastic vasculitis.