PROGNOSTIC FACTORS IN LEUKOCYTOCLASTIC VASCULITIS - A CLINICOPATHOLOGICAL STUDY OF 160 PATIENTS

Objective: To analyze risk factors for systemic involvement and long-t erm course in leukocytoclastic vasculitis. Design: A clinicopathologic al study of 160 patients with leukocytoclastic vasculitis followed up for at least 3 years. Univariate and multivariate analysis were conduc ted by logistic regression methods. Setting: The Bellvitge Hospital, a referral center in Barcelona, Spain. Patients: One hundred Sixty pati ents with cutaneous leukocytoclastic vasculitis. Patients in the categ ories cutaneous leukocytoclastic vasculitis and acute/chronic cutaneou s vasculitis were selected for comparative analysis. Main Outcome Meas ures: Clinical, laboratory, and histopathological findings. Results: O f 89 females and 71 males, aged 14 to 89 years, systemic involvement w as documented in 20% of cases. Perinuclear-staining antineutrophil cyt oplasmic autoantibodies were found in 21% of patients and cryoglobulin s in 25.4%. Of the patients, 1.9% died of systemic vasculitis. The ave rage duration of cutaneous lesions was 27.9 months. In 67.2%, a cause or associated condition was identified. Of the skin specimens, 59.6% s howed vasculitis limited to superficial dermal vessels. Direct immunof luorescence was positive in 84.3% of cases. In the multivariate analys is, paresthesia, fever, and absence ofpainful lesions were found to be risk factors for systemic involvement. Cryoglobulins, arthralgia, and normal temperature were risk factors for chronic cutaneous disease. C onclusion: Our results identify prognostic factors in leukocytoclastic vasculitis and may provide some aid in the management of this heterog eneous group of patients.