The severity of histopathological changes of leukocytoclastic vasculitis is not predictive of extracutaneous involvement

Leukocytoclastic vasculitis is defined by histologic features and can be ob served in a wide range of entities. Independent of the causative disease, e xtracutaneous complications are frequent, mainly in the kidneys and gastroi ntestinal tract. It has been suggested that the severity of histological ch anges could correlate with the clinical course of the disease. We have ther efore compared the severity of histological changes of leukocytoclastic vas culitis to clinical and laboratory findings indicative of extracutaneous in volvement in a large group of patients. Among 289 patients followed for cut aneous vasculitis, we included 184 patients with purpuric papules and prove n leukocytoclastic vasculitis who all had standardized investigations. A cu taneous biopsy was performed early and standardized laboratory investigatio ns were carried out. The slides were retrospectively randomized and the dep th of vasculitis and severity of vascular necrosis were determined accordin g to a semiquantitative scale. These data were compared to the renal, gastr ointestinal and articular symptoms using Fischer's exact test, Chi-square t est and variance analysis. The intensity of vascular necrosis and the depth of vasculitis were no more severe in patients having renal changes, gastro intestinal involvement or articular symptoms. Both variance analysis and Ch i-square tests failed to show a significant increase in the severity score in patients having extracutaneous complications. In this study, the severit y of histopathological changes was not predictive of extracutaneous involve ment. Thus it appears that the degree of involvement of the cutaneous vesse ls probably does not correlate with that of vessels in visceral organs.