Marie Isabelle, Mikolajcz Stéphane, Benichou Jacques, Grassi Vanessa, Levesque Hervé
CHU de Rouen, Département de médecine interne, 76031 Rouen cedex, France.
Presse Med. 2010 Nov;39(11):e247-57. doi: 10.1016/j.lpm.2010.03.020. Epub 2010 Jul 7.
Age onset of cutaneous vasculitis may influence clinical manifestations and outcome of this condition. However, to date, no authors have analyzed characteristics of cutaneous vasculitis, especially causes, in elderly patients (≥ 65 years).
The aims of this retrospective study were to compare clinical and biochemical characteristics as well as causes of cutaneous vasculitis between elderly patients (n=58) and younger subjects (n=74).
Median time onset between first clinical symptoms and diagnosis of cutaneous vasculitis was similar between elderly and younger (15 vs 10 days; P=0.39). Clinical characteristics did not differ between the 2 groups. The following biochemical parameters were more frequently found in elderly patients: higher median levels of erythrocyte sedimentation rate (44 vs 28 mm/h; P=0.006), urea (8 vs 5 mmol/L; P<0.0001), creatininemia (92 vs 74 μmol/L; P=0.004), and lower values of serum protein (P=0.023). The more common causes of cutaneous vasculitis in elderly patients were as follows: infections (n=24), drugs (n=12), systemic vasculitides (n=8) and cancer (n=8); only cancer-associated cutaneous vasculitis was more frequently observed in elderly patients (P=0.02).
Our study suggests that age onset of cutaneous vasculitis may influence causes of cutaneous vasculitis, as cancer were more common in elderly patients. Moreover, infectious manifestations were different in elderly patients (urinary and pulmonary infections) compared to younger patients (otorhinolaryngeal infections). In essence, our data underline that the search for cancer should be performed in elderly patients exhibiting cutaneous vasculitis.