Henley Jill K, Blackmon Joseph A, Fraga Garth R, Rajpara Anand, Maz Mehrdad
University of Kansas Medical Center.
Dermatol Online J. 2013 Sep 14;19(9):19619.
Medication-induced leukocytoclastic vasculitis is a small-vessel vasculitis that most commonly manifests with palpable purpuric lesions on gravity dependent areas. Development of the vasculitis occurs within weeks after the initial administration of the medication, with clearance upon withdrawal of the medication. Glyburide, a sulfonylurea medication, is used to treat non-insulin dependent diabetes mellitus. We report a rare case of glyburide-associated leukocytoclastic vasculitis.
We report a 71-year-old man with type 2 diabetes mellitus who presented with palpable purpura on the lower extremities. Cutaneous biopsy revealed superficial small vessel vasculitis with IgA perivascular deposits. Further questioning revealed three prior episodes of palpable purpura after restarting the glyburide medication, with clearance upon discontinuation. We diagnosed drug-induced vasculitis related to the glyburide.
This case highlights a rarely reported cutaneous adverse reaction to the commonly used diabetic medication, glyburide. Physicians should consider cutaneous vasculitis as a potential side effect of glyburide.
药物性白细胞破碎性血管炎是一种小血管血管炎，最常见的表现是在重力依赖部位出现可触及的紫癜性病变。血管炎在首次使用该药物后的数周内发生，停药后症状消退。格列本脲是一种磺脲类药物，用于治疗非胰岛素依赖型糖尿病。我们报告一例罕见的格列本脲相关性白细胞破碎性血管炎病例。
我们报告一名71岁的2型糖尿病男性患者，其下肢出现可触及的紫癜。皮肤活检显示浅表小血管血管炎伴IgA血管周围沉积。进一步询问发现，在重新使用格列本脲药物后曾有三次出现可触及紫癜的情况，停药后症状消退。我们诊断为与格列本脲相关的药物性血管炎。
本病例突出了一种罕见报道的对常用糖尿病药物格列本脲的皮肤不良反应。医生应将皮肤血管炎视为格列本脲的一种潜在副作用。
