Lambert Jessica, Rodriguez Alexis, Pearcy-Baluyot Mischelle, Shahi Sanjeet K
U.S. Department of Veterans Affairs, Malcom Randall VAMC, VA Optometry Clinic, 5533 SW 64th Street, Gainesville, FL.
U.S. Department of Veterans Affairs, Ocala Community Based Outpatient Clinic, 3307 SW 26th Avenue, Ocala, FL 34471.
Mil Med. 2015 May;180(5):e622-5. doi: 10.7205/MILMED-D-14-00287.
Cutaneous leukocytoclastic vasculitis (LCV) is a systemic condition that can be associated with iritis. LCV is characterized as a small-vessel vasculitis of the cutaneous area. The disease demonstrates purple lesions on the skin due to the destruction of small cutaneous blood vessels. These lesions are palpable and most often coalesce forming larger patches on the surface of the skin. During early stages of LCV, the disease can be undetected due to the infrequency and small size of the skin lesions. As such, the patient might go undiagnosed for years while having symptoms of LCV or iritis of unknown etiology. This article discusses the correlation seen with LCV and iritis. We report a case on a patient that presented to our clinic with a history of bilateral chronic iritis. After extensive laboratory testing, we concluded that the chronicity of her iritis was due to her LCV. The correlation between LCV and iritis was not evident for several years in our patient. We also discuss the correlation with systemic Sjogren's syndrome and LVC and how these two separate diseases are linked in many patients. We will illustrate the importance of serological testing, imaging, and skin lesion biopsy for the diagnosis of LCV.
皮肤白细胞破碎性血管炎（LCV）是一种可伴有虹膜炎的全身性疾病。LCV的特征为皮肤区域的小血管炎。由于皮肤小血管的破坏，该病在皮肤上表现为紫色病变。这些病变可触及，且最常融合形成皮肤表面更大的斑块。在LCV的早期阶段，由于皮肤病变出现频率低且面积小，该病可能未被发现。因此，患者在出现LCV或病因不明的虹膜炎症状时，可能多年未被诊断。本文讨论了LCV与虹膜炎之间的相关性。我们报告了一例有双侧慢性虹膜炎病史的患者前来我们诊所就诊的病例。经过广泛的实验室检查，我们得出结论，她虹膜炎的慢性化是由她的LCV所致。在我们的患者中，LCV与虹膜炎之间的相关性在几年内并不明显。我们还讨论了系统性干燥综合征与LVC之间的相关性，以及这两种不同疾病在许多患者中是如何关联的。我们将说明血清学检测、影像学检查和皮肤病变活检对LCV诊断的重要性。
