Cutaneous leucocytoclastic vasculitis associated with oxacillin.
A 67-year-old man who was treated with oxacillin for one week because of Staphylococcus aureus bacteremia, developed renal failure and diffuse, symmetric, palpable purpuric lesions on his feet. Necrotic blisters were noted on his fingers. Skin biopsies showed findings diagnostic of leucocytoclastic vasculitis. Oxacillin was discontinued and patient was treated with corticosteroids. The rash disappeared after three weeks and renal function returned to normal. Leucocytoclastic vasculitis presents as palpable purpura of the lower extremities often accompanied by abdominal pain, arthralgia, and renal involvement. Etiologic factors or associated disorders include infections, medications, collagen vascular disease and neoplasia. However, in half of the cases no etiologic factor is identified. Usually it is a self-limited disorder, but corticosteroid therapy may be needed in life-threatening cases since early treatment with corticosteroids in severe cases can prevent complications. Oxacillin should be included among the drugs that can cause leucocytoclastic vasculitis.
Koutkia
P
P
Department of Endocrinology, Diabetes and Nutrition, Boston Medical Center, Boston University, 88 East Newton Street, Evans Building, Room #201, Boston, MA 02118, USA. Polyxeni.Koutkia@bmc.org
Mylonakis
E
E
Rounds
S
S
Erickson
A
A
D000368:Aged; D016470:Bacteremia / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010068:Oxacillin / Q000009:adverse effects* / Q000627:therapeutic use; D010406:Penicillins / Q000009:adverse effects* / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000473:pathology
D010406:Penicillins; D010068:Oxacillin