[Antibiotics, purpura and ulcers: a leukocytoclastic vasculitis after clarithromycin].
METHODS
A 47- year-old woman presented with palpable purpura of both lower limbs after taking six tablets of clarithromycin for pneumonia.


METHODS
Apart from mild microhematuria there were no other signs of organ involvement. Histology of a skin biopsy revealed a hypersensitivity vasculitis.


METHODS
A hypersensitivity vasculitis due to clarithromycin was the cause of the purpura. The course of this hypersensitivity vasculitis was severe and protracted over weeks with formation of deep ulcerative skin lesions.


CONCLUSIONS
Clarithromycin may be the cause of a hypersensitivity vasculitis: often the course of the disease is mild, but it may also lead to severe local complications. The diagnosis of hypersensitivity vasculitis can be made in a patient over 16 years of age if there is the combination of a triggering substance, purpura and leukocytoclastic vasculitis. The most important step is immediate withdrawal of the causative agent. A beneficial effect of treatment with steroids on prognosis is not proven.
Zink
A
A
Stadtspital Triemli Zürich, Medizinische Klinik, Zürich, Schweiz.
Erni
S
S
Fliegner
M
M
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D017291:Clarithromycin / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000139:chemically induced* / Q000209:etiology; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy; D012883:Skin Ulcer / Q000139:chemically induced* / Q000209:etiology; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis
D000900:Anti-Bacterial Agents; D017291:Clarithromycin