title: Cutaneous small-vessel vasculitis associated with solid organ malignancies: the Mayo Clinic experience, 1996 to 2009.
abstract: BACKGROUND
  Although rare, cutaneous small-vessel vasculitis (CSVV) secondary to solid organ malignancy has been documented.
  
  
  OBJECTIVE
  We sought to better understand the frequency, clinical course, therapeutic response, and outcome of CSVV associated with solid organ malignancy.
  
  
  METHODS
  We conducted a retrospective chart review of patients seen between 1996 and 2009 with diagnoses of biopsy-proven cutaneous leukocytoclastic vasculitis and solid organ malignancy separated by less than 12 months.
  
  
  RESULTS
  Of 17 patients (mean age, 66.5 years), 10 patients (59%) were male. CSVV occurred before (3 patients; 18%), concurrent with (3 patients; 18%), and after (11 patients; 65%) diagnosis of solid organ malignancy. The most common solid organ malignancy was of the lung (n = 4; 24%). Other associated cancers were breast (n = 3); prostate (n = 2); colon (n = 2); renal (n = 2); thyroid (n = 1); bladder (n = 1); gallbladder (n = 1); and peritoneal (n = 1). Three patients had cutaneous vasculitis in association with malignancy recurrence despite having no cutaneous vasculitis associated with their primary malignancy. Vasculitis remission with use of immunosuppressive agents alone occurred in 9 patients (53%). Eleven patients (65%) were alive at last follow-up (mean follow-up duration, 27 months).
  
  
  CONCLUSIONS
  This was a retrospective study with a relatively small number of patients.
  
  
  CONCLUSIONS
  Solid organ malignancy should be considered as a possible cause of CSVV of unknown origin. In contrast to previous reports, our patients were more likely to respond to immunosuppressive therapies without treatment of the associated malignancy and to be alive at last follow-up.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Joshua O
authors.initials: JO
authors.lastname: Podjasek
authors.forename: David A
authors.initials: DA
authors.lastname: Wetter
authors.forename: Mark R
authors.initials: MR
authors.lastname: Pittelkow
authors.forename: David A
authors.initials: DA
authors.lastname: Wada
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000150:complications / Q000188:drug therapy / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents