Leucocytoclastic vasculitis as onset symptom of ulcerative colitis

Leucocytoclastic vasculitis is a disease whose histopathological features are inflammation of postcapillary venules with neutrophilic infiltration and nuclear debris.1 It is believed to be an immune complex disease triggered by a large array of drugs, chemicals, infections, malignancies, and systemic and autoimmune diseases.2 Various skin manifestations can be associated with inflammatory bowel disease (IBD),3 and IBD can become a diagnostic challenge when cutaneous vasculitis precedes the intestinal disease. Here, we report a case of ulcerative colitis in which the onset symptom was skin leucocytoclastic vasculitis while intestinal illness became overt two years later. A 22 year old male patient was referred to our rheumatology unit because of a two year history of skin lesions on his legs. His family history was negative for rheumatic, skin, and bowel diseases. On admission to the hospital, a macular dark red eruption on the skin of both legs was present. These lesions, with a diameter of 1–2 cm, were non-blanching, slightly itching, with a scabby evolution, and healed with scar formation and skin hyperpigmentation. Skin outbreak had a recurrent course. …