# Systemic Involvement of Leukocytoclastic Vasculitis in Skin of Color

## TL;DR

This paper presents a rare case of leukocytoclastic vasculitis in a patient with dark skin, showing how the condition can affect multiple organs.

## Contribution

The paper highlights the systemic and multi-organ presentation of LCV in a patient with Fitzpatrick phototype V skin.

## Key findings

- The patient exhibited a rash, respiratory symptoms, muscle weakness, hemoptysis, and decreased visual acuity.
- Skin biopsy confirmed LCV with eosinophilia, requiring multidisciplinary treatment.
- The case emphasizes the need for broad differential diagnosis in systemic LCV presentations.

## Abstract

Leukocytoclastic vasculitis (LCV) is an immune-mediated small-vessel vasculitis with various underlying causes. We present a unique case of LCV in an elderly man with Fitzpatrick phototype V skin to highlight multi-organ signs associated with this rare pathology. Our patient presented with an evolving, diffusely spread rash following respiratory symptoms accompanied by muscle weakness, scant hemoptysis, and decreased visual acuity. A comprehensive diagnostic approach, including skin biopsy, revealed LCV with associated eosinophilia. Treatment through a multidisciplinary approach included systemic steroids, topical ointments, and empiric antibiotics. The patient showed gradual improvement and was discharged after nine days of hospitalization. Differential diagnoses for the rash included infections, inflammatory processes, and autoimmune vasculitides such as immunoglobulin A (IgA) vasculitis, urticarial vasculitis, cryoglobulinemic vasculitis, and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides. While most instances of LCV are typically skin-limited and self-resolving, this case highlights diffuse systemic involvement requiring a broad diagnostic perspective.