To the Editor.—
Recently, Cupps et al summarized their clinical experience with chronic vasculitis in 13 patients (1982;247:1994). In an accompanying editorial, Ehrlich (1982;247:2010) has lauded the study for its methods, which allow prognostic and therapeutic clinical information to be gained. Although I agree with the conclusions that therapy is difficult, and that patients have few or no laboratory or systemic abnormalities, the way in which the conclusions have been reached is not logical. This study lumps together patients with leukocytoclastic vasculitis and those with lymphocytic or mixed-cell vasculitis. Thus, with this hetergeneous histological picture, it is not surprising that few systemic symptoms are found. Lymphocytic perivasculitis is rarely if ever complicated by internal disease, whereas leukocytoclastic vasculitis is more frequently associated with laboratory and systemic abnormalities.1 Also, this is a small sample size from which to draw conclusions. A larger sample size, containing patients with a uniform histological
Callen JP. Chronic, Recurrent Small-Vessel Cutaneous Vasculitis. JAMA. 1982;248(10):1181. doi:10.1001/jama.1982.03330100021022
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