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The Cutting Edge: Challenges in Medical and Surgical Therapies
Aug 2012

Treatment of Severe Cutaneous Small-Vessel Vasculitis With Mycophenolate Mofetil

Arch Dermatol. 2012;148(8):887-888. doi:10.1001/archdermatol.2011.3037

Antineutrophilic cytoplasmic antibody (ANCA)-negative, cutaneous, small-vessel vasculitis (CSVV) is a well-described disease with a variety of treatment options. Mycophenolate mofetil (MMF) is an often-used immunosuppressive drug for inflammatory ailments. Herein we describe the first case of ANCA-negative CSVV treated successfully with MMF.

A 46-year-old man presented with a 5-week history of painful purpuric ulcerative lesions on his legs (Figure 1). A skin biopsy specimen taken by his referring physician exhibited perivascular infiltration of polymorphonuclear leukocytes, fibrinoid deposition on the vessel walls, and extravasation of erythrocytes that was diagnostic of small-vessel vasculitis (leukocytoclastic vasculitis). No involvement of the deep dermis or subcutaneous tissue was noted in the pathology report. A prior 10-day course of prednisone had proven ineffective.