Can leukocytoclastic vasculitis be diagnosed without biopsy?

[annc999]

After weeks of having this non-itchy, non-burning, awfully ugly rash, I finally saw a dermatologist. He said it was leukocytoclastic vasculitis. Is it that easy to diagnose without biopsy?

All blood work came back normal (CBC, B12, Folate, TSH). Should I get additional blood work done and/or insist on a biopsy?

The only symptoms besides rash are night sweats and fatigue, but that might not be related.

[AndrewT]

I don't actually know, maybe John will know. Mind you a dermatologist should know, it's their job after all!

Best wishes anyway.

AndrewT

[notsossweets]

Since it's such a rare diagnosis, it's generally not the first diagnosis that physicians suggest. Biopsies are not always conclusive. And, I would recommend anyone getting a biopsy to insist on immunofluorescence on the sampled tissue. A CBC won't reveal all that much either. You'll need reticulocytes, ANA, CRP, ESR, among a host of others. That being said, there isn't one test that is conclusive. ANA and CRP, for example, don't mean a whole lot by themselves; they're merely indicators of inflammation. They're very non-specific beyond that. Don't freak out if one or both are high. It's the bigger picture you should focus on.

If YOU suspect vasculitis, do your research and applaud this physician! If you are unsure, do your research and ask questions. I would not dismiss a physician who throws out a diagnosis like this. S/he may have said it's a "possible" diagnosis, I'm hopeful that's the case given the limited information I and s/he has on your condition. The fact that s/he knows about vasculitis might suggest s/he is smarter than the average bear. I could be totally wrong, too. But, I've met way too many less than average bears.

Good luck with everything!

[annc999]

Thanks, Andrew and notsosweets. I have been on a topical cream for a few days, and the vasculitis seems to be disappearing. I assume it's common to go away and come back.

Some research says it's no big deal (the disease), but some says it can be very serious and attack the organs, etc. Is this something I just need to watch over time? They talk about underlying infections. Could a bacterial infection (recurring) be the beginning of the vasculitis?

Thanks for taking the time to respond.