Colchicine for Skin Involvement in Immunoglobulin A Vasculitis: A Single-Center Case Series and Review of the Literature

BACKGROUND: Immunoglobulin A vasculitis (IgAV) is a systemic small-vessel vasculitis characterized by palpable purpura, often accompanied by joint, gastrointestinal, and/or renal involvement. Although cutaneous manifestations are usually mild and self-limited, they can occasionally present as persistent, severe, or recurrent skin lesions. OBJECTIVES: To assess the efficacy and safety of colchicine in the treatment of complicated cutaneous manifestations of IgAV. METHODS: We conducted a retrospective chart review of patients treated with colchicine for skin manifestation of IgAV at our vasculitis clinic. This was complemented by a search of the PubMed and MEDLINE databases to identify additional reported cases. RESULTS: A total of 30 cases were included, comprising 13 from our institution and 17 from the literature. Indications for colchicine use were persistent purpura lasting more than 4 weeks (n = 18), severe skin involvement including bullae, ulcerations, or widespread purpura (n = 9), and recurrent lesions after a symptom-free interval of at least 1 month (n = 8). Colchicine led to clinical improvement in 90% of patients (27/30), with complete resolution in 67% (20/30). All 12 patients treated with colchicine monotherapy responded favorably. Doses ranged from 0.6 to 1.8 mg/day, and the time to response varied from a few days to 3 months. No adverse effects were reported. CONCLUSIONS: Colchicine appears to be a safe and effective treatment for persistent, severe, or recurrent cutaneous manifestations of IgAV. These findings support its use in clinical practice and highlight the need for prospective controlled studies.