Serum endocan reflects endothelial activation in cutaneous vasculitis

Aim: To assess whether serum endocan-an index of endothelial activation-is elevated in biopsy-confirmed cutaneous leukocytoclastic vasculitis (LCV), its correlations with CRP/ESR/NLR/SII, and its diagnostic performance by ROC analysis.Materials and Methods: In this cross-sectional case-control study, we enrolled 37 biopsy-confirmed LCV patients and 37 age-and sex-matched healthy controls.ELISA measured serum endocan.CRP, ESR, neutrophil-to-lymphocyte ratio (NLR), and the systemic immune-inflammation index (SII) were recorded.Diagnostic performance was assessed by ROC analysis.A prespecified multivariable linear regression adjusted for comorbidities and demographics (CKD, CVD, diabetes, inflammatory diseases, thyroid disorders, age, and sex).Results: Serum endocan levels were higher in LCV than in controls (p = 0.027).Endocan did not correlate with CRP, ESR, NLR, or SII (all p > 0.05).After multivariable adjustment, vasculitis status remained independently associated with higher endocan (small/borderline effect; adjusted R² = 0.042), and a sensitivity backward stepwise model confirmed a significant association (b = 3299.22pg/mL; 95% CI 93.56-6504.87;p = 0.044).ROC analysis showed moderate discrimination (AUC = 0.70); at a prespecified cut-off of > 1077 pg/mL, sensitivity was 49% and specificity 78%.Discussion: Serum endocan is elevated in LCV and appears to reflect localized endothelial activation rather than systemic inflammatory burden.Although its standalone diagnostic power is limited, endocan may serve as a complementary biomarker when interpreted alongside clinical and histopathological findings.