What is cutaneous vasculitis?
Vasculitis means inflammation inside the walls of blood vessels. Cutaneous vasculitis refers to inflammation in blood vessels found within layers of skin. When blood vessels become inflamed, they can become leaky or can close off. This may lead to symptoms such as purple spots on the skin (purpura), lumps (nodules), and breaks in the skin (ulcers).
Who gets cutaneous vasculitis?
Cutaneous vasculitis occurs in both men and women and can affect children and adults. People all over the world can get cutaneous vasculitis.
What causes cutaneous vasculitis?
There are many different causes of cutaneous vasculitis, and sometimes the cause is unknown. Certain medications or toxins can trigger cutaneous vasculitis. Some people experience cutaneous vasculitis as an isolated symptom, or cutaneous vasculitis can occur in the context of a disease that may cause other symptoms throughout the body.
How is cutaneous vasculitis diagnosed?
Cutaneous vasculitis can have a distinct appearance. A doctor with knowledge about cutaneous vasculitis can often examine your skin to determine if an abnormality looks like cutaneous vasculitis. Often, a skin biopsy will be performed to confirm a suspected diagnosis of skin vasculitis. During a skin biopsy, a small piece of tissue is removed from the skin. A pathologist will examine the tissue under a microscope to determine if there is inflammation within the blood vessels contained within the tissue specimen. Cutaneous vasculitis can involve blood vessels that are just underneath the skin as well as deeper vessels in skin. Skin biopsies should be performed by a doctor with experience in diagnosing cutaneous vasculitis to make sure an adequate sample of tissue is collected.
What is the treatment for cutaneous vasculitis?
Triggering factors for cutaneous vasculitis can sometimes be identified, such as some drug or food intake, alcohol ingestion, long periods of standing up, especially in a warm and humid environment. Avoiding these factors can help and limit the risk of recurrence. In other cases, cutaneous vasculitis is a component of a more systemic disease, whose treatment will, most of the time, also be effective for the skin lesions. When there is no obvious cause or in case of recurrent, isolated cutaneous vasculitis, systemic treatments can be considered. Different agents can be tried, including short courses of oral corticosteroids, colchicine, hydroxychloroquine, dapsone, pentoxifylline, indomethacin, azathioprine, methotrexate, mycophenolate mofetil and leflunomide. The efficacy of each of these agents varies between patients and, in the absence of large studies on cutaneous vasculitis, one cannot predict which one may be the best, without trying them successively until finding one that limits the frequency and/or intensity of the flares. All these medications can cause side effects and their use must be balanced with the relative benignity of isolated cutaneous vasculitis. Local treatments with ointments or dermocorticoids have no place but can help when lesions are itchy.