What Is Vasculitis?
Vasculitis is a condition where the blood vessels are inflamed. The blood vessels include arterioles, capillaries, venules, and lymphatics. There are various types of vasculitis. Cutaneous vasculitis is one type that affects the skin.
What Is Cutaneous Vasculitis?
There are different causes for the occurrence of cutaneous vasculitis. It is mostly associated with systemic problems. Since the blood vessels are affected, this condition can present as ulcers, purpura, and nodules. This condition cannot be left untreated because the inflamed blood vessels, when left untreated can further lead to the dilation and collapse of the blood vessels. Hence it will result in the loss of blood supply, leading to severe organ damage.
What Are the Symptoms of Cutaneous Vasculitis?
The first and foremost sign of cutaneous vasculitis is the appearance of purplish or reddish lesions on the legs. It may occur in other parts of the skin. There might also be purpura, ulcers, nodules, and livedo reticularis. If there is any systemic involvement, there might be symptoms such as fever, joint pain, arthralgia, etc. Some lesions look like small spots, but some lesions resemble large bruises. It might recur at regular intervals during the initial episodes.
What Are the Causes of Cutaneous Vasculitis?
The actual reason for the occurrence of cutaneous vasculitis is not known. Some doctors say that cutaneous vasculitis occurs due to infection or connective tissue disorders. It might also happen due to adverse reactions to a few medications. The presence of cancerous cells can also lead to cutaneous vasculitis. The medications causing this condition are Penicillin or Sulfa drugs. Any changes in the environment might also cause this condition. Exposure to dangerous toxins can harm the skin, resulting in cutaneous vasculitis. The main cause of skin manifestation is fungal infections. These patients should topically use antifungal agents under proper recommendations from your doctor. In some cases, cutaneous vasculitis occurs due to an abnormal autoimmune response. When an autoimmune disorder is present, the body's natural defense begins to act against the healthy tissues of the body. This might also be the cost of hypersensitivity reactions, resulting in cutaneous vasculitis.
How Can Cutaneous Vasculitis Be Classified?
Cutaneous Vasculitis can be classified based on severity as:
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Benign
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Self-limited.
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Short-course skin eruption to life.
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Threatening disease with multiple organ failure.
What Are the Types of Cutaneous Vasculitis?
The different types of cutaneous vasculitis are:
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Cutaneous Small-Vessel Vasculitis:
This type affects the small vessels and skin. Internal organs are not affected by this type. The occurrence of cutaneous small-vessel vasculitis is not known. So, it is also referred to as idiopathic cutaneous small-vessel vasculitis.
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Leukocytoclastic Vasculitis:
This typically occurs due to the defect in the neutrophils. This results in an inflammatory condition. After inflammation, degranulation occurs, resulting in the deposition of nuclear debris. This unwanted deposition happens in the vessel walls.
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Hypersensitivity Vasculitis:
Hypersensitivity vasculitis occurs due to an allergic reaction caused by a drug. This might also result from an infection. Both medicines and infections tend to create a hypersensitivity reaction.
How Is Cutaneous Vasculitis Diagnosed?
The diagnosis of cutaneous vasculitis requires urine and blood tests, but a proper case history and clinical examination of the skin lesions might be sufficient in most cases. Your doctor will perform a physical examination of the skin lesions and identify the cause of the condition. Another option of diagnosis is to take a full blood count test. This blood count test will help you determine the actual cause of the disease.
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Liver Function Test: A liver function test is recommended by the doctor to identify hepatic involvement. This test measures the level of particular enzymes and proteins present in the blood.
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Urine Analysis: Urine analysis is done to check for hematuria and proteinuria. This might indicate a defect in the functioning of the renal system.
If the above diagnostic procedures identify the cause, the doctor will continue the treatment plan. In case the cause of cutaneous vasculitis is still not obvious, the doctor will proceed with further diagnostic procedures, which are:
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Antinuclear Antibody Test (ANA): This test is an important diagnostic procedure to identify the presence of autoimmune disorders that might disturb the normal functioning of tissues and organs.
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Antineutrophil Cytoplasmic Antibodies (ANCA): This test will help the doctor diagnose autoimmune vasculitis.
Identification of rheumatoid factors will help;
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The percentage of cryoglobulins should be identified.
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The presence of Hepatitis B and Hepatitis C should be identified because it is known to be associated with certain forms of vasculitis. Sometimes HIV (human immunodeficiency virus) is also known to be associated with cutaneous vasculitis.
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Skin Biopsy: A biopsy specimen is collected from the patient. A biopsy is necessary to confirm the diagnosis of cutaneous vasculitis. Biopsy specimens should be at least 24 to 48 hours old to show the most relevant diagnostic details.
What Are the Treatment Options for Cutaneous Vasculitis?
The exact cause should be identified for a proper treatment plan. If taking any medications causes an infection, stop consuming those medications.
Treatment procedures include:
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Elevation of the legs and adequate rest are the first and foremost requirements for treatment. In cases of severe pain, a doctor might prescribe analgesics.
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Topical steroids can be applied to skin lesions. In severe ulcerated cases, a dressing should be applied.
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Non-steroidal anti-inflammatory drugs (NSAIDs) are given if the patient is not known to have any kidney problems.
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Antihistamines.
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If the symptoms of cutaneous vasculitis continue to prolong, medications such as Dapsone and oral corticoids might be required. In the case of severe and complicated lesions, immunotherapy is mandatory.
Conclusion
In most cases, a complete recovery is possible. In some patients, there will be a recurrence after the initial episode. Even after complete healing, hyperpigmentation may present in black and brown shades. This discoloration on the skin takes a long time to fade away. If a person is more concerned about esthetics, consult a cosmetic surgeon.
