Cutaneous Vasculitis - Types | Causes | Symptoms | Diagnosis | Treatment
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Cutaneous Vasculitis - Types, Causes, Symptoms, Diagnosis, and Treatment

Published on Feb 25, 2022 and last reviewed on Aug 23, 2023   -  4 min read

Abstract

Cutaneous vasculitis is a condition affecting the skin. Read this article to know more about the symptoms, causes, diagnosis, and treatment of cutaneous vasculitis.

Cutaneous Vasculitis - Types, Causes, Symptoms, Diagnosis, and Treatment

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 such type affecting 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 being affected, this condition can present in the form of 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, then there might be symptoms such as fever, pain in joints, 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 in response to any infection or connective tissue disorders. It might also happen as a result of 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 be harmful to the skin, resulting in cutaneous vasculitis. The main cause of skin manifestation is fungal infections. Antifungal agents should be topically used by these patients under proper recommendations from your doctor. In some cases, cutaneous vasculitis occurs as a result of 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, further ending up in cutaneous vasculitis.

What Are the Types of Cutaneous Vasculitis?

The different types of cutaneous vasculitis are:

  • 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.

  • 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.

  • Hypersensitivity Vasculitis:

Hypersensitivity vasculitis occurs due to the 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 tests 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 by taking a full blood count test. This blood count test will help you to determine the actual cause of the disease.

  • Liver Function Test: To identify hepatic involvement, a liver function test is recommended by the doctor. This test measures the level of particular enzymes and protein present in the blood.

  • 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 cause is identified by the above diagnostic procedures, 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, that are:

  • 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.

  • Antineutrophil Cytoplasmic Antibodies (ANCA): This test will help the doctor in diagnosing autoimmune vasculitis.

Identification of rheumatoid factors will help;

  1. The percentage of cryoglobulins should be identified.

  2. 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.

  • Skin Biopsy: A biopsy specimen is collected from the patient. A biopsy is necessary to confirm the diagnosis for cutaneous vasculitis. Biopsy specimens should be at least 24 hours to 48 hours old in order 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 you are taking any medications that are causing infection, then you should probably stop consuming those medications. Treatment procedures include:

  • Elevation of the legs and adequate rest is the first and foremost thing required for treatment. In case of severe pain, analgesics might be prescribed by a doctor.

  • Topical application of steroids can be made to the skin lesions. In the case of severe ulcerated cases, the dressing should be done.

  • Non-steroidal anti-inflammatory drugs (NSAIDs) are given if the patient is not known to have any kidney problems.

  • Antihistamines.

  • If the symptoms of cutaneous vasculitis keep prolonging, medications such as Dapsone and oral corticoids might be required. In the case of severe and complicated lesions, immunotherapy is mandatory for the patient.

How Is the Prognosis for Cutaneous Vasculitis?

In most cases, complete recovery is possible. In some patients, there will be recurrence after the initial episode. Even after complete healing, there may be hyperpigmentation presenting with black and brown shades. This discoloration on the skin takes a long time to fade away. If you are a person who is more concerned about esthetics, then you should probably consult a cosmetic surgeon.

Do you have similar symptoms? Call a doctor online and feel free to discuss it with the doctor.

Frequently Asked Questions


1.

What Causes Cutaneous Vasculitis?

The causes of cutaneous vasculitis are infections such as hepatitis B and hepatitis C, blood cancers, immune system diseases like rheumatoid arthritis, scleroderma, and reactions to certain drugs.

2.

What Are the Signs of Cutaneous Vasculitis?

A purple or reddish rash over the legs, buttocks, and sometimes the upper body is a common symptom of cutaneous vasculitis. Hives, blisters, and open wounds are also possible. When cutaneous vasculitis affects the entire body, the joints, gastrointestinal tract, and kidneys are also affected.

3.

Is Cutaneous Vasculitis Curable?

Cutaneous vasculitis is a serious condition that, if left untreated, can lead to organ failure. It is usually treated with steroids or other medications that suppress the immune system.

4.

How Does Cutaneous Vasculitis Affect?

Any type of primary or secondary vasculitis can affect the skin, including serum sickness, infections like cancers, rheumatologic or other autoimmune disorders, and drug hypersensitivity.

5.

How Long Does Cutaneous Vasculitis Last?

Most idiopathic cutaneous, small vessel vasculitis cases are self-limiting, with 90 percent of cases resolving within weeks to months of onset. Otherwise, treatment is determined by the severity of the disease and can range from an oral corticosteroid to a variety of steroid-free immunosuppressive agents.

6.

What Foods to Avoid for Cutaneous Vasculitis?

Reduce the intake of starchy foods such as bread, potatoes, rice, and pasta, and replace them with fresh fruits and vegetables. Also, avoid eating processed foods and meat raised on grains.

7.

How to Cure Cutaneous Vasculitis?

Colchicine and dapsone are first-line treatments for mild recurrent or persistent disease. Severe cutaneous disease necessitates systemic corticosteroids or stronger immunosuppression like Azathioprine, Methotrexate, and Cyclophosphamide.

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Last reviewed at:
23 Aug 2023  -  4 min read

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