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Cutaneous vasculitis: Treating inflammation

Cutaneous vasculitis refers to inflammation of the blood vessels (arteries, veins, or both) in the skin. Vasculitis (inflammation of the blood vessels) can occur anywhere in the body, but when it occurs on the skin, it is referred to as cutaneous. It is important to get a proper diagnosis because occasionally, cutaneous vasculitis can indicate inflammation in other organs. All of the possible causes need to be investigated.

vasculitis

What causes cutaneous vasculitis?

Vasculitis is not hereditary.

There are many causes of cutaneous vasculitis, but only around 50% of cases have an identified cause. Some of the common causes include:

  • Certain medications
  • Infections
  • Blood disorders
  •  Autoimmune disorders
  • Malignancy (cancer)

When cutaneous vasculitis is triggered, an immune response is induced. This immune response leads to inflammation mediators being produced. These mediators can damage the blood vessels’ walls. Fluid sometimes leaks out of the blood vessels and into the tissue surrounding the veins or arteries that are affected. As a result, it is common to see swelling, especially in the lower extremities around the feet, ankles, and legs.

Infections:

If cutaneous vasculitis occurs as a result of infection, the symptoms will become apparent around 7 – 10 days following a viral or bacterial infection.

Autoimmune diseases:

Arthritis, lupus, and other autoimmune diseases can cause cutaneous vasculitis. An autoimmune condition is when the body starts to attack its own healthy tissue. It is often linked to high inflammation levels.

Medications:

Antibiotics, anticonvulsants, diuretics, and non-steroidal anti-inflammatory agents are associated with vasculitis. It is important to start new medications with caution. If you are concerned that you may be experiencing side-effects, contact your doctor.

Malignancy/blood (hematologic) disorders:

Thickened blood and the presence of antibodies that damage cell walls are all typical symptoms of cancer or blood (hematologic) disorders.

What are the symptoms of cutaneous vasculitis?

Cutaneous small vessel vasculitis (CSVV) is one of the most common forms of vasculitis. This is when the finest blood vessels are affected.

  • It shows non-blanching (the skin doesn’t change colour when pressed).
  • Bruise-looking marks may also appear on the skin. They might be raised and lumpy. These marks are usually around a millimeter in size, up to a few millimetres. Occasionally, they may blister, form a pustule, or wheal which will heal darker in colour.
  • The marks are often not accompanied by any sensations, other times they may cause itching, burning, or pain.
  • The sensations are typically felt in sensitive points on the body – the back of the feet, pressure points on the knees, and also the ankles, and lower legs.
  • When vasculitis affects medium-sized blood vessels the symptoms may be more pronounced. The lumps will be larger and more pronounced, there will be more discolouration (in a network-like shape), and ulceration.

Symptoms that indicate some other organs are involved include the following:

  • Fever
  • Nausea
  • Vomiting
  • Chest pain
  • Breathlessness/coughing
  • Blood in urine/stool
  • Joint weakness and pain
  • Muscle pain
  • Abdominal pain/cramps

How is cutaneous vasculitis diagnosed?

Dr. Khoza can diagnose this condition by looking at the skin. In some cases, she may take a skin biopsy. Dr. Khoza will check your blood pressure, request a urine sample, and take a blood sample for testing. A blood test is necessary to check if there are blood abnormalities, infection, or autoimmune conditions.

In rare cases, a scan may be done to rule out the possibility of vasculitis in other organs.

How is cutaneous vasculitis treated?

First, we will rule out any underlying triggers. Infection can be triggered by a medication. In this instance, that would need to be addressed.

Treating the condition also includes:

  • Leg elevation
  • Rest
  • Pain medication (analgesics)
  • Antihistamines
  • Anti-inflammatory drugs (non-steroidal)
  • Topical steroid applications
  • Oral corticosteroids

The medications you receive will address your symptoms, some people may need a few of the above remedies while others may require fewer. It also depends on the severity of the condition – in some cases, Dr. Khoza may also suggest immunotherapy drugs.

The outcome:

Generally, the condition can be cured provided it is only present in the skin. 90% of cases are resolved with a comprehensive treatment plan. Some of the symptoms may last, severe cases may see the affected areas affected by pigmentation (either lighter or darker skin tone). After a few months, it may return to normal again.

The effects of cutaneous vasculitis can be far-reaching, it is important to address the issue early. You can get the help you need at our friendly consulting rooms, just give us a call and book your appointment: 031 581 2543

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