Q: I am a 27 years old female diagnosed with small blood vessel vasculites on the skin two years back. Sores started developing on the skin on both sides of the ankle. I am taking Wysolone (20 mg) for the last two years and Endoxan (50 mg) for the past one month. But for the last three months, the problem has aggravated. I can see fluid getting formed and there is pain which feels like needle pinching. I underwent tissue typing and immuno pathology tests (indirect immunoflurescence technique), which showed anti-nuclear antibody / ANA / ANF - ++Nuclealar 1:40 DIL, anti-native DNA (nDNA/dsDNA) is negative 1:10 DIL and anti-neutrophil cytoplasmic antibody (ANCA) is also negative 1:20 DIL. A histopathology test showed skin with an underlying superficial blood vessels showing mild perivascular round cell infiltrate along with luminal RBC's and mild vessel wall thickening. No definite fibrinoid necrosis is seen. No vessel wall infiltration by neutrophils is seen. Deeper sections reveal luminal fibrin thrombi with surrounding perivascular inflammatory cells. Mild vessel wall thickening is also seen. Immunoflurescence stains show fluorescence of C3c in the dermal vessels. Recently, I underwent complete blood count, and all came normal except ESR (1/2 hour) is 40 mm and 1 hour is 78 mm. I am experiencing pain and swelling in leg for the last one month. The doctor gave AFX forte to reduce the infection. How can vasculitis be treated?

A:Vasculitis can result from a number of factors. Some of these can be serious and sometimes very banal. Besides skin, other parts of the body may also be involved, the severity and extent may vary from individual to individual. The prognosis thus varies and cannot be predicted accurately. The aim of the treatment/management is to give optimum relief from minimal medication, investigate to rule out any serious underlying disorder (and if present treat it accordingly), establish baseline values for monitoring the effect of drugs and the progress of disease.