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What is the treatment of cuteneous vasculitis?

Q: Is there any treatment for cutaneous vasculitis?

A:Cutaneous vasculitis is a broad group of disorders. The treatment depends upon the type of vasculitis. The term vasculitis refers to inflammation and necrosis of blood vessels. The vasculities are best classified according to the size of the involved vessels into large, medium and small vessel vasculitis. Classification of the vasculitides A. Large vessel vasculitis 1. Giant cell arteritis 2. Takayasu arteritis B. Medium- sized vessel vasculitis 1. Kawasaki disease 2. Polyarterites nodosa (PAN) 3. Benign cutaneous PAN C. Small vessel vasculitis 1. Henoch-Schönlein purpura 2. Cutaneous leukocytoclastic angiitis 3. Microscopic polyangiitis 4. Wegeners granulomatosis 5. Churg - Strauss syndrome The identification of a vasculitic disorder may not always be easy because of the varied clinical presentations. More than one system is often involved and the manifestations can, therefore, be very heterogenous. However, there are some clinical pointers that may suggest the presence of a vasculitic disorder. These are- 1. Prolonged fever of unknown origin 2. Suggestive skin lesions e.g. palpable purpura, gangrene 3. Unexplained peripheral neuropathy especially mononeuritis multiplex 4. Arthralgia/arthritis, myositis, serositis 5. Obscure pulmonary, cardiovascular or renal disease especially when there is multi-system involvement 6. Laboratory parameters indicative of ongoing inflammation: e.g. leukocytosis, elevated ESR/CRP, eosinophilia, hypocomplementemia, cryoglobulinemia, circulating immune complexes. Kawasaki disease and Henoch-Schonlein purpura are the commonest vasculitides seen in children while giant cell arteritis, polyarteritis nodosa and Wegeners granulomatosis are more common in the adults. Early diagnosis and prompt treatment (with corticosteroids or immunosuppressive drugs) can go a long way in decreasing the morbidity and mortality associated with these disorders.


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