Page 395 - The Vasculitides, Volume 1: General Considerations and Systemic Vasculitis

In: The Vasculitides, Volume 1 ISBN: 978-1-63463-110-5
Editors: David S. Younger © 2015 Nova Science Publishers, Inc.

Chapter 19

Dermatologic Aspects of
Systemic Vasculitis

Rami N. Al-Rohil, M.B., B.S. and J. Andew Carlson, M.D., F.R.C.P.?

Department of Pathology, Division of Dermatology and Dermatopathology,
Albany Medical College, Albany, NY, US

Abstract

Systemic and localized vasculitis affects the skin and subcutis due to their large
vascular bed, as well as, hemodynamic factors such as stasis in lower extremities, and
environmental influences as occurs in cold exposure. The initial cutaneous manifestations
of vasculitides include diverse and dynamic patterns of discoloration, swelling,
hemorrhage, and necrosis. One-half of affected patients present with localized, self-
limited disease to the skin without any known trigger or associated systemic disease,
known as idiopathic cutaneous leukocytoclastic vasculitis. Cutaneous vasculitis manifests
as urticaria, erythema, petechiae, purpura, purpuric papules, hemorrhagic vesicles and
bullae, nodules, livedo racemosa, deep punched out ulcers and digital gangrene. Skin
biopsy and dermatopathology contribute relevant information however they require
correlation with the clinical history, physical exam and laboratory findings in order to
reach an accurate diagnosis in a given affected patient.

Introduction

Systemic and localized vasculitis affects the skin and subcutis due to their large vascular
bed, as well as hemodynamic factors such as stasis in lower extremities, and environmental
influences as occurs in cold exposure. The initial cutaneous manifestations of vasculitides
include diverse and dynamic patterns of discoloration, swelling, hemorrhage, and necrosis.
One-half of affected patients present with localized, self-limited disease to the skin without

? Address Correspondence to: J. Andrew Carlson, M.D., F.R.C.P.C., Divisions of Dermatology and
Dermatopathology, Albany Medical College MC-81, Albany, NY 12208. E-mail: [email protected]

Complimentary Contributor Copy