Chapter 17
Cutaneous Small Vessel Vasculitis including Urticarial Vasculitis

https://doi.org/10.1016/S1571-5078(05)05017-8Get rights and content

Publisher Summary

Vasculitis refers to inflammation and necrosis of blood vessels, whether they are arteries, veins or both. It can be local or systemic, and may be primary or secondary to another disease process. The classic cutaneous manifestation of vasculitis is palpable purpura; however, the clinical manifestation greatly depends on the size of the vessel affected. Leukocytoclastic vasculitis is a pathological description used to describe inflammation of post-capillary venules and is clinically more correctly termed “cutaneous small vessel vasculitis (CSVV).” CSVV occurs equally in both sexes and at all ages. It is estimated that 10% of affected patients are children. The histopathologic pattern is that of a leukocytoclastic vasculitis—angiocentric, segmental inflammation with nuclear dust, endothelial-cell swelling, and fibrinoid necrosis. The American College of Rheumatology (ACR) has proposed criteria for the diagnosis of hypersensitivity vasculitis, which corresponds to CSVV.

Section snippets

Prevalence

Incidence and prevalence of UV is unknown. Of patients with urticarial lesions, roughly 5–10% have UV (Black, 1999; Wisnieski, 2000).

Epidemiology

In the hypocomplementemic type, UV

References (73)

  • P. Lamprecht

    TNF-alpha inhibitors in systemic vasculitides and connective tissue diseases

    Autoimmun. Rev.

    (2005)
  • N.P. Sanchez et al.

    The clinical and histopathologic spectrums of urticarial vasculitis: study of forty cases

    J. Am. Acad. Dermatol.

    (1982)
  • M.L. Smith et al.

    Rheumatoid papules: lesions showing features of vasculitis and palisading granuloma

    J. Am. Acad. Dermatol.

    (1989)
  • K.L. Barham et al.

    Vasculitis and neutrophilic vascular reactions

  • H.M. Belmont et al.

    Pathology and pathogenesis of vascular injury in systemic lupus erythematosus. Interactions of inflammatory cells and activated endothelium

    Arthritis Rheum.

    (1996)
  • R.E. Berg et al.

    Urticarial vasculitis

    Int. J. Dermatol.

    (1988)
  • R. Blanco et al.

    Cutaneous vasculitis in children and adults. Associated diseases and etiologic factors in 303 patients

    Medicine (Baltimore)

    (1998)
  • O. Braun-Falco et al.

    Dermatology

    (1991)
  • S. Burge

    The management of cutaneous vasculitis

  • G. Campanile et al.

    Clinical aspects of cutaneous necrotizing vasculitis

    Int. Angiol.

    (1995)
  • X. Chevalier et al.

    Seronegative leukocytoclastic vasculitis preceding the onset of disseminated systemic lupus erythematosus

    Rev. Rheum. Mal. Osteoartic.

    (1990)
  • C. Comacchi et al.

    Vasculite necrotizzante cutanea

    G. Ital. Dermatol. Venereol.

    (1998)
  • C. Comacchi et al.

    Vasculite necrotizzante cutanea

    G. Ital. Dermatol. Venereol.

    (1998)
  • E.L. Dubois et al.

    Clinical and laboratory manifestations of systemic lupus erythematosus

  • E. Ekenstam et al.

    Cutaneous leukocytoclastic vasculitis. Clinical and laboratory features of 82 patients seen in private practice

    Arch. Dermatol.

    (1984)
  • D. Estes et al.

    The natural history of systemic lupus erythematosus by prospective analysis

    Medicine (Baltimore)

    (1971)
  • I. Ghersetich et al.

    Working classification of vasculitis

    Int. Angiol.

    (1995)
  • M.A. Gonzalez-Gay et al.

    Clinical approach to cutaneous vasculitis

    Curr. Opin. Rheumatol.

    (2005)
  • R.G. Gray et al.

    Necrotizing vasculitis as the initial manifestation of rheumatoid arthritis

    J. Rheumatol.

    (1983)
  • T.P. Habif

    Clinical Dermatology

    (1990)
  • C. Hannon et al.

    Vasculitis

  • P.G. Hazen et al.

    Management of necrotizing vasculitis with colchicine. Improvement in patients with cutaneous lesions and Behcet's syndrome

    Arch. Dermatol.

    (1979)
  • G.G. Hunder et al.

    The American College of Rheumatology, Criteria for the classification of vasculitis

    Introduction. Arthritis Rheum.

    (1990)
  • D.J. Ioannidou et al.

    Cutaneous small vessel vasculitis

    An entity with frequent renal involvement. Arch. Dermatol.

    (2002)
  • J.L. Jorizzo

    Behcet's disease. An update based on the 1985 International Conference in London

    Arch. Dermatol.

    (1986)
  • J.L. Jorizzo

    Classification of vasculitis

    J. Invest. Dermatol.

    (1993)
  • View full text