Management of Primary Small-Vessel Vasculitis

Crystal E. Nwannunu, BS; Radhika Shah, BS, MS; Allison L. Limmer, BS, BA; Ravi R. Patel, MD; Uyen Ngoc Mui, MD; Stephen K. Tyring, MD

Disclosures

Skin Therapy Letter. 2020;25(3):5-8. 

In This Article

Abstract and Introduction

Abstract

Small-vessel vasculitides (SVV) are a group of disorders that occur due to primarily systemic inflammation or as sequelae of an infection, malignancy, or other rheumatic disease. Arising in any organ including the skin, the clinical features of SVV encompass a variety of manifestations. A comprehensive diagnostic assessment should be performed as management protocols widely differ. Although rare, physicians should be familiar with the common types of SVV to ensure prompt management and prevention of severe, life-threatening end-organ damage. Given the variable manifestations and associated etiologies of SVV, the following review aims to discuss the pathogenesis of more prevalent SVVs, highlight distinguishing features to aid in patient evaluation and diagnosis, and examine evidence-based management options for treatment and care.

Introduction

Vasculitis is defined as inflammation of blood vessel walls.[1] Such inflammation manifests as thickening, weakening, narrowing, or scarring of the vessels, leading to restricted blood flow and tissue damage. Vasculitides can occur in any organ, including the skin, and can present with a variety of clinical symptoms.[2] This broad spectrum of disease is most often classified by the size of the blood vessel involved.[1,2] Small-vessel vasculitis, the focus of our review, is a disease subtype that targets arterioles, venules, and capillaries.[2] Given this disease's variable manifestations and associated etiologies, the following review aims to discuss the pathogenesis of common primary small-vessel vasculitides (SVV), highlight distinguishing features to aid in patient evaluation and diagnosis, and define evidence-based management options for patient treatment and care.

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