Cutaneous lymphocytic vasculitis is defined as the localized inflammation of the blood vessel due to infiltration of blood vessel walls with lymphocytes. This can cause raised skin welts and rashes that can be quite painful and tender. Normally, the affected area remains darkened even after the lesions are already resolved.
Causes and Risk Factors
Cutaneous lymphocytic vasculitis can be caused by several factors. But in most cases, the underlying cause is unknown and the disease may be self-limiting. There are also cases where it can be part of a more severe type of vasculitis, the systemic vasculitis.
Inflammatory response can occur within the blood vessel wall through three known mechanisms. These mechanisms include:
- Direct injury to the blood vessel wall by viruses or bacteria
- The activation of antibodies, causing an indirect injury with associated inflammation
- Indirect damage because of the activation of complement, a group of proteins in the blood and tissue fluids that attack foreign bodies causing infection
Drugs are also common causes of lymphocytic vasculitis. The medications that are common causes of vasculitis are antibiotics, thiouracil, thiazide diuretics, oral anticoagulants, and nonsteroidal anti-inflammatory drugs. The vasculitis normally clears up when these responsible medications are stopped.
Reduced blood flow can also cause cutaneous vasculitis. Malignancy is also another cause. As the body gets rid of malignant cancer cells, it produces more antibodies in the bloodstream. The release of extra protein to make the blood more viscous can result to vasculitis.
Signs and Symptoms
The signs and symptoms of cutaneous lymphocytic vascuilitis are pain, tenderness, purpura or the appearance of red or purple skin discolorations, and raised skin patches. In some cases, increased pigmentation can also be observed.
The diagnosis of cutaneous lymphocytic vasculitis can be made on the basis of the appearance of the skin without the need for any further tests. Nevertheless, there are cases where a skin biopsy is required to verify the diagnoses. However, the cause can never be explained by this biopsy test in most cases. It should be understood that vasculitis is the common endpoint of many events inside the body. In investigating possible causes, screening tests can also be recommended to determine the extent of the involvement of internal organs.
One of the general measures to treat cutaneous lymphocytic vasculitis is to keep the patient comfortable until the resolution of the rash. Rest is required and analgesics can also provide relief. One should also protect the affected skin from injury.
With proper diagnosis and identification of the main cause of the vasculitis, removing the trigger will normally clear the rash. When the patient experiences a more persistent problem with the skin, corticosteroids, colchicine, non-steroidal inflammatory drugs, dapsone, and hydroxychloroquine can be employed to clear the rash.
Cutaneous lymphocytic vasculitis is a localized problem normally limited to the skin with good prognosis. The problem can be resolved within a period of a few weeks to months. It is important however to note that the event can recur at variable intervals after the first episode. Hence, you need to follow the design treatment and avoid the known triggers.