Palpable purpura (nonblanching, elevated lesions) is the cutaneous hallmark of vasculitis. Other lesions include petechiae (esp. early lesions), necrosis with ulceration, bullae, and urticarial lesions (urticarial vasculitis). Lesions usually most prominent on lower extremities. Associations include infections, autoimmune diseases, primary systemic vasculitides, malignancy, hepatitis B and C, drugs (esp. thiazides), and inflammatory bowel disease. May occur as an idiopathic, predominantly cutaneous vasculitis.
Treatment: Vasculitis Will differ based on cause. Pursue identification and treatment/elimination of an exogenous cause or underlying disease. If part of a systemic vasculitis, treat based on major organ-threatening features (Chap. 159. Vasculitis). Immunosuppressive therapy should be avoided in idiopathic, predominantly cutaneous vasculitis as disease frequently does not respond and rarely causes irreversible organ system dysfunction. |