Cutaneous Manifestations of Vasculitis

Abstract

The cutaneous manifestations of vasculitis are limited to eight main presentations: urticarial papules, macular purpura, palpable purpura, livedo reticularis, retiform purpura, subcutaneous nodules, necrosis, and ulcers. Large-vessel vasculitides rarely have associated cutaneous findings. Cutaneous features of medium-vessel vasculitides include livedo reticularis, retiform purpura, nodules, ulcers, and infarcts/ necrosis. Small-vessel vasculitides most commonly present with urticarial papules, macular purpura, and palpable purpura. Vasculitides that involve both medium and small vessels present, as may be expected, with cutaneous features of both these forms of disease. The most common cutaneous manifestation of small- and medium-vessel vasculitis is palpable purpura. Therefore, patients presenting with palpable purpura should undergo evaluation for systemic involvement and antineutrophil cytoplasmic antibodies positivity. Skin biopsies are helpful to confirm the diagnosis of vasculitis; however, additional work up is required to further classify the vasculitis.