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Cutaneous Small-vessel Vasculitis
Cutaneous small-vessel vasculitis (CSVV), also known as hypersensitivity vasculitis, cutaneous leukocytoclastic vasculitis, hypersensitivity angiitis, cutaneous leukocytoclastic angiitis, cutaneous necrotizing vasculitis and cutaneous necrotizing venulitis, is inflammation of small blood vessels (usually post-capillary venules in the dermis), characterized by palpable purpura. It is the most common vasculitis seen in clinical practice. "Leukocytoclastic" refers to the damage caused by nuclear debris from infiltrating neutrophils in and around the vessels. Signs and symptoms Skin lesions Initially red to pink, flat spots (formally, "macules") and raised bumps (formally, "papules") may be seen on the skin. Once fully developed, the classic appearance is "non-blanching, palpable purpura". This appears as deep red to purple spots that feel raised to the touch. Purpura refers to the red-purple discolored spots, while palpable implies that these spots can be felt as raised from t ...
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Rheumatology
Rheumatology (Greek ''ῥεῦμα'', ''rheûma'', flowing current) is a branch of medicine devoted to the diagnosis and management of disorders whose common feature is inflammation in the bones, muscles, joints, and internal organs. Rheumatology covers more than 100 different complex diseases, collectively known as rheumatic diseases, which includes many forms of arthritis as well as lupus and Sjögren's syndrome. Doctors who have undergone formal training in rheumatology are called rheumatologists. Many of these diseases are now known to be disorders of the immune system, and rheumatology has significant overlap with immunology, the branch of medicine that studies the immune system. Rheumatologist A rheumatologist is a physician who specializes in the field of medical sub-specialty called rheumatology. A rheumatologist holds a board certification after specialized training. In the United States, training in this field requires four years undergraduate school, four year ...
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Micrograph Of Cutaneous Small-vessel Vasculitis
A micrograph or photomicrograph is a photograph or digital image taken through a microscope or similar device to show a magnified image of an object. This is opposed to a macrograph or photomacrograph, an image which is also taken on a microscope but is only slightly magnified, usually less than 10 times. Micrography is the practice or art of using microscopes to make photographs. A micrograph contains extensive details of microstructure. A wealth of information can be obtained from a simple micrograph like behavior of the material under different conditions, the phases found in the system, failure analysis, grain size estimation, elemental analysis and so on. Micrographs are widely used in all fields of microscopy. Types Photomicrograph A light micrograph or photomicrograph is a micrograph prepared using an optical microscope, a process referred to as ''photomicroscopy''. At a basic level, photomicroscopy may be performed simply by connecting a camera to a microscope, th ...
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Septic Embolism
A septic embolism is a type of embolism that is infected with bacteria, resulting in the formation of pus. These may become dangerous if dislodged from their original location. Like other emboli, a septic embolism may be fatal. One of the common microbes that can lead to widespread dissemination of septic emboli is ''Fusobacterium necrophorum'', a Gram negative anaerobic bacillus. Fusobacteriota are commensal organisms in the oral cavity. ''F. necrophorum'' and'' F. nucleatum'' are the most important among the non-spore forming anaerobic bacilli in causing human infections.'' F. necroporum'' may occasionally cause septicaemia with metastatic abscesses (Lemierre's syndrome). Pathogenesis Septic emboli most often originate from extrapulmonary locations which have been infected for a period of time. For example, a person's intravenous access site, which is used to insert intravenous drugs, may become infected. When present in great number, septic emboli can coalesce and mimick a lob ...
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Cholesterol Embolism
Cholesterol embolism occurs when cholesterol is released, usually from an atherosclerotic plaque, and travels as an embolus in the bloodstream to lodge (as an embolism) causing an obstruction in blood vessels further away. Most commonly this causes skin symptoms (usually livedo reticularis), gangrene of the extremities and sometimes kidney failure; problems with other organs may arise, depending on the site at which the cholesterol crystals enter the bloodstream. When the kidneys are involved, the disease is referred to as atheroembolic renal disease. The diagnosis usually involves biopsy (removing a tissue sample) from an affected organ. Cholesterol embolism is treated by removing the cause and giving supportive therapy; statin drugs have been found to improve the prognosis. Signs and symptoms The symptoms experienced in cholesterol embolism depend largely on the organ involved. Non-specific symptoms often described are fever, muscle ache and weight loss. Embolism to the legs cau ...
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Thrombotic Thrombocytopenic Purpura
Thrombotic thrombocytopenic purpura (TTP) is a blood disorder that results in blood clots forming in small blood vessels throughout the body. This results in a low platelet count, low red blood cells due to their breakdown, and often kidney, heart, and brain dysfunction. Symptoms may include large bruises, fever, weakness, shortness of breath, confusion, and headache. Repeated episodes may occur. In about half of cases a trigger is identified, while in the remainder the cause remains unknown. Known triggers include bacterial infections, certain medications, autoimmune diseases such as lupus, and pregnancy. The underlying mechanism typically involves antibodies inhibiting the enzyme ADAMTS13. This results in decreased break down of large multimers of von Willebrand factor (vWF) into smaller units. Less commonly TTP is inherited from a person's parents, known as Upshaw–Schulman syndrome, such that ADAMTS13 dysfunction is present from birth. Diagnosis is typically based on sym ...
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Arthropod Bites And Stings
Many species of arthropods (insects, arachnids and others) regularly or occasionally bite or sting human beings. Insect saliva contains anticoagulants and enzymes that cause local irritation and allergic reactions. Insect venoms can be delivered by their stingers, which often are modified ovipositors, or by their mouthparts. Insect, spider and scorpion venom can cause serious injury or death. Dipterans account for the majority of insect bites, while hymenopterans account for the majority of stings. Among arachnids spider bites and mite bites are the most common. Arthropods bite or sting humans for a number of reasons including feeding or defense. Arthropods are major vectors of human disease, with the pathogens typically transmitted by bites and rarely by stings or other contact. Another common negative effect is interference with military activity. Insects Diptera (True flies) * Black flies (Simuliidae) * Horse-flies (Tabanidae) ** Deer flies/Yellow flies (Chrysops) * Tsetse ...
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Anti-neutrophil Cytoplasmic Antibody
Anti-neutrophil cytoplasmic antibodies (ANCAs) are a group of autoantibodies, mainly of the IgG type, against antigens in the cytoplasm of neutrophils (the most common type of white blood cell) and monocytes. They are detected as a blood test in a number of autoimmune disorders, but are particularly associated with systemic vasculitis, so called ANCA-associated vasculitides (AAV). ANCA IF patterns Immunofluorescence (IF) on ethanol-fixed neutrophils is used to detect ANCA, although formalin-fixed neutrophils may be used to help differentiate ANCA patterns. ANCA can be divided into four patterns when visualised by IF; cytoplasmic ANCA (c-ANCA), C-ANCA (atypical), perinuclear ANCA (p-ANCA) and atypical ANCA (a-ANCA), also known as x-ANCA. c-ANCA shows cytoplasmic granular fluorescence with central interlobular accentuation. C-ANCA (atypical) shows cytoplasmic staining that is usually uniform and has no interlobular accentuation. p-ANCA has three subtypes, classical p-ANCA, p-ANCA ...
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Granuloma Faciale
Granuloma faciale is an uncommon benign chronic skin disease of unknown origin characterized by single or multiple cutaneous nodules, usually occurring over the face. Occasionally, extrafacial involvement is noted, most often on sun-exposed areas. Diagnosis Skin biopsy for histopathology: Focal LCV, diffuse dermal neutrophilia with leukocytoclasia, tissue eosinophilia & perivascular fibrosis. Differential diagnosis The disease mimics many other dermatoses and can be confused with conditions, such as sarcoidosis, discoid lupus erythematosus, mycosis fungoides, and fixed drug eruption. Treatment Topical corticosteroid, Intralesional corticosteroid, Dapsone, Colchicine, Antimalarial, Pulse dye laser, Carbon dioxide laser. History GF was first described in 1945 by John Edwin Mackonochie Wigley (1892–1962). See also * Cutaneous small-vessel vasculitis * List of cutaneous conditions Many skin conditions affect the human integumentary system—the organ system covering ...
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Erythema Elevatum Diutinum
Erythema elevatum diutinum is a form of vasculitis. It has been described as a paraneoplastic syndrome. See also * Cutaneous small-vessel vasculitis * List of cutaneous conditions Many skin conditions affect the human integumentary system—the organ system covering the entire surface of the body and composed of skin, hair, nails, and related muscle and glands. The major function of this system is as a barrier against t ... References External links Vascular-related cutaneous conditions {{Cutaneous-condition-stub ...
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Cryoglobulinemic Vasculitis
Cryoglobulinemic vasculitis is a form of inflammation affecting the blood vessels caused by the deposition of abnormal proteins called cryoglobulins. These immunoglobulin proteins are soluble at normal body temperatures, but become insoluble below 37 °C (98.6 °F) and subsequently may aggregate within smaller blood vessels. Inflammation within these obstructed blood vessels is due to the deposition of complement proteins which activate inflammatory pathways. Cryoglobulinemic vasculitis most commonly affect the skin, causing a raised, pinpoint rash on the lower extremities known as purpura. The kidneys may additionally be affected by this form of vasculitis, resulting in membranoproliferative glomerulonephritis. Fevers, painful muscles and joints, and peripheral nerve damage are other common manifestations of cryoglobulinemic vasculitis. Epidemiology The incidence of cryoglobulinemic vasculitis is low and highly corresponds to the presence of hepatitis C virus infectio ...
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Urticarial Vasculitis
Urticarial vasculitis (also known as "chronic urticaria as a manifestation of venulitis", "hypocomplementemic urticarial vasculitis syndrome", "hypocomplementemic vasculitis" and "unusual lupus-like syndrome") is a skin condition characterized by fixed urticarial lesions that appear histologically as a vasculitis. Mechanism Antibodies are usually raised against foreign proteins, such as those made by a replicating virus or invading bacterium. Virus or bacteria with antibodies opsonized or "stuck" to them highlight them to other cells of the immune system for clearance. Antibodies against self proteins are known as autoantibodies, and are not found in healthy individuals. These autoantibodies can be used to detect certain diseases. C1q C1q is an integral component within the complement pathway – a complicated cascade of protein interactions, culminating in an immune response against a broad variety of pathogens. The anti-C1q antibodies found in patients with hypocomplementemi ...
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Acute Hemorrhagic Edema Of Infancy
Acute hemorrhagic edema of infancy is a skin condition that affects children under the age of two with a recent history of upper respiratory illness, a course of antibiotics, or both. The disease was first described in 1938 by Finkelstein and later by Seidlmayer as "Seidlmayer cockade purpura". See also * Cutaneous small-vessel vasculitis * List of cutaneous conditions * Henoch–Schönlein purpura Henoch–Schönlein purpura (HSP), also known as IgA vasculitis, is a disease of the skin, mucous membranes, and sometimes other organs that most commonly affects children. In the skin, the disease causes palpable purpura (small, raised areas of bl ... References External links Vascular-related cutaneous conditions {{Cutaneous-condition-stub ...
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