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General management approach to common vasculitides

Shriya Kachru and Alexa Shipman
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DOI: https://doi.org/10.7861/clinmed.Let.21.1.5
Clin Med January 2021
Shriya Kachru
Queen Alexandra Hospital, Cosham, UK
Roles: Clinical attachee in general internal medicine
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Alexa Shipman
Queen Alexandra Hospital, Cosham, UK
Roles: Consultant dermatologist
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Editor – We recently read the article, ‘An update on the general management approach to common vasculitides’ by Hng, Zhao and Moots.1

We would like to suggest refinements of the description of dermatological manifestations in a patient with probable vasculitides as outlined their Table 2 and Fig 2, as we are concerned that comments like ‘new persistent rash’ might be a little too generalised and non-specific.

This issue is important to be addressed since there have been significant updates of the classification of vasculitis and dermatologists have strived to define lesions of vasculitis in patients with greater accuracy, and the Chapel Hill Consensus of 2018 reflects those efforts.2

In very simple terms, skin examination findings in vasculitis relate to vessel size. Small vessel vasculitis causes a palpable petechial rash. Medium vessel involvement on the other hand leads to livedo reticularis (a lace like discoloration of skin), ulceration, nodules or macules; while large vessel involvement leads to skin necrosis and ulceration.

We hope our comments are useful and add to the educational aspects of the paper.

  • © Royal College of Physicians 2021. All rights reserved.

References

  1. ↵
    1. Hng M
    , Zhao SS, Moots RJ. An update on the general management approach to common vasculitides. Clin Med 2020;20:572–9.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    1. Sunderkötter CH
    , Zelger B, Chen KR, et al. Nomenclature of Cutaneous Vasculitis: Dermatologic Addendum to the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheumatol 2018;70:171–84.
    OpenUrl
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General management approach to common vasculitides
Shriya Kachru, Alexa Shipman
Clinical Medicine Jan 2021, 21 (1) e118; DOI: 10.7861/clinmed.Let.21.1.5

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General management approach to common vasculitides
Shriya Kachru, Alexa Shipman
Clinical Medicine Jan 2021, 21 (1) e118; DOI: 10.7861/clinmed.Let.21.1.5
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