Is nodular vasculitis serious?

Nodular vasculitis refers to an inflammation of the small blood vessels of the skin caused by the infiltration of lymphocytes. Middle-aged women are the most common group of patients. The disease often occurs in the feet and calves. The surface of the nodules will appear slightly reddish, and patients often feel pain. Sometimes the course of the disease is relatively long, and regular treatment is needed in a timely manner to avoid lasting effects on health.

Is nodular vasculitis serious?

It is more common in women aged 30 to 60 years old, but occasionally in men, with a male to female ratio of about 1:5. It is prone to occur in the lower limbs, especially the posterior side of the calves. The thighs, buttocks and upper arms may also be affected. The lesions are small nodules of bright red, dark red or even normal skin color to larger infiltrated plaques, which are round or oval in shape and often first occur in the calves.

Generally, the nodules are about the size of broad beans, hard, with red and hot surface skin, spontaneous pain or mild tenderness, which disappear in 2 to 4 weeks or remain as fibrous nodules. Ulcers usually do not occur. Nodules often recur after a certain period of time and extend to the feet, thighs and upper limbs, sometimes accompanied by joint pain and soreness and weakness in the lower limbs. The general condition is good, and other systems and organs are rarely affected.

examine

No special findings were found. Except in the acute phase, the erythrocyte sedimentation rate rarely increased. Some patients had high anti-O or elevated gamma globulin.

Histopathology: The walls of medium-sized arteries in the deep dermis and subcutaneous fat layer interstitial tissues were thickened, with varying degrees of occlusive changes. Lymphocytes infiltrated around the blood vessels in a cuff-like manner. Neutrophil infiltration and nuclear fragmentation were possible, but lymphocytes and tissue cells were the main ones. Elastic tissue staining showed that the elastic fibers of the inner and outer elastic membranes were severely broken, the lumen was occluded, and different degrees of fat membrane inflammation were seen in the corresponding lobular areas. Immunopathological examination found that the skin lesions were mainly infiltrated by T lymphocytes.

treat

Supportive care, such as compression stockings, bed rest, and nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, can temporarily relieve symptoms. Antibiotics, sulfonamides, and dapsone have been reported to be effective. Potassium iodide is effective, and there are also reports of treatment with colchicine.