Vasculitic Purpura Explained
Have you noticed red or purple spots on your skin that won’t go away? These could be a sign of vasculitic purpura, a condition caused by inflammation in small blood vessels.
If you’re not familiar with it, don’t worry! We’ll explain what it is, why it happens, and potential causes – including some rare diseases.
What Is Vasculitic Purpura?
Vasculitic purpura refers to red or purple spots on the skin, often starting as tiny dots called petechiae and sometimes merging into larger patches, ecchymoses (bruises). They occur when damaged blood vessels leak blood into surrounding tissue, making the spots visible.
Unlike a typical rash, these spots:
- Don’t fade when pressed
- Appear on the legs, arms, or buttocks typically, but it can occur anywhere on the skin
- And may be slightly raised or flat
Sometimes they itch or feel sore, but in many cases, they are painless. If the underlying inflammation becomes more severe, the rash can develop into blisters or ulcers.
What Causes Purple Spot Rashes?
Purpura refers to purple or reddish spots on the skin that appear when small amounts of blood leaks out of the blood vessels and collect under the skin.
Common causes include:
- Autoimmune rare diseases such as EGPA or Lupus
- Reactions to medications, including
- antibiotics
- Viral or bacterial infections
- Blood clotting disorders
When a purpuric rash is accompanied with other symptoms such as fatigue, breathing problems, or nerve pain, it may signal a systemic condition that requires medical attention.
Types of Vasculitic Purpura
There are several types of vasculitis that can cause purpura. These include:
Cutaneous Small-Vessel Vasculitis
This type affects only the skin. It can result from medications, infections or autoimmune reactions. It usually resolves on its own but treatment may be required if symptoms persist.
Henoch-Schönlein Purpura (IgA Vasculitis)
More common in children, it causes purpura along with joint pain, abdominal discomfort and kidney involvement. It’s caused by abnormal immune deposits in the vessels.
Cryoglobulinemic Vasculitis
Often linked to chronic infections or autoimmune diseases, this type can cause skin ulcers, joint pain and kidney disease.
EGPA (Eosinophilic Granulomatosis with Polyangiitis)
A systemic form of vasculitis that includes asthma and high eosinophil counts. It can affect multiple organs and requires long-term treatment.
Diagnosis
A careful diagnosis begins with a physical examination and a review of your symptoms. If vasculitis is suspected, doctors may recommend blood tests to check for inflammation markers, immune antibodies like ANCA, and elevated eosinophils.
A skin biopsy is required to confirm a diagnosis of cutaneous vasculitis. In this procedure, a small sample of affected skin is removed and examined under a microscope to look for damage in the blood vessels.
Other tests, such as urine analysis or imaging scans, may be used to check for organ involvement if symptoms suggest that more than just the skin is affected.
Treatment
Besides ongoing monitoring, treatment depends on the underlying cause and severity of the symptoms. When vasculitic purpura is limited to the skin, it may resolve on its own or with supportive care.
In these cases, treatment might involve:
- Rest and monitoring
- Short-term use of corticosteroids
- Avoidance of known triggers like medications
Treatment is more intensive in severe cases, using corticosteroids often as the first step to reduce inflammation. Immunosuppressive drugs may be added, especially if internal organs are involved. Biologic therapies are also available and help control the symptom.
Taking action
Vasculitic purpura may look like a simple rash, but it can be an early signal of a much more complex process in the body. If you’re presenting unexplained red or purple dots in your skin, along with other symptoms, don’t wait to get it checked. Early diagnosis and treatment can protect your health and improve quality of life.