Skip to main content
SpringerLink
Log in

Cutaneous manifestations in systemic vasculitis

  • Autoimmune Vasculitis
  • Published:
Clinical Reviews in Allergy & Immunology Aims and scope Submit manuscript

Conclusions

This article has emphasized the extreme polymorphism of cutaneous manifestations in the course of systemic vasculitis. Skin involvement, which may represent the onset of the clinical picture in many cases, does not permit an immediate diagnosis but may orient the physician to further investigations.

In our experience most patients who are referred to the dermatologist suffer from cutaneous features in apparent absence of visceral involvement. This group of patients forms a distinct subset of vasculitis characterized by the same polymorphic pattern of skin lesions observed in the systemic forms. The rare involvement of multiorgan systems suggests the existence of a continuum between cutaneous forms and systemic vasculitic syndromes as classified by the ARA. The causes of this protean clinical expression should be further investigated: different and, until now, unrecognized factors may act synergistically with common pathogenetic mechanisms. These factors could be represented by the existence of particular lymphocyte subsets with selective skin homing or by an anatomical background. The similarity of the therapeutic approach provides additional evidence for this unifying hypothesis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Swerlick, R. A. and Lawley, T. J. (1989),Med. Clin. North Am. 73, 1221–1235.

    PubMed  CAS  Google Scholar 

  2. Ryan, T. J. (1992), inTextbook of Dermatology, vol. 3, 5th ed., Rook, G. A. W., Wilkinson, J. and Ebling, F. J. G., eds., Blackwell, Oxford, UK, pp. 1893–1961.

    Google Scholar 

  3. Sams, W. M., Jr., Thorne, E. G., Small, P., Mass, M. F., McIntosh, R. M., and Stanford, R. E. (1976),Arch. Dermatol. 112, 219–226.

    Article  PubMed  Google Scholar 

  4. Hunder, G. G., Arend, W. P., Bloch, D. A., Calabrese, L. H., Fauci, A. S., Fries, J. F., Leavitt, R. Y., Lie, J. T., Lightfoot, R. W., Jr., Masi, A. T., McShane, D. J., Michel, B. A., Mills, J. A., Stevens, M. B., Wallace, S. L., and Zvaifler, N. J. (1990),Arthritis Rheum. 33, 1065–1067.

    Article  PubMed  CAS  Google Scholar 

  5. Bloch, D. A., Michel, B. A., Hunder, G. G., McShane, D. J., Arend, W. P., Calabrese, L. H., Edworthy, S. M., Fauci, A. S., Fries, J. F., Leavitt, R. Y., Lie, J. T., Lightfoot, R. W., Jr., Masi, A. T., Mills, J. A., Stevens, M. B., Wallace, S. L., and Zvaifler, N. J. (1990),Arthritis Rheum. 33, 1068–1073.

    Article  PubMed  CAS  Google Scholar 

  6. Lie, J. T. et al. (1990),Arthritis Rheum. 33, 1074–1087.

    Article  PubMed  CAS  Google Scholar 

  7. Cupps, T. R., Springer, R. M., and Fauci, A. S. (1982),JAMA 247, 1994–1998.

    Article  PubMed  CAS  Google Scholar 

  8. Fredenberg, M. F. and Malkinson, F. D. (1987),J. Am. Acad. Dermatol. 16, 772–778.

    PubMed  CAS  Google Scholar 

  9. Fauci, A. S. (1983),J. Allergy Clin. Immunol. 72, 211–223.

    Article  PubMed  CAS  Google Scholar 

  10. Bonnefoy, M. and Claudy, A. L. (1988),Ann. Dermatol. Venereol. 115, 27–32.

    PubMed  CAS  Google Scholar 

  11. Kurzrock, R. and Cohen, P. (1993),Clin. Dermatol. 11, 175–187.

    Article  PubMed  CAS  Google Scholar 

  12. Gibson, L. E. (1990),Mayo Clin. Proc. 65, 221–229.

    PubMed  CAS  Google Scholar 

  13. Hiltz, R. E. and Cupps, T. R. (1994),Curr. Opinion Rheumatol. 6, 20–24.

    CAS  Google Scholar 

  14. Callen, J. P. (1993),Curr. Opinion in Rheumatol. 5, 33–40.

    Article  CAS  Google Scholar 

  15. Michel, B. A. (1992),Curr. Opinion Rheumatol. 4, 3–8.

    CAS  Google Scholar 

  16. Calabrese, L. H. (1991),Curr. Opinion Rheumatol. 3, 23–27.

    CAS  Google Scholar 

  17. Zax, R. H., Hodge, S. J., and Callen, J. P. (1990),Arch. Dermatol. 126, 69–72.

    Article  PubMed  CAS  Google Scholar 

  18. Soter, N. A., Mihm, M. C., Jr. Gigli, I., Dvorak, H. F., and Austen, K. F. (1976),J. Invest. Dermatol. 66, 344–350.

    Article  PubMed  CAS  Google Scholar 

  19. Massa, M. C. and Su, W. P. D. (1984),J. Cutan. Pathol. 11, 132–139.

    Article  PubMed  CAS  Google Scholar 

  20. Smoller, B. R., McNutt, S., and Contreras, F. (1990),Arch. Dermatol. 126, 84–89.

    Article  PubMed  CAS  Google Scholar 

  21. Boom, B. W., Mommaas, A. M., Daha, M. R., and Vermeer, B.-J. (1991),J. Dermatol. Sci. 2, 308–315.

    Article  PubMed  CAS  Google Scholar 

  22. Claudy, A. (1990),Ann. Dermatolol. Venereol. 117, 419–422.

    CAS  Google Scholar 

  23. Sams, W. M., Jr., Claman, H. N., Kohler, P. F., McIntosh, R. M., Small, P., and Mass, M. F. (1975),J. Invest. Dermatol. 64, 441–445.

    Article  PubMed  Google Scholar 

  24. Schroeter, A. L., Copeman, P. W. M., Jordon, R. E., Sams, W. M., Jr., and Winkelmann, R. K. (1971),Arch. Dermatol. 104, 254–259.

    Article  PubMed  CAS  Google Scholar 

  25. Braverman, I. M. and Yen, A. (1975),J. Invest. Dermatol. 64, 105–112.

    Article  PubMed  CAS  Google Scholar 

  26. Lightfoot, R. W., Jr., Michel, B. A., Bloch, D. A., Hunder, G. G., Zvaifler, N. J., McShane, D. J., Arend, W. P., Calabrese, L. H., Leavitt, R. Y., Lie, J. T., Masi, A. T., Mills, J. A., Stevens, M. B., and Wallace, S. L. (1990),Arthritis Rheum. 33, 1088–1093.

    Article  PubMed  Google Scholar 

  27. Jorizzo, J. L. (1991), inClinical Dermatology, vol. 1, Demis, D. J., ed., Lippincott, Philadelphia, section 5–6.

    Google Scholar 

  28. Lever, W. F. and Shaumberg-Lever, G. (1990),Histopathology of the Skin, 7th ed., Lippincott, Philadelphia, pp. 185–206.

    Google Scholar 

  29. Laevitt, R. Y. and Fauci, A. S. (1986),Am. J. Med. 81, 79–85.

    Article  Google Scholar 

  30. Borrie, P. (1972),Br. J. Dermatol. 87, 87–95.

    Article  PubMed  CAS  Google Scholar 

  31. Leung, D. Y. M. (1993),Curr. Opinion Rheumatol. 5, 41–50.

    CAS  Google Scholar 

  32. Spector, R. J. (1991), inClinical Dermatology, vol. 2, Demis, D. J., ed., Lippincott, Philadelphia.

    Google Scholar 

  33. Gibson, L. E. (1990),Dermatol. Clin. 8, 335–345.

    PubMed  CAS  Google Scholar 

  34. Gibson, L. E. and Winkelmann, R. K. (1986),J. Am. Acad. Dermatol. 14, 492–501.

    PubMed  CAS  Google Scholar 

  35. Finan, M. C. (1991), inClinical Dermatology, vol. 2, Demis, D. J., ed., Lippincott, Philadelphia, section 7–76A.

    Google Scholar 

  36. Masi, A. T., Hunder, G. G., Lie, J. T., Michel, B. A., Bloch, D. A., Arend, W. P., Calabrese, L. H., Edworthy, S. M., Fauci, A. S., Leavitt, R. Y., Lightfoot, R. W., Jr., McShane, D. J., Mills, J. A., Stevens, M. B., Wallace, S. L., and Zvaifler, N. J. (1990),Arthritis Rheum. 33, 1094–1100.

    Article  PubMed  CAS  Google Scholar 

  37. Lawley, T. J. and Kubota, Y. (1990),Dermatol. Clin. 8, 681–687.

    PubMed  CAS  Google Scholar 

  38. Patterson, J. B. (1991), inClinical Dermatology, vol. 1, Demis, D. J., ed., Lippincott, Philadelphia, section 5–8.

    Google Scholar 

  39. Burrows, N. P. and Lockwood, C. M. (1995),Br. J. Dermatol.,132, 173–181.

    Article  PubMed  CAS  Google Scholar 

  40. Daoud, M. S., Gibson, L. E., Deremee, R. A., Specks, U., El-Azhary, R. A., and Su, W. P. D. (1994),J. Am. Acad. Dermatol.,31, 605–612.

    Article  PubMed  CAS  Google Scholar 

  41. Mangold, M. C. and Callen, J. P. (1992),J. Am. Acad. Dermatol.,26, 579–584.

    PubMed  CAS  Google Scholar 

  42. Rademaker, M., Lowe, D. G., and Munro, D. D. (1989),J. Am. Acad. Dermatol. 21, 740–745.

    PubMed  CAS  Google Scholar 

  43. Ducros, B., Dellinger, A., Riou, R. C., Nove Josserand, R., Adnaqui, M., Vital Durand, D., Thiolet, J., and Levrat, R. (1989),Ann. Dermatol. Venereol.,16, 461–466.

    Google Scholar 

  44. Arend, W. P., Beat, A. M., Bloch, D. A., Hunder, G. G., Calabrese, L. E., Edworthy, S. M., Fauci, A. S., Leavitt, R. Y., Lie, J. T., Lightfoot, R. W., Jr., Masi, A. T., McShane D. J., Mills, J. A., Stevens, M. B., Wallace, S. L., and Zvaifler, N. J. (1990),Arthritis Rheum. 33, 1129–1134.

    Article  PubMed  CAS  Google Scholar 

  45. Hunder, G. G., Bloch, D. A., Michel, B. A., Stevens, M. B., Arend, W. P., Calabrese, L. E., Edworthy, S. M., Fauci, A. S., Leavitt, R. Y., Lie, J. T., Lightfoot, R. W., Jr., Masi, A. T., McShane, D. J., Mills, J. A. M. B., Wallace, S. L., and Zvaifler, N. J. (1990),Arthritis Rheum.,33, 1122–1128.

    Article  PubMed  CAS  Google Scholar 

  46. O'Brien, J. P., inClinical Dermatology, vol. 1, Demis, D. J., ed., Lippincott, Philadelphia, pp. XX–XX.

  47. Af Ekenstam, E. and Callen, J. (1984),Arch. Dermatol.,120, 484–489.

    Article  Google Scholar 

  48. Calabrese, L. E., Michel, B. A., Bloch, D. A., Arend, W. P., Edworthy, S. M., Fauci, A. S., Fries, J. F., Hunder, G. G., Leavitt, R. Y., Lie, J. T., Lightfoot, R. W., Jr., Masi, A. T., McShane, D. J., Mills, J. A., Stevens, M. B., Wallace, S. L., and Zvaifler, N. J. (1990),Arthritis Rheum. 33, 1108–1113.

    Article  PubMed  CAS  Google Scholar 

  49. Soter, N. A., Austen, K. F., and Gigli, I. (1974),J. Invest. Dermatol. 63, 485–490.

    Article  PubMed  CAS  Google Scholar 

  50. Tan, R. S. (1974),Br. J. Dermatol.,91, 209–215.

    Article  PubMed  CAS  Google Scholar 

  51. Hodge, S. J., Callen, J. P., and Ekenstam, E. (1987),J. Cutaneous Pathology 14, 279–284.

    Article  CAS  Google Scholar 

  52. Mills, J. A., Michel, B. A., Bloch, D. A., Calabrese, L. H., Hunder, G. G., Arend, W. P., Edworthy, S. M., Fauci, A. S., Laevitt, R. Y., Lie, J. T., Lightfoot, R. W., Jr., Masi, A. T., McShane, D. J., Stevens, M. B., Wallace, S. L., and Zvaifler, N. J. (1990),Arthritis Rheum.,33, 114–121.

    Article  Google Scholar 

  53. Michel, B. A., Hunder, G. G., Bloch, D. A., and Calabrese, L. H. (1992),J. Rheumatol. 19, 521–528.

    Google Scholar 

  54. Szer, I. S. (1994),Curr. Opinion Rheumatol.,16, 25–31.

    Article  Google Scholar 

  55. Piette, W. W. and Seabury, S. M. (1989),Arch. Dermatol.,125, 53–56.

    Article  PubMed  CAS  Google Scholar 

  56. Van Hale, H. M., Gibson, L. E., and Schroter, A. L. (1986),J. Am. Acad. Dermatol. 15, 665–670.

    PubMed  Google Scholar 

  57. Rowell, N. R. and Goodfield, M. J. D. (1992) inTextbook of Dermatology, vol. 3, 5th ed., Rook, G. A. W., Wilkinson, J., and Ebling, F. J. G., eds., Blackwell, Oxford, UK, pp. 2163–2294.

    Google Scholar 

  58. Yasue, T. (1986),Arch. Dermatol. 122, 66–70.

    Article  PubMed  CAS  Google Scholar 

  59. Grigor, R., Edmonds, J., Lewkonia, R., Bresnihan, B., and Hughes, G. R. (1978),Ann. Rheum. Dis. 37, 121–128.

    PubMed  CAS  Google Scholar 

  60. Peterson, L.L. (1984),J. Am. Acad. Dermatol. 10, 379–384.

    PubMed  CAS  Google Scholar 

  61. Philpott, J. A., Goltz, R. W., and Park, R. K. (1966),Arch. Derm. 94, 732–738.

    Article  PubMed  Google Scholar 

  62. Sibbitt, W. L. (1991) inClinical Dermatology, vol. 1, Demis, D. J., ed., Lippincott, Philadelphia.

    Google Scholar 

  63. Alarcon-Segovia D., Deleze, M., Oria, C. V., Sanchez-Guerrero, J., Gomez-Pacheco, L., Cabiedes, J., Fernandez, L., and Ponce de Leon, S. (1989),Medicine 168, 353–365.

    Google Scholar 

  64. Frances, C., Tribout, B., Boisnic, S., Drouet, L., Piette, A. M., Bletry, O., Wechsler, B., and Godeau, P. (1989),Dermatologica,178, 194–201.

    PubMed  CAS  Google Scholar 

  65. Asherson, R. A., Khamashta, M. A., Ordi-Ros, J., Derksen, R. H., Machin, S. J., Barquinero, J., Outt, H. H., Harris, E. N., Vilardell-Torres, M., and Hughes, G. R. (1989),Medicine 68, 366–374.

    Article  PubMed  CAS  Google Scholar 

  66. Hughes, G. R. V., Asherson, R. A., and Khamashta, M. A. (1989),Ann. Rheum. Dis. 48, 355,356.

    PubMed  CAS  Google Scholar 

  67. Stephansson, E. A. and Scheynius, A. (1993),Eur. J. Dermatol. 3, 285–288.

    Google Scholar 

  68. Matarredona, J., Sendagorta, E., and Rocamora, A. (1986),Int. J. Dermatol. 25, 446,447.

    Article  PubMed  CAS  Google Scholar 

  69. O'Loughlin, S., Schroeter, A. L., and Jordon, R. E. (1978),Arch. Dermatol. 114, 879–883.

    Article  PubMed  Google Scholar 

  70. Ruzicka, T. and Goerz, G. (1981),Dermatologica 162, 203–205.

    Article  PubMed  CAS  Google Scholar 

  71. Alexander, E. L., Arnet, F. C., and Provost, T. T. (1983),Ann. Intern. Med. 98, 155–159.

    PubMed  CAS  Google Scholar 

  72. Dienstag, J. L., Rhodes, A. R., and Bhan, A. K. (1978),Ann. Intern. Med. 89, 34–40.

    PubMed  CAS  Google Scholar 

  73. Mitchell, G. G., Magnusson, A. R., and Weiler, J. M. (1980),Am. J. Med. 75, 875,876.

    Article  Google Scholar 

  74. McDuffie, F. C., Sams, W. M., Jr., and Maldano, J. E. (1973),Mayo Clin. Proc. 48, 340–348.

    PubMed  CAS  Google Scholar 

  75. Jorizzo, J. L. and Daniels, J. C. (1983),J. Am. Acad. Dermatol. 8, 439–457.

    PubMed  CAS  Google Scholar 

  76. Jorizzo, J. L., Solomon, A. R., Zanolli, M. D., and Leshin, B. (1988),J. Am. Acad. Dermatol. 19, 983–1005.

    PubMed  CAS  Google Scholar 

  77. Callen, J. P. (1985),Dermatol. Clin. 3, 153–163.

    PubMed  CAS  Google Scholar 

  78. Chevrant-Breton, J., Logeais, B., and Pibouin, M. (1989),Ann. Dermatol. Venereol. 116, 577–589.

    PubMed  CAS  Google Scholar 

  79. Su, W. P. D., Schroeter, A. L., Perry, H. O. and Powell, F. C. (1986),J. Cutaneous Pathol.,13, 323–330.

    Article  CAS  Google Scholar 

  80. Wyhinny, P. P. and Malkinson, F. D. (1991), inClinical Dermatology, vol. 1, Demis, D. J., ed., Lippincott, Philadelphia, section 5–12.

    Google Scholar 

  81. Malkinson, F. D. (1987),Arch. Dermatol. 123, 333–336.

    Article  PubMed  CAS  Google Scholar 

  82. Thomas, M., Payne, R., and Black, M. M. (1982),Clin. Exp. Dermatol. 7, 523–528.

    Article  PubMed  CAS  Google Scholar 

  83. Delaporte, E., Gaveaud, D. J., Piette, F. A., and Bergoend, H. A. (1989),Arch. Dermatol. 125, 1101–1104.

    Article  PubMed  CAS  Google Scholar 

  84. Berth-Jones, J. and Hutchinson, P. E. (1989),Br. J. Dermatol. 121, 123–127.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Dermatological Sciences, University of Milan-IRCCS Ospedale Maggiore, Via Pace N. 9, 20122, Milan, Italy

    Irene Decleva, Angelo Valerio Marzano, Mauro Barbareschi & Emilio Berti

Authors
  1. Irene Decleva
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Angelo Valerio Marzano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mauro Barbareschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emilio Berti
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Decleva, I., Marzano, A.V., Barbareschi, M. et al. Cutaneous manifestations in systemic vasculitis. Clinic Rev Allerg Immunol 15, 5–20 (1997). https://doi.org/10.1007/BF02828274

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02828274

Keywords

Search

Navigation