Vasculitis op de Onderbenen - Alles Wat Je Moet Weten Over Deze Huidziekte

Immunoglobulin A (IgA) vasculitis rash

In IgA vasculitis, the antibody IgA aggregates in small blood vessels. This causes these vessels to become inflamed and begin leaking blood.

Anyone experiencing a new, unexplained rash should consult a medical professional. Only a doctor can diagnose vasculitis and provide an individualized treatment plan.

In most cases, vasculitis rash will disappear within a few weeks or months. Around 1 in 10 people with skin vasculitis will experience a recurrence of this condition. Their rash may return after a few months or years.

Treatment for skin vasculitis is generally effective , and symptoms tend to subside within a few weeks or months.

Anyone with skin vasculitis should speak with a doctor to learn more about what to expect from treatment in their unique case.

The treatment for vasculitis depends on the type of vasculitis and whether it has spread to other parts of the body. Doctors generally recommend bed rest and elevating affected areas to reduce swelling. They may also prescribe over-the-counter (OTC) medications such as ibuprofen to help with the pain.

Some people may not require any prescription medication to treat their vasculitis. Their condition may resolve fully after taking medications such as antihistamines or ibuprofen.

In more advanced cases, treatment may include the following:

• steroids
• immunosuppressant medications
• anti-inflammatory drugs

Certain drugs that treat arthritis symptoms can also help with skin vasculitis. One medication, etanercept (Enbrel), helps reduce inflammation and joint swelling. This can improve the symptoms of skin vasculitis.

The drug colchicine can also help reduce vasculitis discomfort. This works by reducing inflammation throughout the body.

Returning to mild exercise as soon as vasculitis symptoms permit is important during vasculitis recovery. Gentle exercise can increase joint strength and flexibility during the healing process.

Vasculitis Diagnosis

Your doctor will ask about your medical history and do a physical exam. There's no test just for vasculitis. But because it tends to result from other conditions, you may need tests to look for inflammation and figure out what's causing your symptoms. These tests may include:

• Blood tests. Certain types of blood cells or antibodies can be signs of vasculitis.
• Urine tests. These check for kidney damage.
• Imaging tests. X-rays, MRIscans, CT scans, PET scans, and ultrasounds show inflammation in your blood vessels and organs. You might also have an angiogram, in which your doctor injects dye into your bloodstream. It shows up on X-rays to give a better picture of your blood vessels.
• Heart tests. An echocardiogram tests how well your heart is working.
• Biopsy. Your doctor takes a sample of tissue. A specialist can check it for signs of inflammation or damage.

Vasculitis Treatment

Which vasculitis treatment your doctor recommends depends on what’s causing it and which organs it affects. It's usually meant to control the inflammation and prevent organ and blood vessel damage.

Medications

Steroids like prednisone are the most common medications prescribed to fight the inflammation vasculitis causes. Your doctor will watch you closely for side effects like high blood pressure, high blood sugar, and bone problems, especially if you take them for a long time.

Other medications, like azathioprine (Azasan, Imuran), cyclophosphamide (Cytoxan), methotrexate (Rheumatrex, Trexall), mycophenolate (CellCept, Myfortic), rituximab (Riabni, Rituxan, Ruxience, Truxima), or tocilizumab (Actemra) can be prescribed along with steroids. Which medication you might need depends on how serious your vasculitis is, whether it's in your organs, and your medical history.

Surgery

Sometimes vasculitis can cause issues that need surgery to repair. For instance, if your blood vessel walls bulge and form an aneurysm, surgery can lower the chances that it will burst. If you have a blocked artery, you could need surgery to restore blood flow to the area. But any kind of organ damage might require surgery.

What organ systems may be affected?

It is important to note that not every organ system will be affected in every patient. The pattern of organ involvement (and symptoms) is unique to the individual, as well as the type of vasculitis (category).

Skin

A variety of rashes, the most classic of which is “palpable purpura” –purplish–red spots, usually found on the legs. These spots can usually be felt by the examiner’s fingertips, hence the descriptor “palpable”.

This is a classic example of palpable purpura. These lesions result from the leakage of blood into the skin through inflamed, damaged blood vessels. They tend to occur in “crops”. This type of vasculitis involves very small diameter blood vessels in the skin.

Repeated bouts of purpura may lead to hyperpigmented (darkened) areas of the skin.

Joints

Symptoms range from full–blown arthritis to aches in the joints without obvious swelling (arthralgias).

This is an example of Henoch-Schönlein purpura: cutaneous vasculitis manifested by palpable purpura and arthritis (note the right ankle swelling). The diagnosis was confirmed by a skin biopsy, with immunofluorescence positive for IgA deposition witin blood vessel walls.

Lungs

Cough (particularly coughing up blood), shortness of breath, a pneumonia–like appearance to a patient’s chest X–ray, lung “infiltrates”, and the development of cavities in the lungs are among the manifestations that may occur in forms of vasculitis with lung involvement.

How to Treat Acute Vasculitis Rash

Most vasculitis rashes (without systemic involvement) resolve on their own with simple home therapies.

These therapies include:

• Rest, especially avoiding prolonged standing or walking
• Elevation and compression of the affected area
• Pain relief with an NSAID, such as Advil or Motrin (ibuprofen) or Aleve (naproxen)
• Eliminating or managing underlying triggers (e.g., discontinuing a medication or taking an antiviral for a viral infection).

If a vasculitis rash is unresponsive to the above interventions or recurrent, corticosteroids ("steroids") taken by mouth may be prescribed. Alternative medication options include colchicine or dapsone .

If systemic vasculitis is present, strong medications that suppress the immune system, such as Imuran ( azathioprine ), CellCept ( mycophenolate mofetil ), or Rituxan ( rituximab ), are often considered.