TY  - CHAP
M1  - Book, Section
TI  - Systemic Necrotizing Arteritis
A1  - Merkel, Peter A.
A1  - Monach, Paul A.
A2  - Kang, Sewon
A2  - Amagai, Masayuki
A2  - Bruckner, Anna L.
A2  - Enk, Alexander H.
A2  - Margolis, David J.
A2  - McMichael, Amy J.
A2  - Orringer, Jeffrey S.
PY  - 2019
T2  - Fitzpatrick's Dermatology, 9e
AB  - AT-A-GLANCECutaneous  vasculitis  can  be  a  presenting  feature  of  a  systemic  disease  affecting  other  organ  systems.  Thus,  all  patients  with  cutaneous  vasculitis  need  to  be  evaluated  for  possible  systemic  vasculitis  including  all  forms  of  small-  and  medium-vessel  vasculitis.Additional  testing  for  vasculitis  is  guided  by  findings  from  medical  history  and  physical  examination,  but  should  usually  include  routine  laboratory  testing  of  renal  function,  evaluating  for  hepatitis  B  and  C  viral  infections,  serologic  testing  for  ANA  and  ANCA,  selected  radiographic  imaging,  and  other  tests  as  indicated  by  presentation.Skin  biopsy  is  nearly  always  essential  to  establish  a  diagnosis  of  vasculitis  and  biopsies  can  help  determine  the  type  of  vasculitis.Mimics  of  idiopathic  vasculitis  need  to  be  considered,  especially  including  infection,  malignancy,  thrombosis,  or  embolic  disease.Drug-induced  vasculitis  frequently  presents  with  skin  lesions.  However,  all  patients  with  suspected  drug-induced  disease  should  still  be  evaluated  for  other  possible  causes  or  types  of  vasculitis.Treatment  of  vasculitis  that  involves  the  skin  is  guided  by  the  disease  and  the  organ  systems  involved.  For  the  systemic  necrotizing  vasculitides,  glucocorticoids  are  always  used,  initially  at  high  doses  for  severe  disease.  Additional  immunosuppressive  medications  depend  on  the  type  of  vasculitis,  extent  of  disease,  and  comorbidities  of  the  patient.Treatment  of  suspected  drug-induced  vasculitis  may  include  discontinuing  the  suspected  etiologic  agent  and  careful  observation  but  could  also  involve  treatment  with  glucocorticoids  or  other  drugs.Use  of  immunosuppressive  medications  should  be  overseen  by  physicians  experienced  with  the  use  of  this  class  of  drugs.Comprehensive  clinical  followup  of  all  patients  with  vasculitis  is  an  essential  aspect  of  management.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - dermatology.mhmedical.com/content.aspx?aid=1161349881
ER  -