Hypersensitivity Vasculitis Follow-up
- Author: Jeffrey P Callen, MD; Chief Editor: William D James, MD more...
Further Inpatient Care
In hypersensitivity vasculitis (leukocytoclastic vasculitis), inpatient care is needed for patients who have severe vasculitic syndromes with multiple organ dysfunction. Most patients with cutaneous vasculitis are treated in an outpatient setting.
Further Outpatient Care
Design of a follow-up program depends on the vasculitic syndrome, its chronicity, and the organ systems affected. Further follow-up care may not be needed once the process is inactive in a patient with hypersensitivity vasculitis.
Patients with Henoch-Schönlein purpura may develop impairment of renal function or hypertension; regular follow-up care, even after complete clearing of disease, is needed.[23]
Inpatient & Outpatient Medications
Management of patients with chronic cutaneous vasculitis is a challenge. Dietary restriction may be tried in absence of an identifiable cause. Colchicine (0.6 mg bid) and/or dapsone (100-200 mg/d) may control disease. Other agents (including immunosuppressive/cytotoxic agents) may be administered in patients with unresponsive or poorly responsive conditions.
Transfer
Consider transfer to a tertiary care facility for patients with severe visceral disease. Patients with chronic cutaneous disease are often referred to a tertiary care center for specialty care.
Complications
Vasculitis may be complicated by ulceration of skin or by end-organ dysfunction.
Prognosis
The prognosis of patients with cutaneous vasculitis depends on the underlying syndrome or the presence of end-organ dysfunction, as follows:
- Patients with disease that primarily affects the skin and/or the joints have a good prognosis.
- Patients with Wegener granulomatosis, polyarteritis nodosa, Churg-Strauss syndrome, or severe necrotizing vasculitis have a potentially fatal disease. Treatments with corticosteroids and/or immunosuppressive/cytotoxic agents often save the patient's life.
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