Flashcards in Vasculitis Deck (67):
What is stasis dermatitis?
Erythematous, pruritic, scaling patches on the lower extremities due to impaired *venous* circulation
What are the chronic skin changes that result from stasis dermatitis?
What is vasculitis? How does it appear?
Inflammation of the blood vessels that appears as palpable purpuric papule /
What is atrophy?
Thinning or depression of skin d/t reduction of the underlying tissue
Is stasis dermatitis related to venous or arterial issues?
What are the two major systemic issues that cause stasis dermatitis?
What are the three major, general causes of capillary disease?
Which is a more common cause of leg ulcers: venous or arterial issues?
What are the two major risk factors for the development and persistence of ulcers?
What is the general appearance of arterial ulcers? Where on the body do they usually occur?
-Lower, lateral leg
-Punched out", with well demarcated edges and a pale base
What are the associated skin findings of arterial ulcers? (2)
Loss of hair
Shiny, atrophic skin
True or false: there is often an exudate with arterial ulcers
False--lack of blood supply means none
Which usually has stasis pigmentation: arterial or venous causes of stasis?
Which usually has lipodermatosclerosis: arterial or venous causes of stasis?
What are the associated symptoms of arterial ulcers?
Claudication and pain
What is the normal value of the ABI?
More than 0.90
What position should the patient be in when testing the ABI?
True or false: once the ABI is down, it is too late for preventative measures
What may cause a false elevation of the AKI?
What causes the hyperpigmentation with venous insufficiency?
What are the usual findings with venous insufficiency of the LEs
Erythematous, brown plaques with fine fissuring and scaling
True or false: venous stasis dermatitis is usually pruritic
Which has atrophy and which has swelling: venous vs arterial insufficiency
Swelling = venous
Atrophy = arterial
What, generally, causes venous stasis dermatitis?
Which gender is predisposed to venous insufficiency?
True or false: prolonged standing is a risk factor for the development of venous stasis dermatitis
True or false: larger heights is a risk factor for the development of venous insufficiency
What are the early s/sx of venous insufficiency?
What are the late s/sx of venous insufficiency?
-White and atrophic scarring
Inverted champagne bottle appearance of the legs = ?
Lipodermatosclerosis from venous insufficiency
What are some of the serious complications from venous insufficiency?
What is the treatment for venous stasis dermatitis?
-High potency steroids
-Keeping wound moist
What is the timeframe that is needed to treat venous stasis dermatitis with compression?
Under what value of ABI is a contraindication to compression wrapping?
What is the treatment for infected venous ulcers?
Debridement of necrotic tissue, and systemic abx
How often should dressings be changed with venous ulcers?
once weekly or maybe slightly more often, but not too much as to disturb the wound constantly
What is the role of topical abx in the treatment of venous ulcers?
Do not use--ineffective
Patients with venous ulcers that do not demonstrate response to treatment after what timeframe should be referred to dermatology?
What is the preulcerative lesion?
What is the skin temperature for arterial, venous, and diabetic ulcers?
Arterial = cold
Venous - warm
DM = warm and dry
Arterial, venous, or diabetic ulcer: irregular margin with punched out edges and little exudate
Arterial, venous, or diabetic ulcer: irregular margin, sloping edges, pink base. Exudative
Arterial, venous, or diabetic ulcer: overlying callus, undermined, red, often deep and infected
Arterial, venous, or diabetic ulcer: skin changes that are shiny and taut, without edema
Arterial, venous, or diabetic ulcer: skin changes with erythema, edema, hyperpigmentation, and lipodermatosclerosis
What are purpura?
Red-purple lesions that result from the extravasation of blood into the skin or mucous membranes
Are purpura palpable?
What is the size range of purpur?
3- 5 mm
What is the order of lesions that describe the extravasation of blood into the skin or mucous membranes?
Which is usually inflammatory: macular or palpable purpura?
Macular is non-inflammatory
Papules = vascular inflammation
What is diascopy?
Use of a glass slide to apply pressure to a skin lesion in order to distinguish erythema (secondary to vasodilation) from erythrocyte extravasation)
What are some causes of petechiae?
What causes the purpura with meningococcemia?
Do hyper or hypo coagulable states cause purpura?
Does the rash from RMSF spare the hand?
How does vasculitis progress?
Expands outward, then intrude on the lumen
Small vessel vasculitis usually results in what skin finding?
Medium vessel vasculitis usually results in what skin finding?
Purpura and fixed livedo reticularis
Large vessel vasculitis usually results in what skin finding?
Ulceration and necrosis
What is the pathophysiology behind HSP?
complexes of immunoglobulin A (IgA) and complement component 3 (C3) are deposited on arterioles, capillaries, and venules. As with IgA nephropathy, serum levels of IgA are high in HSP and there are identical findings on renal biopsy; however, IgA nephropathy has a predilection for young adults while HSP is more predominant among children
What are the classic s/sx of HSP?
Are the purpura present in HSP palpable?
How do you diagnose vasculitis?
What is Kawasaki disease?
an autoimmune disease in which the medium-sized blood vessels throughout the body become inflamed. It is largely seen in children under five years of age. It affects many organ systems, mainly those including the blood vessels, skin, mucous membranes, and lymph nodes. Its rarest but most serious effect is on the heart, where it can cause fatal coronary artery aneurysms in untreated children
What are the s/sx of Kawasaki disease? (5)
-bilateral conjunctival injection
What is the treatment for Kawasaki disease?
ASA and IVIG