Cutaneous Vasculi̇ti̇s
Özet
Vasculitis is a disease characterized by thinning of the vessel wall and narrowing or occlusion of the vessel lumen due to cells that inflame the vessel wall. The vessel wall becomes thinner, vessel permeability increases, and rupture occurs in the vessel wall. The prevalence of skin involvement is high in vasculitis. Vasculitides in which skin involvement is more prominent than systemic involvement are called cutaneous vasculitides. Cutaneous vasculitis typically involves the dermal and subcutaneous vessels of small or medium size. The clinical and pathological observations of vasculitis are dependent upon the size of the damaged blood vessels and the specific site of involvement. While palpable purpura is the most frequently observed clinical manifestation of vasculitis, other cutaneous lesions such as infiltrative erythema, purpura, purpuric papules, petechiae, urticaria, livedo reticularis, nodules, hemorrhagic bullae and vesicles, digital gangrene, deep ulcers, and may also be present. The visibility and accessibility of the skin as an organ present notable advantages in terms of disease detection and early diagnosis, as it allows for both physical assessment and biopsy procedures. Since the skin lesions in systemic and cutaneous vasculitis show similar clinical and pathological features, systemic involvement should be investigated in detail before diagnosing cutaneous vasculitis.
Referanslar
Callen JP, Requena L. Cutaneous vasculitis and panniculitis. In: Hochberg MC, Gravallese EM, Silman AJ (eds.) Rheumatology 7th edition. Philadelphia: Elsevier; 2019. p. 1412– 1421.
Chen KR, Carlson JA. Clinical Approach to Cutaneous Vasculitis. American Journal of Clinical Dermatology. 2008;9(2): 71–92. doi: 10.2165/00128071-200809020-00001
Jennette JC, Falk RJ, Andrassy K, et al. Nomenclature of Systemic Vasculitides. Arthritis & Rheumatism. 1994;37(2): 187–192. doi: 10.1002/art.1780370206
Jennette JC, Falk RJ, Bacon PA, et al. 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis & Rheumatism. 2013;65(1): 1–11. doi: 10.1002/art.37715
Sunderkötter CH, Zelger B, Chen K, et al. Nomenclature of Cutaneous Vasculitis. Arthritis & Rheumatology. 2018;70(2): 171–184. doi: 10.1002/art.40375
Caproni M, Verdelli A. An update on the nomenclature for cutaneous vasculitis. Current Opinion in Rheumatology. 2019;31(1): 46–52. doi: 10.1097/BOR.0000000000000563
Goeser MR, Laniosz V, Wetter DA. A Practical Approach to the Diagnosis, Evaluation, and Management of Cutaneous Small-Vessel Vasculitis. American Journal of Clinical Dermatology. 2014;15(4): 299–306. doi: 10.1007/s40257-014-0076-6
Filosa A, Verdelli A, Bianchi B, et al. Cutaneous vasculitidis: histology and immunofluorescence. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia. 2015;150(2): 183–191.
Demirkesen C. Approach to cutaneous vasculitides with special emphasis on small vessel vasculitis: histopathology and direct immunofluorescence. Current Opinion in Rheumatology. 2017;29(1): 39–44. doi: 10.1097/BOR.0000000000000346
Alberti-Violetti S, Berti E, Marzano A V. Cutaneous and systemic vasculitides in dermatology: a histological perspective. Italian Journal of Dermatology and Venereology. 2018;153(2). doi: 10.23736/S0392-0488.18.05886-8
Pina T, Blanco R, González-Gay MA. Cutaneous vasculitis: a rheumatologist perspective. Current allergy and asthma reports. 2013;13(5): 545-554. doi: 10.1007/s11882-013-0367-7
Marzano AV, Raimondo MG, Berti E, et al. Cutaneous Manifestations of ANCA-Associated Small Vessels Vasculitis. Clinical Reviews in Allergy & Immunology. 2017;53(3): 428–438. doi: 10.1007/s12016-017-8616-5
Jarrot PA, Kaplanski G. Pathogenesis of ANCA-associated vasculitis: An update. Autoimmunity Reviews. 2016;15(7): 704–713. doi: 10.1016/j.autrev.2016.03.007
Nakazawa D, Masuda S, Tomaru U, et al. Pathogenesis and therapeutic interventions for ANCA-associated vasculitis. Nature Reviews Rheumatology. 2019;15(2): 91–101. doi: 10.1038/s41584-018-0145-y
Morita TCAB, Criado PR, Criado RFJ, et al. Update on vasculitis: overview and relevant dermatological aspects for the clinical and histopathological diagnosis – Part II. Anais Brasileiros de Dermatologia. 2020;95(4): 493–507. doi: 10.1016/j.abd.2020.04.004
Ratzinger G, Zelger BG, Carlson JA, et al. Vasculitic wheel - an algorithmic approach to cutaneous vasculitides. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2015;13(11): 1092–1117. doi: 10.1111/ddg.12859
Frumholtz L, Laurent-Roussel S, Lipsker D, et al. Cutaneous Vasculitis: Review on Diagnosis and Clinicopathologic Correlations. Clinical Reviews in Allergy & Immunology. 2021;61(2): 181–193. doi: 10.1007/s12016-020-08788-4
Lava SAG, Milani GP, Fossali EF, et al. Cutaneous Manifestations of Small-Vessel Leukocytoclastic Vasculitides in Childhood. Clinical Reviews in Allergy & Immunology. 2017;53(3): 439–451. doi: 10.1007/s12016-017-8626-3
Fraticelli P, Benfaremo D, Gabrielli A. Diagnosis and management of leukocytoclastic vasculitis. Internal and Emergency Medicine. 2021;16(4): 831–841. doi: 10.1007/s11739-021-02688-x
Marzano AV, Maronese CA, Genovese G, et al. Urticarial vasculitis: Clinical and laboratory findings with a particular emphasis on differential diagnosis. Journal of Allergy and Clinical Immunology. 2022;149(4): 1137–1149. doi: 10.1016/j.jaci.2022.02.007
Nakamura K, Tsunemi Y, Kaneko F, et al. Mucocutaneous Manifestations of Behçet’s Disease. Frontiers in Medicine. 2021;7. doi: 10.3389/fmed.2020.613432
Espinoza GM, Wheeler J, Temprano KK, et al. Cogan’s Syndrome: Clinical Presentations and Update on Treatment. Current Allergy and Asthma Reports. 2020;20(9): 46. doi: 10.1007/s11882-020-00945-1
Ikeda T. Recent topics related to etiology and clinical manifestations of cutaneous arteritis. Frontiers in Medicine. 2022;9. doi: 10.3389/fmed.2022.1022512
Turska M, Parada-Turska J. [Cutaneous polyarteritis nodosa]. Wiadomosci lekarskie (Warsaw, Poland : 1960). 2018;71(1 pt 1): 73–77.
Karadag O, Jayne DJ. Polyarteritis nodosa revisited: a review of historical approaches, subphenotypes and a research agenda. Clinical and experimental rheumatology. 2018;36 Suppl 111(2): 135–142.
Morgan AJ, Schwartz RA. Cutaneous polyarteritis nodosa: a comprehensive review. International Journal of Dermatology. 2010;49(7): 750–756. doi: 10.1111/j.1365-4632.2010.04522.x
Sánchez-Guerrero J, Gutiérrez-Ureña S, Vidaller A, et al. Vasculitis as a paraneoplastic syndrome. Report of 11 cases and review of the literature. The Journal of rheumatology. 1990;17(11): 1458–1462.
Solans-Laqué R, Bosch-Gil JA, Pérez-Bocanegra C, et al. Paraneoplastic vasculitis in patients with solid tumors: report of 15 cases. The Journal of rheumatology. 2008;35(2): 294–304.
Fain O, Hamidou M, Cacoub P, et al. Vasculitides associated with malignancies: Analysis of sixty patients. Arthritis & Rheumatism. 2007;57(8): 1473–1480. doi: 10.1002/art.23085
Khan TA, Cuchacovich R, Espinoza LR, et al. Vasculopathy, hematological, and immune abnormalities associated with levamisole-contaminated cocaine use. Seminars in arthritis and rheumatism. 2011;41(3): 445–454. doi: 10.1016/j.semarthrit.2011.04.010.
Sandhu JK, Albrecht J, Agnihotri G, et al. Erythema elevatum et diutinum as a systemic disease. Clinics in Dermatology. 2019;37(6): 679–683. doi: 10.1016/j.clindermatol.2019.07.028
Doktor V, Hadi A, Hadi A, et al. Erythema elevatum diutinum: a case report and review of literature. International Journal of Dermatology. 2019;58(4): 408–415. doi: 10.1111/ijd.14169
Hasbún C, Moya N, Morales C. Eritema indurado de Bazin como una reactivación de una tuberculosis latente en una paciente con tratamiento biológico anti-factor de necrosis tumoral. Revista chilena de infectología. 2022;39(1): 100–102. doi: 10.4067/S0716-10182022000100100
Fonseca Aizpuru EM, Rodríguez Ávila EE, Arias Miranda I, et al. Revisión de 11 casos de eritema indurado en un hospital de segundo nivel. Anales de Medicina Interna. 2008;25(7). doi: 10.4321/S0212-71992008000700018
Corrà A, Verdelli A, Mariotti EB, et al. Cutaneous vasculitis: Lessons from COVID-19 and COVID-19 vaccination. Frontiers in Medicine. 2022;9. doi: 10.3389/fmed.2022.1013846
Maronese CA, Zelin E, Avallone G, et al. Cutaneous vasculitis and vasculopathy in the era of COVID-19 pandemic. Frontiers in Medicine. 2022;9. doi: 10.3389/fmed.2022.996288
Genovese G, Moltrasio C, Berti E, et al. Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives. Dermatology. 2021;237(1): 1–12. doi: 10.1159/000512932
McGonagle D, Bridgewood C, Ramanan AV, et al. COVID-19 vasculitis and novel vasculitis mimics. The Lancet Rheumatology. 2021;3(3): e224–e233. doi: 10.1016/S2665-9913(20)30420-3
Fraticelli P, Benfaremo D, Gabrielli A. Diagnosis and management of leukocytoclastic vasculitis. Internal and Emergency Medicine. 2021;16(4): 831–841. doi: 10.1007/s11739-021-02688-x
Sunderkötter C, Bonsmann G, Sindrilaru A, et al. Management of leukocytoclastic vasculitis. Journal of Dermatological Treatment. 2005;16(4): 193–206. doi: 10.1080/09546630500277971
Tsampau D, Buggiani G, Hercogova J, et al. Cutaneous necrotizing vasculitis: a rational therapeutic approach. Dermatologic Therapy. 2012;25(4): 335–339. doi: 10.1111/j.1529-8019.2012.01480.x
Russell JP, Gibson LE. Primary cutaneous small vessel vasculitis: approach to diagnosis and treatment. International Journal of Dermatology. 2006;45(1): 3–13. doi: 10.1111/j.1365-4632.2005.02898.x
Martinez-Taboada MVM, Blanco MR, Garcia-Fuentes MM, et al. Clinical Features and Outcome of 95 Patients With Hypersensitivity Vasculitis. The American Journal of Medicine. 1997;102(2): 186–191. doi: 10.1016/S0002-9343(96)00405-6
Lotti T, Ghersetich I, Comacchi C, et al. Cutaneous small-vessel vasculitis. Journal of the American Academy of Dermatology. 1998;39(5): 667–690. doi: 10.1016/S0190-9622(98)70039-8
Cupps TR. Chronic, Recurrent Small-Vessel Cutaneous Vasculitis. JAMA. 1982;247(14): 1994. doi: 10.1001/jama.1982.03320390056044
Caplan A, Fett N, Rosenbach M, et al. Prevention and management of glucocorticoid-induced side effects: A comprehensive review. Journal of the American Academy of Dermatology. 2017;76(1): 1–9. doi:10.1016/j.jaad.2016.01.062
Callen JP. Colchicine is effective in controlling chronic cutaneous leukocytoclastic vasculitis. Journal of the American Academy of Dermatology. 1985;13(2): 193–200. doi: 10.1016/S0190-9622(85)70158-2
Sais G, Vidaller A, Jucglà A, et al. Colchicine in the treatment of cutaneous leukocytoclastic vasculitis. Results of a prospective, randomized controlled trial. Archives of dermatology. 1995;131(12): 1399–1402.
Micheletti RG, Werth VP. Small Vessel Vasculitis of the Skin. Rheumatic Disease Clinics of North America. 2015;41(1): 21–32. doi: 10.1016/j.rdc.2014.09.006
Micheletti RG, Pagnoux C. Management of cutaneous vasculitis. La Presse Médicale. 2020;49(3): 104033. doi: 10.1016/j.lpm.2020.104033
Ghazanfar MN, Thomsen SF. Omalizumab for Urticarial Vasculitis: Case Report and Review of the Literature. Case reports in dermatological medicine. 2015;2015: 576893. doi: 10.1155/2015/576893
Referanslar
Callen JP, Requena L. Cutaneous vasculitis and panniculitis. In: Hochberg MC, Gravallese EM, Silman AJ (eds.) Rheumatology 7th edition. Philadelphia: Elsevier; 2019. p. 1412– 1421.
Chen KR, Carlson JA. Clinical Approach to Cutaneous Vasculitis. American Journal of Clinical Dermatology. 2008;9(2): 71–92. doi: 10.2165/00128071-200809020-00001
Jennette JC, Falk RJ, Andrassy K, et al. Nomenclature of Systemic Vasculitides. Arthritis & Rheumatism. 1994;37(2): 187–192. doi: 10.1002/art.1780370206
Jennette JC, Falk RJ, Bacon PA, et al. 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis & Rheumatism. 2013;65(1): 1–11. doi: 10.1002/art.37715
Sunderkötter CH, Zelger B, Chen K, et al. Nomenclature of Cutaneous Vasculitis. Arthritis & Rheumatology. 2018;70(2): 171–184. doi: 10.1002/art.40375
Caproni M, Verdelli A. An update on the nomenclature for cutaneous vasculitis. Current Opinion in Rheumatology. 2019;31(1): 46–52. doi: 10.1097/BOR.0000000000000563
Goeser MR, Laniosz V, Wetter DA. A Practical Approach to the Diagnosis, Evaluation, and Management of Cutaneous Small-Vessel Vasculitis. American Journal of Clinical Dermatology. 2014;15(4): 299–306. doi: 10.1007/s40257-014-0076-6
Filosa A, Verdelli A, Bianchi B, et al. Cutaneous vasculitidis: histology and immunofluorescence. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia. 2015;150(2): 183–191.
Demirkesen C. Approach to cutaneous vasculitides with special emphasis on small vessel vasculitis: histopathology and direct immunofluorescence. Current Opinion in Rheumatology. 2017;29(1): 39–44. doi: 10.1097/BOR.0000000000000346
Alberti-Violetti S, Berti E, Marzano A V. Cutaneous and systemic vasculitides in dermatology: a histological perspective. Italian Journal of Dermatology and Venereology. 2018;153(2). doi: 10.23736/S0392-0488.18.05886-8
Pina T, Blanco R, González-Gay MA. Cutaneous vasculitis: a rheumatologist perspective. Current allergy and asthma reports. 2013;13(5): 545-554. doi: 10.1007/s11882-013-0367-7
Marzano AV, Raimondo MG, Berti E, et al. Cutaneous Manifestations of ANCA-Associated Small Vessels Vasculitis. Clinical Reviews in Allergy & Immunology. 2017;53(3): 428–438. doi: 10.1007/s12016-017-8616-5
Jarrot PA, Kaplanski G. Pathogenesis of ANCA-associated vasculitis: An update. Autoimmunity Reviews. 2016;15(7): 704–713. doi: 10.1016/j.autrev.2016.03.007
Nakazawa D, Masuda S, Tomaru U, et al. Pathogenesis and therapeutic interventions for ANCA-associated vasculitis. Nature Reviews Rheumatology. 2019;15(2): 91–101. doi: 10.1038/s41584-018-0145-y
Morita TCAB, Criado PR, Criado RFJ, et al. Update on vasculitis: overview and relevant dermatological aspects for the clinical and histopathological diagnosis – Part II. Anais Brasileiros de Dermatologia. 2020;95(4): 493–507. doi: 10.1016/j.abd.2020.04.004
Ratzinger G, Zelger BG, Carlson JA, et al. Vasculitic wheel - an algorithmic approach to cutaneous vasculitides. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2015;13(11): 1092–1117. doi: 10.1111/ddg.12859
Frumholtz L, Laurent-Roussel S, Lipsker D, et al. Cutaneous Vasculitis: Review on Diagnosis and Clinicopathologic Correlations. Clinical Reviews in Allergy & Immunology. 2021;61(2): 181–193. doi: 10.1007/s12016-020-08788-4
Lava SAG, Milani GP, Fossali EF, et al. Cutaneous Manifestations of Small-Vessel Leukocytoclastic Vasculitides in Childhood. Clinical Reviews in Allergy & Immunology. 2017;53(3): 439–451. doi: 10.1007/s12016-017-8626-3
Fraticelli P, Benfaremo D, Gabrielli A. Diagnosis and management of leukocytoclastic vasculitis. Internal and Emergency Medicine. 2021;16(4): 831–841. doi: 10.1007/s11739-021-02688-x
Marzano AV, Maronese CA, Genovese G, et al. Urticarial vasculitis: Clinical and laboratory findings with a particular emphasis on differential diagnosis. Journal of Allergy and Clinical Immunology. 2022;149(4): 1137–1149. doi: 10.1016/j.jaci.2022.02.007
Nakamura K, Tsunemi Y, Kaneko F, et al. Mucocutaneous Manifestations of Behçet’s Disease. Frontiers in Medicine. 2021;7. doi: 10.3389/fmed.2020.613432
Espinoza GM, Wheeler J, Temprano KK, et al. Cogan’s Syndrome: Clinical Presentations and Update on Treatment. Current Allergy and Asthma Reports. 2020;20(9): 46. doi: 10.1007/s11882-020-00945-1
Ikeda T. Recent topics related to etiology and clinical manifestations of cutaneous arteritis. Frontiers in Medicine. 2022;9. doi: 10.3389/fmed.2022.1022512
Turska M, Parada-Turska J. [Cutaneous polyarteritis nodosa]. Wiadomosci lekarskie (Warsaw, Poland : 1960). 2018;71(1 pt 1): 73–77.
Karadag O, Jayne DJ. Polyarteritis nodosa revisited: a review of historical approaches, subphenotypes and a research agenda. Clinical and experimental rheumatology. 2018;36 Suppl 111(2): 135–142.
Morgan AJ, Schwartz RA. Cutaneous polyarteritis nodosa: a comprehensive review. International Journal of Dermatology. 2010;49(7): 750–756. doi: 10.1111/j.1365-4632.2010.04522.x
Sánchez-Guerrero J, Gutiérrez-Ureña S, Vidaller A, et al. Vasculitis as a paraneoplastic syndrome. Report of 11 cases and review of the literature. The Journal of rheumatology. 1990;17(11): 1458–1462.
Solans-Laqué R, Bosch-Gil JA, Pérez-Bocanegra C, et al. Paraneoplastic vasculitis in patients with solid tumors: report of 15 cases. The Journal of rheumatology. 2008;35(2): 294–304.
Fain O, Hamidou M, Cacoub P, et al. Vasculitides associated with malignancies: Analysis of sixty patients. Arthritis & Rheumatism. 2007;57(8): 1473–1480. doi: 10.1002/art.23085
Khan TA, Cuchacovich R, Espinoza LR, et al. Vasculopathy, hematological, and immune abnormalities associated with levamisole-contaminated cocaine use. Seminars in arthritis and rheumatism. 2011;41(3): 445–454. doi: 10.1016/j.semarthrit.2011.04.010.
Sandhu JK, Albrecht J, Agnihotri G, et al. Erythema elevatum et diutinum as a systemic disease. Clinics in Dermatology. 2019;37(6): 679–683. doi: 10.1016/j.clindermatol.2019.07.028
Doktor V, Hadi A, Hadi A, et al. Erythema elevatum diutinum: a case report and review of literature. International Journal of Dermatology. 2019;58(4): 408–415. doi: 10.1111/ijd.14169
Hasbún C, Moya N, Morales C. Eritema indurado de Bazin como una reactivación de una tuberculosis latente en una paciente con tratamiento biológico anti-factor de necrosis tumoral. Revista chilena de infectología. 2022;39(1): 100–102. doi: 10.4067/S0716-10182022000100100
Fonseca Aizpuru EM, Rodríguez Ávila EE, Arias Miranda I, et al. Revisión de 11 casos de eritema indurado en un hospital de segundo nivel. Anales de Medicina Interna. 2008;25(7). doi: 10.4321/S0212-71992008000700018
Corrà A, Verdelli A, Mariotti EB, et al. Cutaneous vasculitis: Lessons from COVID-19 and COVID-19 vaccination. Frontiers in Medicine. 2022;9. doi: 10.3389/fmed.2022.1013846
Maronese CA, Zelin E, Avallone G, et al. Cutaneous vasculitis and vasculopathy in the era of COVID-19 pandemic. Frontiers in Medicine. 2022;9. doi: 10.3389/fmed.2022.996288
Genovese G, Moltrasio C, Berti E, et al. Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives. Dermatology. 2021;237(1): 1–12. doi: 10.1159/000512932
McGonagle D, Bridgewood C, Ramanan AV, et al. COVID-19 vasculitis and novel vasculitis mimics. The Lancet Rheumatology. 2021;3(3): e224–e233. doi: 10.1016/S2665-9913(20)30420-3
Fraticelli P, Benfaremo D, Gabrielli A. Diagnosis and management of leukocytoclastic vasculitis. Internal and Emergency Medicine. 2021;16(4): 831–841. doi: 10.1007/s11739-021-02688-x
Sunderkötter C, Bonsmann G, Sindrilaru A, et al. Management of leukocytoclastic vasculitis. Journal of Dermatological Treatment. 2005;16(4): 193–206. doi: 10.1080/09546630500277971
Tsampau D, Buggiani G, Hercogova J, et al. Cutaneous necrotizing vasculitis: a rational therapeutic approach. Dermatologic Therapy. 2012;25(4): 335–339. doi: 10.1111/j.1529-8019.2012.01480.x
Russell JP, Gibson LE. Primary cutaneous small vessel vasculitis: approach to diagnosis and treatment. International Journal of Dermatology. 2006;45(1): 3–13. doi: 10.1111/j.1365-4632.2005.02898.x
Martinez-Taboada MVM, Blanco MR, Garcia-Fuentes MM, et al. Clinical Features and Outcome of 95 Patients With Hypersensitivity Vasculitis. The American Journal of Medicine. 1997;102(2): 186–191. doi: 10.1016/S0002-9343(96)00405-6
Lotti T, Ghersetich I, Comacchi C, et al. Cutaneous small-vessel vasculitis. Journal of the American Academy of Dermatology. 1998;39(5): 667–690. doi: 10.1016/S0190-9622(98)70039-8
Cupps TR. Chronic, Recurrent Small-Vessel Cutaneous Vasculitis. JAMA. 1982;247(14): 1994. doi: 10.1001/jama.1982.03320390056044
Caplan A, Fett N, Rosenbach M, et al. Prevention and management of glucocorticoid-induced side effects: A comprehensive review. Journal of the American Academy of Dermatology. 2017;76(1): 1–9. doi:10.1016/j.jaad.2016.01.062
Callen JP. Colchicine is effective in controlling chronic cutaneous leukocytoclastic vasculitis. Journal of the American Academy of Dermatology. 1985;13(2): 193–200. doi: 10.1016/S0190-9622(85)70158-2
Sais G, Vidaller A, Jucglà A, et al. Colchicine in the treatment of cutaneous leukocytoclastic vasculitis. Results of a prospective, randomized controlled trial. Archives of dermatology. 1995;131(12): 1399–1402.
Micheletti RG, Werth VP. Small Vessel Vasculitis of the Skin. Rheumatic Disease Clinics of North America. 2015;41(1): 21–32. doi: 10.1016/j.rdc.2014.09.006
Micheletti RG, Pagnoux C. Management of cutaneous vasculitis. La Presse Médicale. 2020;49(3): 104033. doi: 10.1016/j.lpm.2020.104033
Ghazanfar MN, Thomsen SF. Omalizumab for Urticarial Vasculitis: Case Report and Review of the Literature. Case reports in dermatological medicine. 2015;2015: 576893. doi: 10.1155/2015/576893
