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Systemic dermatology

Vasculitis key points test

Vasculitis may be provoked by: #! Hepatitis B infection #! Group A streptococcal tonsillitis #! Penicillin #! Systemic lupus erythematosus Explanation: Vasculitis may be provoked by various bacterial and viral infections, drugs, connective tissue disease and malignancy. Characteristic signs of hypersensitivity vasculitis include: #! Palpable purpura # Urticaria-like plaques #! Urinary casts # Painful subcutaneous nodules Explanation: Cutaneous hypersensitivity vasculitis results in palpable purpura, erythematous plaques, bullae and ulceration. Renal involvement is recognized by urinary casts. GI tract involvement may result in blood in the faeces. Henoch-Schönlein purpura: * Histology is necrotising vasculitis affecting muscular arteries * Direct immune fluorescence shows intramural venular IgG deposition * Associated with meningococcal disease *! May cause renal failure Explanation: Henoch-Schönlein purpura is diagnosed by IgA deposition in skin and renal venules. It results in necrotising vasculitis affecting small vessels. It is associated with viral infections and beta haemolytic streptococcal infection. Characteristic signs of polyarteritis nodosa include: # Palpable purpura # Urticaria-like plaques #! Urinary casts #! Painful subcutaneous nodules Explanation: Polyarteritis nodosa (PAN) affects muscular arteries resulting in subcutaneous nodules. Systemic PAN may result in renal disease. Characteristic signs of urticarial vasculitis include: * Palpable purpura *! Urticaria-like plaques * Urinary casts * Painful subcutaneous nodules Explanation: Urticarial vasculitis looks like urticaria, but the weals are persistent and may gradually fade over days to weeks with ecchymoses.