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What are vasculitic ulcers?

Photo: What are vasculitic ulcers?
Vasculitis is a collective term given to the range of diseases caused by inflammation of the blood vessels. Vascular system is the term given to intricate system of blood vessels in the body.

These blood vessels are the arteries that pass oxygenated blood to the body tissues and the veins that return oxygen depleted blood from the tissues back to the heart for reoxygenation.

Vasculitic ulcers are becoming increasingly  common, hence there is an urgent need to clearly define such ulcers and develop an appropriate treatment plan. Vasculitic ulcers are in fact a collection of inflammatory conditions that affect the integrity of micro vessels in the human body. These vessels include arterioles, capillaries and postcapillary venules.

How do they occur?

Although the actual cause of vascular ulcers is unknown, it is understood that an abnormal immune response and inflammation of the blood vessels are the two main instigating factors.
  • Three main mechanisms of inflammation have been defined:
  • Injury to vessels walls by foreign bacteria or viruses
  • Activation of certain antibodies that indirectly damage the vessel wall
  • Activation of complements— protein complexes that activate inflammatory processes

Vasculitis is also seen in patients with hepatitis B, cancer, exposure to harmful chemicals and rheumatic diseases such as lupus.

These ulcers are frequently found on the lower leg and foot where the anatomical structure of micro vessels is a predisposing factor. However vasculitis also affects the lungs, kidneys, muscles and skin of any part of the body.

Clinical assessment

The severity of the ulcer will be assessed by observing several parameters:

  • The site of the ulcer i.e. leg, foot
  • Edges of the ulcer i.e. raised or flat. This helps determine the type of ulcer present, venous or arterial.
  • Exposure of any bone or tendon
  • Presence of any discharge — indicating infection

Vasculitis is associated with generalised fatigue and malaise and can lead to weakness and weight loss. Those with vasculitis of the lungs will also have shortness of breath and cough.

Treatment

Vasculitis is routinely treated with cortisone based medications to suppress the immune response and stop the progression of the disease.

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