Other distributions include localized areas on the upper body or over several areas of the body.With treatment, the lesions typically resolve in weeks to months and leave behind flat spots that are darker than the surrounding skin (see "Postinflammatory hyperpigmentation" on "Hyperpigmentation"). A portion of cases may be persistent or recurrent. This tends to occur when the vasculitis is associated with chronic conditions such as connective tissue diseases. Associated symptoms
In most cases skin lesions do not cause symptoms, however itching, burning, or pain may occur.Frequently reported symptoms include mild fever, muscle pain, joint pain, or an overall feeling of discomfort. Additional symptoms depend on the cause of the vasculitis and if other organ systems are involved. For example, if the vasculitis is a manifestation of Henoch–Schönlein purpura, individuals may also experience abdominal pain or blood in the urine. Cause
Cutaneous vasculitis can have various causes including but not limited to medications, bacterial and viral infections or allergens. It is estimated that 45–55% of cases are idiopathic, meaning the cause is unknown. In cases where a cause can be determined, medications and infectious pathogens are most common in adults, while IgA vasculitis (Henoch–Schönlein purpura) frequently affects children. Other etiologies include autoimmune conditions and malignancies, usually hematologic (related to the blood). The small vessels in the skin affected are located in the superficial dermis and include arterioles (small arteries carrying blood to capillaries), capillaries, and venules (small veins receiving blood from capillaries). In general, immune complexes deposit in vessel walls leading to activation of the complement system.
Small vessel cutaneous vasculitis is a diagnosis of exclusion and requires ruling out systemic causes of the skin findings. Skin biopsy (punch or excisional) is the most definitive diagnostic test and should be performed with 48 hours of appearance of the vasculitis. A skin biopsy will be able to determine if the clinical findings are truly due to a vasculitis or due to some other cause. Classification
Subtypes of small-vessel vasculitis include:: 833–6 
IgA vasculitis (Henoch-Schönlein purpura)
Acute hemorrhagic edema of infancy
Urticarial vasculitis
Cryoglobulinemic vasculitis
Erythema elevatum diutinum
Granuloma faciale
ANCA-associated vasculitis
Arthropod bites
Platelet dysfunction or deficiency
Cholesterol emboli
Septic emboli
Livedoid vasculopathy

Treatment
Treatment should be directed towards the specific underlying cause of the vasculitis. If no underlying cause is found and the vasculitis is truly limited to the skin then treatment is primarily supportive. Such treatment involves measures such as leg elevation, stockings, and topical steroids to relieve itching/burning. If the vasculitis does not self-resolve within 3–4 weeks, more aggressive treatment may be warranted. Oral colchicine or dapsone are often used for this purpose. If rapid control of symptoms is needed, a short course of high-dose oral steroids may be given. Immunosuppressive agents such as methotrexate and azathioprine may be used in truly refractory cases not responsive to colchicine or dapsone. Additional images
See also
Skin lesion
List of cutaneous conditions

References


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