Hypersensitivity vasculitis is an extreme reaction to a drug, infection, or foreign substance. It leads to inflammation and damage to blood vessels, mainly in the skin. The term is not used much currently because more specific names are considered more precise.
Cutaneous small vessel vasculitis; Allergic vasculitis; Leukocytoclastic vasculitis
Hypersensitivity vasculitis, or cutaneous small vessel vasculitis, is caused by:
It usually affects people older than age 16.
Often, the cause of the problem cannot be found even with a careful study of medical history.
Hypersensitivity vasculitis may look like systemic, necrotizing vasculitis, which can affect blood vessels throughout the body and not just in the skin. In children, it can look like Henoch-Schonlein purpura.
Symptoms may include:
The health care provider will base the diagnosis on symptoms. The provider will review any medicines or drugs you have taken and recent infections. You will be asked about cough, fever, or chest pain.
A complete physical exam will be done.
Blood and urine tests may be done to look for systemic disorders such systemic lupus erythematosus, dermatomyositis, or hepatitis C. The blood tests may include:
Skin biopsy shows inflammation of the small blood vessels.
The goal of treatment is to reduce inflammation.
Your provider may prescribe aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or corticosteroids to reduce inflammation of the blood vessels. (Do not give aspirin to children except as advised by your provider).
Your provider will tell you to stop taking medicines that could be causing this condition.
Hypersensitivity vasculitis most often goes away over time. The condition may come back in some people.
People with ongoing vasculitis should be checked for systemic vasculitis.
Complications may include:
Call your provider if you have symptoms of hypersensitivity vasculitis.
Do not take medicines that have caused an allergic reaction in the past.
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Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill consensus conference nomenclature of vasculitides. Arthritis Rheum. 2013;65(1):1-11. PMID: 23045170 pubmed.ncbi.nlm.nih.gov/23045170/.
Patterson JW. The vasculopathic reaction pattern. In: Patterson JW, ed. Weedon's Skin Pathology. 5th ed. Philadelphia, PA: Elsevier; 2021:chap 9.
Stone JH. The systemic vasculitides. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 254.
Sunderkötter CH, Zelger B, Chen KR, et al. Nomenclature of cutaneous vasculitis: dermatologic addendum to the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheumatol. 2018;70(2):171-184. PMID: 29136340 pubmed.ncbi.nlm.nih.gov/29136340/.
Reviewed By: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.