Management issues in vasculitis

In a Congress devoted to both rheumatic disease and skin disease, vasculitis is an appropriate topic for discussion. Many dermatologists believe that rheumatology has made a mess of the classification of vasculitis and with respect to management it is too drug orientated. When vasculitis is uncomplicated and affects only a single organ it behaves benignly and needs only attention to protection and decreasing the vulnerability of the skin to gravitational 'stasis', pressure, cooling and immobility. Complicated, multi-system vasculitis frequently needs much of the same skin care plus additional drug therapies. Unfortunately, there is no evidence that vasculitis of the skin is responsive to such drugs other than single case reports and uncontrolled trials. Where the cause of the vasculitis is a known infection, food or drug, autoimmune process or neoplasm, removal of the cause is an appropriate policy.