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Overview of the Vascular System01:20

Overview of the Vascular System

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The vascular system comprises an extensive network of arteries, capillaries, and veins. The vascular system can be broadly divided into the blood and lymphatic systems. Typically, blood vessels can be categorized into three histological regions: tunica intima, tunica media, and tunica adventitia. The tunica intima consists of a single layer of endothelial cells attached to the basal lamina. Underlying the basal lamina is a connective tissue layer and an elastic lamina that gives stability and...
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Cutaneous small vessel vasculitis in the COVID-19 era: a systematic review.

Katherine Oakley Olson1, Siddharth Patel2, Prutha Pathak3

  • 1Department of Medical Education, Alabama College of Osteopathic Medicine, Dothan, AL, USA.

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|May 14, 2025
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Summary

Cutaneous small vessel vasculitis (CSVV) can occur after COVID-19 infection or vaccination. While most cases are self-limiting, severe reactions appear more common with infection than vaccination.

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Area of Science:

  • Dermatology
  • Immunology
  • Infectious Diseases

Background:

  • Dermatological adverse effects are potential outcomes of COVID-19 infection and vaccination.
  • Cutaneous small vessel vasculitis (CSVV) is an autoimmune disorder characterized by neutrophilic inflammation of dermal vessels, typically presenting as palpable purpura on the extremities.
  • While serious autoimmune reactions are rare, CSVV has been reported in the context of COVID-19.

Purpose of the Study:

  • To conduct a systematic review of cutaneous small vessel vasculitis (CSVV) cases reported during the COVID-19 pandemic.
  • To analyze and compare the characteristics of CSVV associated with COVID-19 infection versus COVID-19 vaccination.

Main Methods:

  • Systematic review adhering to the PRISMA 2020 checklist.
  • Literature search across PubMed, Google Scholar, Cochrane, and Embase databases.
  • Inclusion of case reports, case series, correspondence, and letters to the editor in English, followed by data summarization and analysis.

Main Results:

  • A total of 39 cases of CSVV were reviewed: 27 linked to COVID-19 vaccination and 12 to COVID-19 infection.
  • The mean age of onset was similar between groups, but the mean time to onset was shorter for vaccination-related cases.
  • Systemic steroids were the common treatment, with most patients achieving complete recovery, although some infection-related cases had persistent issues.

Conclusions:

  • Most cases of CSVV in the COVID-19 era are self-limiting with no long-term sequelae.
  • More severe cutaneous small vessel vasculitis reactions seem to be associated with COVID-19 infection compared to COVID-19 vaccination.