Chronic, recurrent small-vessel cutaneous vasculitis. Clinical experience in 13 patients

The clinical experience in 13 patients with small-vessel cutaneous vasculitis limited to the skin is presented. Within the spectrum of what is referred to as "hypersensitivity vasculitis," this group of patients represents a distinctive clinical entity characterized by (1) clinical, laboratory, and histopathologic features of the hypersensitivity vasculitis group; (2) chronic and recurrent isolated cutaneous vasculitis eruptions; (3) absence of disease progression to systemic involvement during long-term follow-up; and (4) relative unresponsiveness to immunosuppressive therapy, including treatment with corticosteroids (prednisone) and cyclophosphamide. Because this disease remains limited to the skin, potentially toxic immunosuppressive regimens with prolonged daily corticosteroids or cytotoxic agents should be avoided. Treatment of local symptoms, particularly lower extremity pain, remains a difficult treatment problem in some patients.