THE SKIN and subcutaneous tissues are frequently involved by a number of systemic vasculitides, as demonstrated and discussed in the article by Frances et al,1 and also can be the sole site of vascular inflammation, as observed in the patients described by Siberry et al2 in this issue of the Archives. Various patterns of cutaneous discoloration, swelling, hemorrhage, and necrosis may be the initial or most accessible manifestations of localized or systemic vasculitis (Table 1), thus often involving dermatologists and dermatopathologists in the diagnosis and management of patients with vasculitis.
To conclude that a patient has vasculitis confined to the skin, the known systemic manifestations of vasculitides must be looked for and found absent. Even if initially absent, systemic features may subsequently develop. When systemic features accompany cutaneous vasculitis, the patient must be categorized into one of the recognized clinicopathologic vasculitis syndromes for appropriate prognostication and treatment (Table 2
Jennette CJ, Milling DM, Falk RJ. Vasculitis Affecting the SkinA Review. Arch Dermatol. 1994;130(7):899-906. doi:10.1001/archderm.1994.01690070093015