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Lower limb vasculitis
I got red rashes in my lower limbs since 3yrs I showed to many dermatologists but they couldn't guess. Later one doctor told me get skin biopsy and he declared it to be lymphatic vasculitis. He gave some ointment applying which I lost melanocytes on my feet and now my feet looks pale in colour. I got those red rashes on both legs. They swell sometimes and gives out little puss and then a small pit is formed there. I did ANA & ANCA tests which are negative. I'm not able to understand where I should go for treatment. When I searched in Google is written rheumatologists treats vasculitis. Recently I showed to a rheumatologist and he too was puzzled looking at ANA &ANCA tests coming negative. Please give some light on my disease. Is it curable and what are reasons this disease? I don't get any fever when these rashes are active. From last few months I'm getting little knee pain in one leg. Occasionally itchy. These rashes are red and painful only in winter otherwise brown dried up.
Thank
Vasculitis in simple words its the inflammation of blood vessels. The causes are plenty. Infections (viral, bacterial, fungal), drugs, connective tissue disorders (SLE, scleroderma,), malignancy and sometimes idiopathic that is cause is not known. Vasculitis can affect skin as well as internal organ like heart, kidney, bone, brain,eyes, gastrointestinal and lungs. You need to do battery of tests. Since its there for 6 yrs may be its idiopathic. skin biopsy along with direct immunofluorescence is helpful. There are ANCA negative vasculitis which is mor common than ANCA posiyive. So don't need to be surprised or worried. The treatment options for this is colchocine, dapsone, cortiocsteroids, azathiprine, cyclosporine, cyclophosphamide, methotrexate, mycophenolate mofetil and biologicals.. symptomatically it can be treated qith antihistamines, limb elevation, compression therapy. Also on biopsyits mentioned lichen sclerosus et atophicus. Review the biopsy slide again with different pathologist. Usetopic tacrolimus 1% oint over there.
Next Steps
CBC, LFT, RFT, ÀNA PROFILE, HBsAG, HCV antibodies, RA factor, CRP, ASLO titre, T3 T4 TSH, USG abdomen, Chest X ray, ECG. If these tests are normal and after starting the above treatment if you don't improve then special tests like serum and urine electrophoresis, C3, C5 levels to be done. You should be fine after treating with above any one of the medications
Health Tips
avoid prolonged standing, and use compression stockings. limb elevation is useful.
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