According to abbreviationfinder, HSV stands for hypersensitivity vasculitis. Hypersensitivity vasculitis is inflammation of the skin vessels. The triggers can be drugs or infections to which the immune system overreacts in the sense of an allergy. The disease can spread from the skin to internal organs. Serious bodily harm then threatens as a result of hypersensitivity vasculitis.
What is hypersensitivity vasculitis?
Hypersensitivity vasculitis is typically characterized by small hemorrhages in the skin. Intense red punctiform spots form, which can grow up to three millimeters in size.
Hypersensitivity vasculitis is an inflammatory disease of blood vessels. By definition, many forms of vasculitis have in common that an autoimmune reaction is the basis or is involved. This is when the immune system attacks the body’s own tissues. The vasculitides thus belong to the rheumatic group of forms in their manifestation.
Vasculitides are divided into:
- Cutaneous vasculitides, in which only the vessels of the skin are affected and
- Systemic vasculitis, in which the vessels of internal organs also show the inflammatory symptoms.
Another classification is based on the size of the diseased vessels. Hypersensitivity vasculitis is a form of cutaneous vasculitis with inflammation of small skin vessels.
Causes
Hypersensitivity vasculitis is characterized by deposits of protein complexes on the walls of the skin vessels. This protein precipitation results from an immune reaction. First, the immune system produces specific immunoglobulins (antibodies), which combine with other proteins.
These proteins are called antigens and trigger the immune response. Exogenous (exogenous) factors come into consideration as antigens in the context of hypersensitivity vasculitis. These can be viral or bacterial infections or medication. On the other hand, endogenous (body’s own) triggers can be involved in the biochemical cascade.
It is still unknown why the immune system, which otherwise only targets foreign particles, suddenly attacks the body’s own components. An inflammatory reaction always results when an antigen is bound by an antibody. Autoimmune reactions are usually a contributory cause of hypersensitivity vasculitis.
Symptoms, Ailments & Signs
Hypersensitivity vasculitis is typically characterized by small hemorrhages in the skin. Intense red punctiform spots form, which can grow up to three millimeters in size. After a few days, these spots turn from red to purple.
At first they appear only on the lower legs. As the disease progresses, new punctiform hemorrhages develop parallel to the darkening spots, which can also spread from the lower legs to the thighs. The patches are usually symptom-free. Only in some cases do they burn or itch. In the case of severe inflammation, they turn dark red and expand their diameter to several millimeters.
In particularly severe cases, the upper layer of skin (skin) can also die off in the middle of the spots. The dead epidermis turns light gray or forms blisters. In even more severe cases, even the connective tissue-like dermis dies off, leaving black nodules behind. After their detachment, small painful ulcers develop.
As a rule, vascular inflammation appears suddenly. However, it also recedes within a few weeks and heals with the formation of brown spots. However, the inflammation can always come back. Sometimes the joints, the gastrointestinal tract or the kidneys are also affected. Thus, hypersensitivity vasculitis can occasionally be accompanied by swelling in the joints, slight intestinal bleeding or a mostly mild kidney inflammation.
Diagnosis & History
Hypersensitivity vasculitis begins with patches of blue-purple mottled skin that spread from the ends of the extremities toward the center of the body. This skin marking results in a typical picture with many small areas and larger areas in between.
The bluish tint results from circulatory disorders in the irritated and narrowed vessels. The dermatologist will recognize hypersensitivity vasculitis by this. Itching or pain may accompany the symptoms, but this occurs in relatively few patients. As the disease progresses, areas of skin can die off (necrosis). Diagnostically, a blood laboratory is now required that specifically focuses on the immunological findings.
In particular, the rheumatic factors must also be taken into account. The search for the involvement of internal organs also has top priority. Therefore, clinical examinations, for example using radiological methods, are also part of the diagnosis of hypersensitivity vasculitis.
Complications
Hypersensitivity vasculitis causes various symptoms. These usually depend on the severity of the disease. If left untreated, hypersensitivity vasculitis can cause damage to internal organs, including death. The affected person suffers from discoloration of the skin as a result of the disease.
This usually turns blue and is covered with spots. Likewise, bleeding occurs on the skin and the skin is covered with blisters. It is not uncommon for the muscles and joints to ache, which leads to difficulties in everyday life and restricted movement in many patients. Furthermore, the patients suffer from reduced resilience and fever.
The patient feels tired and exhausted and no longer actively participates in life due to the hypersensitivity vasculitis. Treatment of hypersensitivity vasculitis takes place with the help of drugs and various therapies. There are no further complications. However, a positive course of the disease cannot be guaranteed in every case. In many cases, ointments and creams can also be used to relieve pain.
When should you go to the doctor?
Since hypersensitivity vasculitis is a disease that requires treatment, a doctor must be consulted as soon as unusual changes in the appearance of the skin appear. If blistering and discoloration of the skin occurs, a doctor is needed. If swelling develops, or if there is pain in the joints or muscles, a doctor should clarify the symptoms. If you lose the usual level of strength, exhaustion, inner weakness or general malaise, you should consult a doctor.
Further examinations are necessary if there are repeated bleeding or wheals on the skin. Palpable small patches on the body are signs of a disease that requires medical attention. Persistent itching and heavy legs should also be examined by a doctor. If open wounds form, the wound must be treated sterilely. A doctor’s visit is necessary as soon as inflammation, fever or the formation of pus occurs.
If the skin changes spread over the body or if emotional problems arise, a doctor should be consulted. In the event of circulatory disorders, a doctor should be consulted immediately. There is a risk of further diseases and a life-threatening condition if left untreated. Sensitivity disorders, numbness and tingling in the limbs are warning signals from the body. They require medical clarification of the cause.
Treatment & Therapy
In therapy, hypersensitivity vasculitis turns out to be a search for the trigger of the immunological overreaction. The doctor can eliminate exogenous factors, so infections can be treated with antibiotics if necessary.
If the side effect of a medication is present, the doctor must change the medication. Alleviating the symptoms is the second pillar of therapy. In many cases, bed rest is indicated, with the legs best placed in an elevated position, because this is where the skin changes are usually the most serious. Patients wear compression stockings to support this . Cortisone-like preparations can be used to suppress the inflammatory reactions.
The pharmaceuticals are either applied as ointments or given as tablets. Oral administration is more likely in severe cases, when skin necrosis is already to be complained about. In addition, doctors have also achieved success with colchicine in the treatment of hypersensitivity vasculitis. The substance from the autumn crocus acts like a cytostatic.
Possible drug therapy also includes immunosuppressants, i.e. agents for reducing the immunological activity. If, in addition to the skin, internal organs are also affected, the dermatologist will consult colleagues from the relevant disciplines. Otherwise, permanent organ damage is a possible consequence of hypersensitivity vasculitis.
Outlook & Forecast
The prognosis of hypersensitivity vasculitis is favorable. Since the symptoms are triggered by the administration of certain medications, the symptoms can be alleviated by changing and optimizing the treatment plan that has been developed. The existing underlying disease is treated further in these patients with an alternative treatment method. If the medication that caused the hypersensitivity vasculitis is discontinued, the state of health usually improves within a few hours. With the removal of the active ingredients from the organism, the symptoms are minimized. Normally, freedom from symptoms is documented after a few days.
In rare cases, however, the prognosis can be unfavorable. If the trigger of the hypersensitivity vasculitis is not found as quickly as possible, or if the patient does not contact the doctor treating him to discuss the deterioration of his state of health, there is a risk of an acute situation. This can potentially be life-threatening.
If the organs are damaged, functional disorders can lead to organ failure. This increases the risk of the patient dying prematurely. The healing process is particularly difficult if the hypersensitivity vasculitis is not recognized. With a gradual increase in symptoms, it is often difficult to find the cause of the symptoms. This increases the likelihood of permanent damage and increases the risk of mortality.
Prevention
Preventing hypersensitivity vasculitis is difficult because the body’s complex responses to drugs or other chemicals are virtually unpredictable. Allergy sufferers should keep a watchful eye on their bodies and be very sensitive to their general well-being. Changes in the skin in particular should be a reason to see a doctor. This is where the obvious symptoms of hypersensitivity vasculitis appear.
Aftercare
Treatment of hypersensitivity vasculitis entails a recovery period. Aftercare usually begins with bed rest with legs elevated to alleviate the skin changes. The doctor often prescribes compression stockings, and cortisone-like preparations are also helpful against the typical inflammatory reactions.
As part of drug therapy, patients receive immunosuppressive drugs, which they must take exactly as recommended by the doctor. In the event of damage to the internal organs, further specialist advice may be required. The body’s overreactions to certain drugs and chemicals are unpredictable.
For this reason, there are hardly any blanket preventive measures for those affected. Allergy sufferers should carefully monitor their state of health in order to identify any changes as soon as possible. The increased sensitivity helps to react quickly and arrange a doctor’s appointment at short notice. Skin changes in particular can be an indication of the disease.
So that the skin does not become inflamed further and the existing irritations do not get worse, it is best for patients to completely avoid cosmetics. The doctor gives you useful advice on thorough and careful hygiene, which you should follow carefully. For a quick improvement and for the stabilization of the immune system, it is helpful to avoid alcohol during the illness.
You can do that yourself
Because of the potential complications of hypersensitivity vasculitis, it is important for sufferers to strictly follow the doctor’s instructions. The specialist usually prescribes rest or even bed rest. In addition, the patient often takes various medications to reduce the symptoms caused by the hypersensitivity vasculitis. Since hypersensitivity vasculitis is sometimes caused by drugs, no additional drugs should be taken unless specifically prescribed by the doctor.
At best, patients with hypersensitivity vasculitis allow themselves a break from their everyday obligations in order to facilitate the regeneration of the attacked organism and to observe their own state of health more closely. Especially after taking medication, it is important to pay attention to whether other side effects occur. In such cases, the patients with hypersensitivity vasculitis contact the responsible physician immediately. In general, it is important for the success of the treatment of hypersensitivity vasculitis that the patient undergoes close check-ups with the doctor.
In order not to provoke further inflammation of the skin and not aggravate the existing ones, patients during hypersensitivity vasculitis refrain from using cosmetics as much as possible. Thorough personal hygiene, coordinated with the doctor, is nevertheless essential. To support the immune system, sick people also refrain from consuming alcohol during the time of the illness.
