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Cutaneous Vasculitis — SCE Dermatology MCQ

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ModerateConnective Tissue & VasculitisCutaneous VasculitisSCE Dermatology

A 22-year-old woman presents with cutaneous small vessel vasculitis. She has palpable purpura on her lower legs with no systemic features. Drug history is unremarkable. Infection screen is negative. ANA, ANCA, cryoglobulins, complement, and immunoglobulins are all normal. What is the most likely classification?

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Correct answer: B — Cutaneous small vessel vasculitis — idiopathic (hypersensitivity vasculitis)

When comprehensive investigation for cutaneous small vessel vasculitis reveals no identifiable cause (negative drug history, infection screen, autoimmune screen, immunoglobulins, cryoglobulins, complement), the vasculitis is classified as idiopathic (hypersensitivity vasculitis). This accounts for approximately 50% of cutaneous vasculitis cases. The prognosis is generally good — most episodes are self-limiting (resolving within weeks to months). Treatment is supportive: leg elevation, compression, NSAIDs, and for more severe/persistent cases, Dapsone or Colchicine. Short courses of oral Prednisolone may be used for significant episodes. Long-term follow-up is recommended as underlying causes may emerge.

Reference: BAD 2017 Vasculitis Guidelines; NICE