Granulomatous vasculitis. 2015

A V Marzano, and Y Balice, and S Tavecchio, and C Desimine, and A Colombo, and E Berti
Operative Unit of Dermatology, Department of Transplantation, Medico-Surgical Physiopathology,University of Milan, Ca' Granda IRCCS Foundation, Ospedale Maggiore Policlinico, Milan, Italy - angelovalerio.marzano@policlinico.mi.it.

Granulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Wegener's granulomatosis and Churg-Strauss Syndrome respectively, are systemic granulomatous vasculitides affecting small- and medium-sized blood vessels. Both GPA and EGPA are included within the group of antineutrophilic cytoplasmic antibodies (ANCA)-associated vasculitides, on the basis of the detection of such autoantibodies in a significant proportion of affected patients. Two main settings of GPA, possibly overlapping each other, are recognized: a localized form, which is limited to the upper airways but is highly relapsing and refractory, and a diffuse form, which is initially more severe but then less commonly recurrent. In EGPA, a prodromic phase characterized by asthma and rhino-sinusitis is followed by an eosinophilic phase, marked by peripheral eosinophilia, and then by a vasculitic phase, in which skin lesions are a prominent feature together with peripheral neuropathy and renal involvement. Polymorphic cutaneous manifestations can occur during the course of both GPA and EGPA, and include palpable purpura, livedo reticularis, papules, nodules, vesiculo-bullae and necrotic-ulcerative lesions most commonly involving the lower extremities; pyoderma gangrenosum-like ulcers and lesions resembling erythema multiforme have been described in GPA and EGPA, respectively. Oral involvement is not uncommon in GPA and may manifest as nonspecific erosive lesions or as a hyperplastic gingivitis named strawberry gingivitis. Considering that skin involvement is common in ANCA-associated vasculitides and may also be their presenting sign, the role of dermatologist is crucial in the early diagnosis of these forms as well as of vasculitis in general.

UI MeSH Term Description Entries
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D003880 Dermatology A medical specialty concerned with the skin, its structure, functions, diseases, and treatment.
D004802 Eosinophilia Abnormal increase of EOSINOPHILS in the blood, tissues or organs. Eosinophilia, Tropical,Hypereosinophilia,Tropical Eosinophilia,Hypereosinophilias,Tropical Eosinophilias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001323 Autoantibodies Antibodies that react with self-antigens (AUTOANTIGENS) of the organism that produced them. Autoantibody
D014890 Granulomatosis with Polyangiitis A multisystemic disease of a complex genetic background. It is characterized by inflammation of the blood vessels (VASCULITIS) leading to damage in any number of organs. The common features include granulomatous inflammation of the RESPIRATORY TRACT and KIDNEYS. Most patients have measurable autoantibodies (ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES) against MYELOBLASTIN. Granulomatosis, Wegener's,Wegener Granulomatosis,Wegener's Granulomatosis,Granulomatosis with Polyangiitides,Granulomatosis, Wegener,Polyangiitides, Granulomatosis with,Polyangiitis, Granulomatosis with,with Polyangiitides, Granulomatosis,with Polyangiitis, Granulomatosis
D015267 Churg-Strauss Syndrome Widespread necrotizing angiitis with granulomas. Pulmonary involvement is frequent. Asthma or other respiratory infection may precede evidence of vasculitis. Eosinophilia and lung involvement differentiate this disease from POLYARTERITIS NODOSA. Allergic Angiitis,Allergic Granulomatous Angiitis,Angiitis, Allergic Granulomatous,EGPA Disorder,Eosinophilic Granulomatosis with Polyangiitis,Vasculitis, Churg-Strauss,Allergic Angiitis and Granulomatosis,Allergic Granulomatosis,Allergic Granulomatous and Angiitis,Eosinophilic Granulomatous Vasculitis,Granulomatous Allergic Angiitis,Allergic Angiitides,Allergic Angiitides, Granulomatous,Allergic Angiitis, Granulomatous,Allergic Granulomatoses,Allergic Granulomatous Angiitides,Angiitides, Allergic,Angiitides, Allergic Granulomatous,Angiitides, Granulomatous Allergic,Angiitis, Allergic,Angiitis, Granulomatous Allergic,Churg Strauss Syndrome,Churg-Strauss Vasculitis,Disorder, EGPA,Disorders, EGPA,EGPA Disorders,Granulomatoses, Allergic,Granulomatosis, Allergic,Granulomatous Allergic Angiitides,Granulomatous Angiitides, Allergic,Granulomatous Angiitis, Allergic,Granulomatous Vasculitides, Eosinophilic,Granulomatous Vasculitis, Eosinophilic,Syndrome, Churg-Strauss,Vasculitides, Eosinophilic Granulomatous,Vasculitis, Churg Strauss,Vasculitis, Eosinophilic Granulomatous
D042241 Early Diagnosis Methods to determine in patients the nature of a disease or disorder at its early stage of progression. Generally, early diagnosis improves PROGNOSIS and TREATMENT OUTCOME. Early Detection of Disease,Diagnosis, Early,Disease Early Detection

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