By Gary M. White, MD
Rheumatoid vasculitis (RV) is a necrotizing vasculitis of medium-size vessels occuring in a patient with rheumatoid arthritis.
- 90% of patients with RV have skin involvement, the most common being deep ulcers about the ankles.
- RV is more frequent in the patients with severe RA of longer duration and anti-CCP positivity.
- The rheumatoid factor is typically high.
Deep cutaneous ulcers are most typical. Cutaneous features may range from in indolent skin disease (e.g. nail fold infarcts, petechia and livedo reticularis) to a life-threatening multiorgan vasculitis resembling polyarteritis nodosa (e.g. with necrotic ulcers, digital gangrene and mononeuritis multiplex).
Referral to a rheumatologist is in order.
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