What Is Perivascular Dermatitis?

Perivascular dermatitis is skin irritation associated with inflammation around the blood vessels. People with this condition develop rashes, flaking, and dry skin in areas where the irritated blood vessels run. 

People may experience this dermatological problem anywhere on the body, but the face, hands, feet, and arms are common locations for this condition. Treatment options are variable and include fairly conservative choices and more invasive techniques for managing skin irritation.

The condition may or may not be associated with changes in the layers of the skin (epidermal changes). Edema of the skin layer dermis is frequently seen in advanced cases of dermatitis. In addition to the vessel walls swelling (endothelial cells), there is the disintegration of the vascular walls.

Dermatitis is a generalized term that refers to the inflammation of the skin. There are different types of dermatitis, with atopic dermatitis, contact dermatitis, and seborrheic dermatitis being the most prevalent ones. Perivascular dermatitis is skin inflammation with the involvement of blood vessels of the skin.

Perivascular dermatitis is classified into superficial and deep types. As the name indicates, the superficial type affects the skin’s blood vessels. On the other hand, deep perivascular dermatitis involves all vessels-superficial and deep. Therefore, superficial perivascular dermatitis is more common than the deep type.

In most cases, clusters of white blood cells (lymphocytes) aggregate and cause skin inflammation, i.e., dermatitis. In the early stages of the disease, there is infiltration of small blood cells, neutrophils, and eosinophils. Later on, lymphocytes migrate to the site. 

On analysis of patients, physicians have concluded that the disease is idiopathic or often has unknown causes. There appears to be a genetic predisposition for perivascular dermatitis, although not all patients have a family history of the disease. 

However, the disease can occur when the area around the blood vessels becomes inflamed. That can be attributed to allergic responses or irritation like being exposed to coarse fabrics. 

Infections can also trigger inflammation around vessels. Dermatitis can be genetic. However, other common causes include overreactions by the immune system, environmental factors like air pollutants or fragrances, and exposure to certain chemicals.

Underlying auto-immune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, Sjorgen’s syndrome, etc., are risk factors for perivascular dermatitis. Certain drugs such as anticonvulsants, antipsychotics, and antibiotics may also trigger the disease. In addition, researchers believe that influenza vaccines and interferons can also trigger the disease.

Studies have shown there is a direct link between psychological stress/anxiety and the occurrence of dermatitis. Other causative factors for perivascular dermatitis include hormonal changes. As per studies, there exists a connection between hormonal level (sex hormones) changes and dermatitis.

Prone patients may develop skin disorders when exposed to irritants (environmental, chemical, etc.). On exposure, the skin develops redness, swelling, and itching, and it may take days or weeks to resolve, especially if the patient continues to be exposed to the irritant.

Perivascular dermatitis is linked to a skin condition of babies and infants, i.e., Gianotti Crosti syndrome. The syndrome is characterized by the formation of itchy blisters on the skin of arms and legs. 

Like most forms of dermatitis, perivascular dermatitis also goes away by itself. However, patients should consult a dermatologist if the condition persists for a long time or interferes with their daily activities. 

Generally, the disease goes away within 2 to 4 weeks, but the duration may vary for different individuals depending on the age, comorbid conditions, and extent of the disease.

Some measures for treating perivascular dermatitis include changing the diet, wearing different clothing, and being especially alert to skin irritation in the heat and during exercise sessions. Adding dietary supplements, like vitamin D supplements, can be a fruitful step. A meta-analysis shows that vitamin D can improve dermatitis conditions.

Topical and oral medications can also be prescribed to reduce inflammation and swelling. Some patients find lotions and hydrocortisone creams to soothe the skin, along with cool compresses to address the heat of inflammation. In addition, the application of a cool, wet cloth provides relief. Oral antihistamines can also be helpful. 

A warm bath with a baking soda mixture is an effective home remedy. The solution helps alleviate symptoms of dry skin and dermatitis. You can also find medicated shampoos in the market to symptomatically manage your condition. A dilute bleach bath- vinegar mixed in warm water soothes the skin and improves the symptoms. 

If the problem persists, scrapings may be taken to look for infection, and patients can consider options like allergy testing and an elimination diet to find out what, exactly, they are reacting to.

Patients should follow precautions to prevent further aggravation and the spread of the rashes. The most basic step to be taken is to avoid scratching and rubbing the area. Covering the dry skin with dressing can keep patients from scratching again and again. Patients must ensure that the clothing is not scratchy or rough. 

Patients should use unscented mild laundry detergents to wash clothes, sheets, and towels that have come in contact with affected skin. In cases of allergic responses, it is crucial to identify the specific allergen. Once identified, patients must stay away from the environmental allergen.

A crucial step in the prevention of perivascular dermatitis is managing stress levels. Emotional stress is identified as a direct cause of some types of dermatitis. Therefore, prone individuals must adopt some relaxation and meditation techniques. For example, yoga is an effective way of lowering anxiety and stress levels in the body.

Patients with perivascular dermatitis may find that their skin irritation attracts unwanted attention from people around them. It can be helpful to remind people that dermatitis is not contagious and that it is not dangerous to touch someone who has this condition. 

Soothing creams can minimize the appearance of inflammation to keep patients more comfortable in social settings, and some people may also use makeup. Although, makeup can increase irritation and prolong healing times.

Patients who experience recurrent perivascular dermatitis despite taking reasonable precautions like avoiding allergens may want to see a dermatologist, and perhaps an immunologist, for further evaluation. There may be another underlying problem that has not been addressed, and treating that could be necessary to resolve the skin irritation. 

Patients with this condition should also ensure it is noted in their charts, so care providers know to watch out for it. If they experience skin irritation in reaction to medications, it is crucial to confirm that prescriptions and over-the-counter medications do not contain any reactive ingredients.

Skin irritation and redness are symptoms of perivascular dermatitis. It results in reddish lumps or patches on the skin around the hair follicles, and it often itches or burns. Little blisters or lumps that are filled with a clear fluid might also appear sometimes. The illness may be brought on by a number of things, including allergies, stress, and certain drugs. While it may appear anywhere on the body, it most often affects the face, neck, and upper arms.

The appearance of tiny bumps or blisters filled with clear fluid, together with skin redness and inflammation, itching, and burning, are all signs of perivascular dermatitis. On occasion, the afflicted region may feel warm, sensitive, and swollen. Skin peeling, scaling, and discoloration are possible further symptoms.

An aberrant immune response to stimuli, including stress, certain drugs, and allergens, is the most frequent cause of perivascular dermatitis. Perivascular dermatitis may also be brought on by an infection, a response to certain chemicals, or skin care products. As a number of things might cause the syndrome, determining its precise origin is sometimes challenging.

Depending on the underlying etiology of the problem, perivascular dermatitis receives a variety of treatments. The majority of the time, itching and inflammation may be controlled using topical creams or ointments. In order to lessen the body's immunological reaction, oral medicines may also be recommended. Furthermore, laser or light therapy may be suggested. Systemic drugs may be required in extreme situations.

Perivascular dermatitis cannot be passed from one person to another and is not infectious. Yet, contact with a region of the skin that is afflicted might transmit the disease. In order to prevent additional irritation, it is crucial to keep the afflicted region clean and dry and to avoid direct contact with it.