1. A microscopic examination of the sample taken from a skin lesion indicates hyphae. What type of infection might this indicate? Bacterial Viral Parasitic Fungal 2. A child with a sandpaper-textured rash probably has: rubeola strept infection varicella roseola 3. A 40-year-old female patient presents to the clinic with multiple, painful reddened nodules on the anterior surface of both legs. She is concerned. These are probably associated with her
pre-existing conditions such as rheumatoid arthritis or vasculitis. The reddened nodules on the anterior surface of the patient’s legs could be indicative of a condition known as nodular vasculitis. Nodular vasculitis is a form of vasculitis that primarily affects the skin and is characterized by the development of painful nodules or tender subcutaneous plaques on the lower extremities. This condition is typically seen in patients with underlying systemic diseases such as rheumatoid arthritis, systemic lupus erythematosus, or inflammatory bowel disease.
Nodular vasculitis is thought to be an immune-mediated inflammatory response that targets the small blood vessels in the skin, leading to the formation of painful nodules. The exact cause of nodular vasculitis is unknown, but it is believed to involve a combination of genetic and environmental factors. It is thought that certain individuals may have a genetic predisposition to developing the condition, and exposure to various triggers such as infections or medications can then lead to the development of nodular vasculitis.
Clinically, nodular vasculitis presents as tender, erythematous nodules or plaques on the lower extremities, specifically the anterior surface of the legs. The nodules may vary in size and can range from a few millimeters to several centimeters in diameter. The lesions may be solitary or multiple and typically develop over a period of weeks to months. In some cases, the nodules may ulcerate and develop crusts. The patient may also experience associated symptoms such as fever, fatigue, and arthralgia.
The diagnosis of nodular vasculitis is primarily based on clinical presentation and histopathological examination of a skin biopsy. The biopsy typically shows leukocytoclastic vasculitis, which is characterized by the presence of fibrinoid necrosis and neutrophilic infiltration within the walls of small blood vessels. This histological finding supports the diagnosis of nodular vasculitis.
Treatment of nodular vasculitis depends on the underlying cause and severity of the disease. In cases where nodular vasculitis is associated with an underlying systemic disease, treatment of the underlying condition is essential. This may involve the use of medications such as corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or immunosuppressive agents. Local measures, such as the application of topical corticosteroids or dressings, may also be helpful in managing the symptoms associated with nodular vasculitis.
Prognosis for patients with nodular vasculitis is generally favorable, with most patients experiencing spontaneous resolution of the skin lesions within several months. However, the underlying systemic disease, if present, may require ongoing management. It is important for patients to follow up with their healthcare provider regularly to monitor and manage their condition.
In conclusion, the presence of multiple, painful reddened nodules on the anterior surface of both legs in a 40-year-old female patient is likely indicative of nodular vasculitis. This condition is often associated with underlying systemic diseases and is characterized by an immune-mediated inflammatory response that targets the small blood vessels in the skin. Clinicians should be aware of the clinical features and diagnostic approach to nodular vasculitis in order to provide appropriate management and support for patients with this condition.