NODULAR VASCULITIS (ERYTHEMA INDURATUM)

GENERAL

Clinical Manifestations
  • Chronic inflammatory nodules of the legs that showed histopathologic changes similar to those of erythema induratum, that is, vasculitis of the larger vessels and panniculitis.
  • 2 variants: erythema induratum of Bazin type and nodular vasculitis or erythema induratum of Whitfield type. The Bazin type is related with tuberculous origin, but Whitfield type is not.

  • Nodular vasculitis mainly affects women aged 30 to 60. Men are less often affected. The nodules or lumps are usually found on the backs of the lower legs but they may also occur on the thighs and arms. One or both legs may be involved. Lesions range in size from small bumps to large plaques. They may be more easily seen than felt.

    Other features include:

    • Aching legs
    • Red-purple discoloration
    • Cool skin
    • Varicose veins.

    Evolution of the nodules is usually slow although in some there can be acute inflammation or ulceration. Ulcers usually persist for several weeks then heal. Most nodules heal slowly with little atrophy or scarring. If superficial, they give the impression of being tethered to the skin and may leave a depression that takes several months to fill.

    Nodules may continue to erupt at irregular intervals over months or years.

  • Nodular vasculitis is a type of panniculitis. The exact cause is unknown but the patchy inflammation in the blood vessels and lymphatics in the deep dermis and subcutaneous fat appears to relate to a slowed circulation. Factors contributing to this include:

    • Cold, fat legs
    • Venous disease
    • Hypertension (high blood pressure).
Treatment Principle
Herb Formulas
Points

QI AND BLOOD DEFICIENCIES WITH BLOOD HEAT AND/OR DAMP-HEAT LEADING TO BLOOD STAGNATION

Clinical Manifestations
  • Chronic inflammatory nodules of the legs
  • Mainly affects women aged 30 to 60
  • Men are less often affected
  • The nodules or lumps are usually found on the backs of the lower legs but they may also occur on the thighs and arms
  • One or both legs may be involved
  • Lesions range in size from small bumps to large plaques
  • They may be more easily seen than felt
  • Aching legs
  • Red-purple discoloration
  • Cool skin
  • Varicose veins
  • There can be acute inflammation or ulceration
  • Nodules may continue to erupt at irregular intervals over months or years
Treatment Principle
  • Tonify Qi and Blood
  • Clear Heat
  • Resolve Dampness
  • Invigorate the Blood
  • Break up Stasis
Herb Formulas
Points