New Classification and Algorithm to Classify and Diagnose Primary Cutaneous Vasculitis from a Dermatological Point of View

Abstract

　Classifying primary cutaneous vasculitis has proven to be both challenging and controversial. We previously set out to establish a classification system and algorithm to diagnose vasculitis with cutaneous manifestations from a dermatological point of view based on the 1994 Chapel Hill Consensus Conference Classification and our research results with approval from the Guideline Committee of Vasculitis within the Japanese Dermatological Association (Katsuoka Group) . We recently developed a new version of the classification and algorithm for primary cutaneous vasculitis based on the 2012 Chapel Hill Consensus Conference Classification with approval from the Guideline Committee of Vasculitis within the Japanese Dermatological Association (Furukawa Group) . Cutaneous symptoms are highly noticeable, and by interpreting the cutaneous manifestations, dermatologists can ascertain the type of affected vessels. Palpable purpura is indicative of small vessel vasculitis in the upper dermis. On the other hand, livedo racemose is indicative of medium-sized vessel vasculitis in the lower dermis to subcutaneous fat. Dermatological examinations using the proposed algorithm in vasculitis patients may enable us to refine our earlier diagnostic strategies. Furthermore, we organized a Japanese committee (Kawakami Group) to make a new version of the classification and algorithm for primary cutaneous vasculitis.