Cutaneous Vasculitis in Autoimmune Rheumatic Diseases: Clinical Clues, Vascular Pathogenesis and Management

Abstract

Background: Cutaneous vasculitis is an important clinical presentation of autoimmune rheumatic diseases, which can be an indication of systemic immune dysregulation. It tends to manifest itself in cases of Systemic Lupus Erythematosus, Rheumatoid Arthritis and other connective tissue disorders. Small-scale organised data on clinical presentation, vascular pathogenesis and clinical management outcomes are important clinically, but have not been supported to date in a single analytical model. The following paper will address clinical clues, vascular processes and reaction tendency of cutaneous vasculitis of autoimmune rheumatic disorders.

Objective: The main aim of this research was to examine the connection between clinical presentation, vascular inflammatory process and treatment outcomes in autoimmune rheumatic disease-related endogenous cutaneous vasculitis patients. The study was also to establish the demographic factors which influence the severity and response to treatment of the disease.

Methods: A cross-sectional study design was used as a quantitative study. A cohort of respondents with autoimmune rheumatic diseases who had either or both cutaneous and non-cutaneous vasculitis was recruited into the study and gave their data (n=221). It was a structured questionnaire, which took the form of a 5-point Likert scale; however, the questionnaire contained four broad domains, namely clinical clues, vascular pathogenesis, management practices and awareness. Demographic factors were age, gender, education, occupation, disease duration and type of diagnosis. Descriptive and inferential statistics were used to conduct the statistical analysis. Shapiro- WIlk test assisted in running the test of normality. Reliability was ascertained on Cronbach's alpha and Bartlett's Test, whereas the validity was ascertained on KMO. To establish relationships and predictive associations between variables, inferential statistics such as Independent Samples t-test, One-way ANOVA, Kruskal-Wallis test, Chi-Square test, Pearson correlation and regression analysis were used.

Results: Findings revealed that all the variables were normally distributed (approximately) and hence, parametric tests could be conducted. The internal consistency was noted to be excellent as Cronbach's alpha was between 0.88 and 0.94. Its validity was proved by the test of adequate sampling (KMO = 0.89, p < 0.001); thus, it can be applied to a multivariate analysis. The inferences revealed that the performance in terms of clinical and management was very diverse among the genders, age groups, and the categories of diagnostic identities. Correlation analysis showed great positive correlations existing between clinical clues, pathogenesis, management and awareness. The most interesting correlation was a potential relationship between management and overall disease score, which implies that there is a positive relationship between the effectiveness of treatment and the condition of patients. The regression analysis revealed that the clinical clues, the pathogenesis and awareness were the significant predictors of the management outcomes, as they revealed a substantial portion of the variance. The clinical clues turned out to be the strongest predictor, which shows the importance of early symptom identification as one of the means to rectify the situation with a disease.

Conclusion: The paper finds that cutaneous vasculitis is one of the important clinical signs of disease activity in autoimmune rheumatic diseases. Vascular inflammation, patient awareness and clinical presentation are intertwined with one another and influence the outcome of the treatment dramatically. It is important to note that early diagnosis and early intervention can enhance the prognosis and help to avoid complications. One aspect that the authors emphasise is that the method of clinical evaluation and patient-based management of autoimmune rheumatic disorders should also be evaluated, which, in turn, depends on the combination of various methods and techniques of combinatorics.