Hypersensitivity Vasculitis And The Dental Team

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Hypersensitivity vasculitis is a condition caused by an extreme reaction to drugs and other stimuli. Members of the dental team can have especially good opportunities to influence the health and well-being of patients well beyond just their oral health that is why it’s very important to visit them to know more about this diseases. Unfortunately, years of increasing specialisation and ‘payment by results’ has tended to focus the attention of dental professionals ever more closely on the oral cavity and less on the patient as a whole.

The standard medications linked to vasculitis include:

  • allopurinol
  • phenytoin
  • some blood pressure medications
  • certain antibiotics such as sulfa drugs and penicillin

It’s known to inflame the blood vessels in the skin. There are three main categories of vasculitis. In all types, the blood vessels get inflamed, and the organ served by the blood vessels get necrosed. Mostly the skin is affected although the joints, kidneys, and bowels may also be affected. The typical symptom is skin rashes which can be small or large raised purpled spots. Signs in the skin include itching, pain, burning and sometimes the outbreak may not have any symptoms. Bowel involvement may lead to a variety of symptoms such as diarrhea and abdominal pain. Members of the dental team have added opportunities when it comes to the health and well being of patients. Most people visit their dentist regularly and are taken through a scrutinized medical history which may reveal early signs of vasculitis. Several types of vasculitis have oral characteristics that can only be recognized by someone in the dental team. Other less common symptoms that can be experienced include a mild fever and enlarged lymph nodes.

Diagnosing hypersensitivity vasculitis requires patients to meet the following criteria:

  • You used a drug before skin rash developments.
  • You are older than 16 years.
  • You have a skin rash containing both flat and raised spots.
  • You have a skin rash with palpable purpura.
  • A biopsy of your skin rash showing white blood cells surrounding the blood vessels.

However, organs such as the nervous system, lungs, kidneys, gastrointestinal tract, and heart can also be involved.

The standard treatment involves prescribing the patient with anti-inflammatory medication. Drugs should be stopped if they are implicated as the cause. Patients with joint disease may respond to colchicine or dapsone. Patients with severe conditions may require treatment with steroids.

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