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What Are the Hallmarks of Cutaneous Vasculitis? With Harrison Nguyen, MD, MBA, MPH
In this segment of his SDPA Fall interview, Nguyen highlighted his second talk ‘Patterns in Red and Purple: Decoding Vasculitis in the Skin.’
A session was presented by Harrison Nguyen, MD, MPA, MPH, at the Society of Dermatology Physician Associates (SDPA) 2025 Fall Conference in San Antonio, titled ‘Patterns in Red and Purple: Decoding Vasculitis in the Skin.’1
In a previous interview with HCPLive, Nguyen, a clinical assistant professor of dermatology at Baylor College of Medicine, spoke on the pathways driving chronic spontaneous urticaria (CSU).2 In this interview, Nhuyen highlighted his session on vasculitis, responding to questions about the hallmarks of this cutaneous condition.
"Vasculitis is often presents on the skin, and what's important to understand is that vasculitis is often a reaction, as opposed to a primary disease,” Nguyen explained. “So, the job as dermatologists and dermatology clinicians is to be able to recognize that it's vasculitis and then to put our detective hats on to see if there's any important drivers of this reactive pattern. The majority of the time…we can treat symptomatically, but in the situations where there are other conditions that may be driving vasculitis, it's important for us to identify those.
Nguyen went on to describe other elements in his talk. Dermatologists, Nguyen noted, are often the individuals to whom vasculitis first presents, and patients can be afraid of this condition.
“It can present differently based on the type of vasculitis,” Nguyen expressed. “We often classify it based on the vessel size. So small vessel vasculitis, medium vessel vasculitis, and large vessel vasculitis, present differently. Small vessel vasculitis often presents with papules and often in the lower extremities, as it gets larger vessels, and then we start to see things like retiform purpura ulcers. But it's important for us to do the right workup to make this diagnosis. A biopsy is important.”
Nguyen continued his discussion of the session on cutaneous vasculitis, highlighting the approach to a biopsy for this condition.
“Biopsies are being done, but I hope that we can emphasize that it's important to also do a “DIF’ or a direct immunofluorescence biopsy,” Nguyen said. “Also, the selection of the lesion can be helpful. We don't want too fresh of a lesion, and we don't want it too old of a lesion either, because that can actually distort the interpretation. So really, a lesion that's 24 to 48 hours in age is the right time, right lesion to biopsy.”
For any additional information on this topic, view the full video posted above. To find out more about the conference, view the latest coverage.
The quotes implemented in this interview summary were edited for clarity.
Nguyen had no relevant financial disclosures of note.
References
Nguyen H. Patterns in Red and Purple: Decoding Vasculitis in the Skin. Presented at the Society of Dermatology Physician Associates (SDPA) Fall Conference, November 5-9, San Antonio, TX.
Nguyen H. Immune Pathways Driving Chronic Spontaneous Urticaria, With Harrison Nguyen, MD, MBA, MPH. HCPLive. November 10, 2025. https://www.hcplive.com/view/immune-pathways-chronic-spontaneous-urticaria-harrison-nguyen-md-mba-mph.
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