Capillaritis/ Inflamed Capillaries

Capillaritis is the name given to a harmless skin condition in which there are reddish-brown patches caused by leaky capillaries. It is also known as pigmented purpura.

The capillaries are small blood vessels near to the skin surface. They can sometimes become inflamed. Blood cells may pass through small gaps that arise between the cells, which make up the capillary walls. The result is tiny red dots appearing on the skin, described as cayenne pepper spots. These can turn brown and sometimes fade over time, but may be permanent. 

Cause:

The cause of capillaritis is usually unknown. Occasionally it arises as a reaction to a medication, a food additive or a viral infection. Capillaritis may develop after exercise.

Clinical features:

There are several descriptive types of capillaritis, which often behave similarly.

Examples include:

• Schamberg’s disease (progressive pigmented purpura)
  • This is the most common type of capillaritis. Crops of red-brown, flat patches with cayenne pepper spots on their borders appear for no apparent reason. Although most common on the lower legs, Schamberg’s can arise on any part of the body. It is usually irregularly distributed on both sides with few or many patches. There are no symptoms.

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• Lichen Aureus
  • Lichen aureus is a solitary brown-yellow patch that is very persistent. It often overlies a varicose vein.

Treatment:

There is no known cure for most cases of capillaritis. It can disappear within a few weeks, recur from time to time, or frequently persist for years.

• Consider if a medication could be the cause: discontinue it for several months to find out if the capillaritis improves.
• Try avoiding food preservatives and artificial coloring agents. Return to a normal diet if there is no improvement after several months.
• Topical steroids can be helpful for itching but rarely clear the capillaritis.
• If the lower leg is affected, consider wearing graduated compression elastic hose.
• Currently available lasers are not particularly helpful for this condition.