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the wingless one
10-09-2006, 12:08 AM
Does anyone else periodically get bumps of various sizes around the elbows? Sometimes it means a flare is coming and sometimes it doesn't...I can't quite figure it out. I also get this red bump just above the bottom knuckle of my middle finger which usually coincides with flares. When I used to wear a gold ring on my left hand, middle finger, it would appear on the left middle knuckle. After I got engaged I moved that same ring to the right hand, also middle knuckle, and now the bump appears on the right middle knuckle. No bumps on the finger that my engagement ring is on but that one is platinum. Anyone know what the explanation might be?

Saysusie
10-09-2006, 01:06 PM
Your small red bumps may be indications of Vasculitis. This is not uncommon in people with Lupus. Vasculitis is an inflammation of the blood vessels. Inflammation is a condition in which tissue is damaged by blood cells entering the tissues. In inflammatory diseases like Lupus, these cells are mostly white blood cells. White blood cells circulate and serve as our major defense against infection. Ordinarily, white blood cells destroy bacteria and viruses. However, they can also damage normal tissue if they invade it.
Vasculitis can affect the very small blood vessels (capillaries), medium-size blood vessels (arterioles or venules), or large blood vessels (arteries or veins).
Several things can happen to an inflamed blood vessel. If it is a small vessel, it may break and produce tiny areas of bleeding in the tissue. These areas will appear as small red or purple dots on the skin.
If a larger vessel is inflamed, it may swell and produce a nodule which may be felt if the blood vessel is close to the skin surface. The inside of the vessel tube may become narrowed so that blood flow is reduced.
The inside of the vessel tube may become totally closed, usually by a blood clot which forms at the site of inflammation. If blood flow is reduced or stopped, the tissues which receive blood from that vessel begin to die. For example, a person with vasculitis of a medium-sized artery in the hand may develop a cold finger which hurts whenever it is used.
When Vasculitis is caused by Lupus, the antigens causing the immune complexes are often not known. In some cases, the complexes contain DNA and anti-DNA antigens, or Ro (also called SS-A) and anti-Ro antigens. A recently discovered antibody, ANCA (anti-neutrophil cytoplasm antibody), can cause vasculitis in some individuals with Lupus.
The symptoms of Vasculitis depends upon: what tissues are involved and
the severity of the tissue damage.
Some patients are not ill but notice occasional red spots on their skin.
Others are very ill and can have systemic symptoms and major organ damage.
A list of symptoms based on the tissues in which vasculitis occurs include:

Systemic symptoms (this set of complaints can occur in many illnesses and is not specific to vasculitis):
fever
generally feeling bad (malaise)
muscle and joint pain
poor appetite
weight loss
fatigue.

Skin Symptoms - Common vasculitis skin lesions are:
red or purple dots (petechiae), usually most numerous on the legs and hands, larger spots, about the size of the end of a finger (purpura), some of which look like large bruises.
Less common vasculitis lesions are:
hives
an itchy lumpy rash
painful or tender lumps.
Areas of dead skin can appear as:
ulcers (especially around the ankles
small black spots at the ends of the fingers or around the fingernails and toes (nail fold infarcts)
gangrene of fingers or toes.
Joints
aching in joints and arthritis with pain
swelling and heat in joints
deformities resulting from this arthritis are rare.

Let me know if this has been helpful or if it fits what you describe.

Peace and Blessings
Saysusie

the wingless one
10-11-2006, 05:32 PM
Thanks for the response Saysusie it was very helpful =) I'm a little bit confused though because I do often get joint pain around the same time as the bumps appear but it's not usually in the same place as where the bump appears? Also, the bumps usually only stay for a day or two, sometimes longer, but usually not. Is this typical of Vasculitis or do the bumps associated with that tend to last longer? Also, is there anything I should be doing about Vasculitis other than the medications I am already on for my lupus?

Thank you again!

Saysusie
10-12-2006, 06:28 PM
It sounds as if your bumps and joint pains are indications of a lupus flare. The problem is that no one can predict Lupus Flares and, like the disease itself, the flares are unique to each of us. Therefore, it is hard to say how long the symptoms will last or why they progress the way they do. Since you are quite aware of how they progress for you, that can be helpful in determining if you are having a Lupus flare and in methods that you can use to avoid those flares. But, as I said, these will be unique to you.
The treatment for vasculitis depends on several factors: the severity of the vasculitis, your general health, and your past reactions (positive and negative) to medications.
Many cases of vasculitis do not require treatment. For example, a few spots on the skin now and then (if not combined with other symptoms) may not require any medications. Most physicians recommend cortisone-type medications as the initial treatment for vasculitis., such as:
prednisone, prednisolone, methylprednisolone (brand name: Medrol)
Some people with severe vasculitis or vasculitis that does not respond well to cortisone-type drugs will need to be treated with cytotoxic drugs.
Cytotoxic drugs kill the cells that cause inflammation in the blood vessels. The two most frequently used are: azathioprine (brand name: Imuran)
cyclophosphamide (brand name: Cytoxan). Cytotoxic medications are usually used in combination with prednisone and are often effective in treating vasculitis.

Peace and Blessings
Saysusie

the wingless one
10-12-2006, 10:35 PM
Ohh...thanks =) I guess the medications I'm already on should be sufficient then...I've mentioned the bumps to my rheumy before but I don't think they've actually ever coincided with an office visit and he doesn't seem too concerned about them...told me it was probably just part of the lupus. I guess it's just one of those things hehe. Thanks again!