Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Other dermatoses


Reviewer: Mowafak Hamodat MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns (Canada) (see Reviewers page)
Revised: 1 August 2011, last major update August 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.


● Most cases are due to immune complexes
● May be limited to skin (focal or generalized) or involve internal organs
Large vessel vasculitis: associated with Churg-Strauss allergic granulomatosis, polyarteritis nodosa, giant cell arteritis, Wegener’s granulomatosis and lymphomatoid granulomatosis
Leukocytoclastic vasculitis: neutrophilic inflammation with fibrinoid necrosis and fragmented neutrophilic nuclei (leukocytoclasis); it presents as purpuric palpable lesions of lower legs; systemic cases are associated with Henoch-Schonlein pupura (fever, arthralgias, abdominal pain, hematura); also chronic idiopathic urticaria, hypocomplementemia, essential mixed cryoglobulinemia, drug reactions and connective tissue disorders
Localized vasculitis, non-necrotizing, involving vessels larger than capillaries: granuloma faciale, erythema elevatum diutinum and localized, chronic fibrosing vasculitis
Lymphocytic, non-necrotizing vasculitis of small, superficial vessels: bilateral nonblanching purpuric and pigmented macules on ankles and lower legs; due to drug eruption, erythema multiforme, Mucha-Habermann disease, some viral infections, collagen vascular disease, PLEVA and erythema multiforme

Fibrin thrombi: present in segmented, hyalinizing vasculitis
Infarct of skin: associated with malignant atrophic papulosis (Dego's disease); intimal proliferation of deep-seated arteriole
Purpura: non-blanching, erythematous macules or papules due to extravasation of red blood cells into dermis
Septic vasculitis: also referred to (somewhat erroneously) as non-leukocytoclastic vasculitisis, a variant of acute vasculitis associated with various septicemic states, including meningococcal, gonococcal, Pseudomonas and Streptococcal septicemia, infective endocarditis (particularly due to Staphylococcus aureus), secondary syphilis and rickettsial infections

Clinical images

Various images

Micro description

● Inflammatory infiltrate in wall of dermal or subcutaneous vessels; may be neutrophilic, lymphocytic or granulomatous
● Often red blood cell extravasation
● Variable fibrinoid necrosis of vessel walls
● Variable secondary changes in overlying epidermis and sweat glands

Micro images

Small vessel vasculitis (drug induced)

Other vasculitis

Lupus related vasculitis

Virtual slides

Leukocytoclastic vasculitis

Positive stains

● Immunoglobulins, complement or fibrin in the vessel wall by direct immunofluorescence

Differential diagnosis

Sweet’s syndrome: neutrophils in dermis, but no distinct vascular involvement

Additional references

eMedicine - leukocytoclastic vasculitis

End of Skin-nontumor> Other dermatoses > Vasculitis

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).