Difference between revisions of "Small vessel leukocytoclastic vasculitis"

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Clinical:
Clinical:
*Palpable purpura, usu. lower extremity.
*Palpable purpura, usu. lower extremity.
Treatment:<ref name=pmid24756249>{{Cite journal  | last1 = Goeser | first1 = MR. | last2 = Laniosz | first2 = V. | last3 = Wetter | first3 = DA. | title = A practical approach to the diagnosis, evaluation, and management of cutaneous small-vessel vasculitis. | journal = Am J Clin Dermatol | volume = 15 | issue = 4 | pages = 299-306 | month = Aug | year = 2014 | doi = 10.1007/s40257-014-0076-6 | PMID = 24756249 }}</ref>
*Remove underlying cause - if known.
*Colchicine or dapsone.
*Immunosuppression.


==Microscopic==
==Microscopic==

Revision as of 03:53, 14 August 2015

Small vessel leukocytoclastic vasculitis
Diagnosis in short

Leukocytoclastic vasculitis. H&E stain.

LM small vessels intramural inflammatory cells (neutrophils), vessel damage (fibrin deposition)
LM DDx dermatitides with perivascular inflammation
Stains PAS -ve
Site blood vessels - see vasculitides

Signs palpable purpura
Prevalence uncommon
Prognosis dependent on underlying cause

Small vessel leukocytoclastic vasculitis, also leukocytoclastic vasculitis (abbreviated LCV), is an inflammatory process of the small blood vessel.

General

  • Most common cutaneous vasculitis.[1]

Clinical:

  • Palpable purpura, usu. lower extremity.

Treatment:[2]

  • Remove underlying cause - if known.
  • Colchicine or dapsone.
  • Immunosuppression.

Microscopic

Features:[1]

  • Small upper dermis vessels with:
    1. Neutrophils.
    2. Vessel damage: fibrin deposition (bright pink acellular stuff).

Has a very broad DDx:[1]

  1. Infectious:
  2. Vasculitic disorders:
  3. Other:

DDx:

Image

Case

www

Stains

  • PAS - look for fungus.

See also

References

  1. 1.0 1.1 1.2 Brinster, NK. (Nov 2008). "Dermatopathology for the surgical pathologist: a pattern-based approach to the diagnosis of inflammatory skin disorders (part II).". Adv Anat Pathol 15 (6): 350-69. doi:10.1097/PAP.0b013e31818b1ac6. PMID 18948765.
  2. Goeser, MR.; Laniosz, V.; Wetter, DA. (Aug 2014). "A practical approach to the diagnosis, evaluation, and management of cutaneous small-vessel vasculitis.". Am J Clin Dermatol 15 (4): 299-306. doi:10.1007/s40257-014-0076-6. PMID 24756249.
  3. Kraft, DM.; Mckee, D.; Scott, C. (Aug 1998). "Henoch-Schönlein purpura: a review.". Am Fam Physician 58 (2): 405-8, 411. PMID 9713395.