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A Clinical Atlas of 101 Common Skin Diseases

Allergic (Leukocytoclastic) Vasculitis

A systemic inflammatory process involving venules by deposits of fibrin within their wall in conjunction with neutrophils and nuclear “dust” of neutrophils in the dermis and, at times, the subcutaneous fat. The clinical manifestations ar…

A Clinical Atlas of 101 Common Skin Diseases

Livedo Vasculitis and Livedo Reticularis

A type of small-vessel vasculitis (venulitis) of the skin, occurring especially in the vicinity of the ankle, characterized at first by purpuric macules and patches that, in time, may become hemorrhagic blisters that ulcerate and heal with white, st…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vasculitis

…is histopathologic of livedo vasculitis is the finding of both fibrin in the wall and thrombi in the lumen of some vessels, sometimes both of them together in the same vessel (Fig. 5.223 A&B). As already has been said, although fibrin resides in…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…rophils in perivascular and interstitial array in company with fibrin in the wall of a venule = Leukocytoclastic vasculitis, fully developed This lesion can be said to be developed fully because fibrin is so abundant in the wall of venules, being app…

Histologic Diagnosis of Inflammatory Skin Diseases

Livedo vasculitis

…rate of lymphocytes and interstitial infiltrate of neutrophils Fibrin in the wall and fibrin thrombi in the lumen of venules in the upper part of the dermis mostly; sometimes, the lower half of the dermis is affected and, episodically, the subcutaneo…

Histologic Diagnosis of Inflammatory Skin Diseases

Rheumatoid nodule

…developed Perivascular infiltrates of lymphocytes Deposits of fibrin of various sizes in the deep reticular dermis and/or the subcutaneous fat Neutrophils and nuclear “dust” of neutrophils scattered in the mass of fibrin Fibrin surrounde…

Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

In this section, algorithms used to reach specific diagnosis are predicated on “nonspecific” findings recognized best at higher magnification. Other changes requisite for specific diagnoses, i.e., denominators that are essential, then ar…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Lymphocytic Vasculitis?

…with intact neutrophils and, in lesions developed fully, with fibrin in the wall of venules. In septic vasculitis, neutrophils predominate, but are unaccompanied by nuclear “dust” of neutrophils or fibrin in the wall of venules; they are…

Histologic Diagnosis of Inflammatory Skin Diseases

Behçet’s Disease

Behçet”s disease Synonyms Aphthosis Behçet Aphthosis Presentation stereotypical Age and sex Onset usually in the third decade of life with male predominance Distribution of lesions Face for acneiform lesions, lower extremities for panniculit…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ubbing. 10.23.16A: Fibrosing dermatitis + 10.23.16B: Fibrin, an ulcer, and epidermal hyperkeratosis, hypergranulosis, and acanthosis = Chondrodermatitis nodularis helicis The ulcer, fibrin, and fibrosing granulation tissue are signs of sust…

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