Differential Diagnosis in Dermatopathology

Allergic (leukocytoclastic) vasculitis vs. Septic vasculitis

An arteritis in the subcutaneous fat manifested clinically at first by one or more red nodules that, in time, become ulcerated and heal with scars, usually on the posterior aspect of the legs of short, thick-legged women. No cause is usually found,…

Therapeutic Strategies in Dermatology

Lichen Planus: Initial Evaluation

…bullous lichen planus. Differential diagnosis Leukocytoclastic vasculitis, or palpable purpura, presents as violaceous-to-purpuric papules occasionally with a central pustule, vesiculation, or necrosis often in dependent areas, such as the legs, hips…

Therapeutic Strategies in Dermatology

Cutaneous Allergic (Leukocytoclastic) Vasculitis: Overview

Overview In approximately 50% of cases, cutaneous leukocytoclastic vasculitis (LCV) is caused by associated disease or underlying infection, or by a chemical or drug. The therapeutic strategy is to treat the underlying disorder. Recreational cocaine…

Therapeutic Strategies in Dermatology

Erythema Elevatum Diutinum: Key Points

Key Points Erythema elevatum diutinum (EED) is a rare chronic form of fibrosing vasculitis. Firm, red to brown or violaceous nodular lesions developing over joints of the elbows, knees, hands, and feet, often in a symmetric pattern, is the hallmark…

Therapeutic Strategies in Dermatology

Dermatomyositis: Overview

Overview Patients with dermatomyositis (DM) often have multisystem involvement and therefore require a multidisciplinary approach. Consultation with a rheumatologist is strongly encouraged. A subset of patients will have only skin disease (amyopathi…

Therapeutic Strategies in Dermatology

Leukocytoclastic Vasculitis: References

…tter DA, Pittelkow MR, Wada DA. (2012). Cutaneous small-vessel vasculitis associated with solid organ malignancies: the Mayo Clinic experience, 1996 to 2009, JAAD, 66(2):e55-65. Ting TV. (2014). Diagnosis and management of cutaneous vasculitis in chi…

A Clinical Atlas of 101 Common Skin Diseases

Persistent Pigmented Purpuric Dermatitis

An inflammatory process, but not a vasculitis, that involves the legs especially with purpuric macules and subtle papules (Schamberg’s disease), lichenoid papules (lichenoid purpura of Gougerot-Blum), and scaly papules (eczematid-like purpura

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vasculitis

…hroughout the entire course of the process of leukocytoclastic vasculitis, including very early lesions of manifestations of it as disparate as Henoch-Schönlein purpura (Fig. 5.225 A&B) and granuloma faciale (Fig. 5.226 A&B) /erythema elevatu…

Therapeutic Strategies in Dermatology

Leukocytoclastic Vasculitis: Clinical Case

Case 1 40-year-old female admitted to the hospital for wound infection following a right knee surgery indicated for anterior and posterior cruciate ligament and meniscal tear, performed one week ago. Upon admission, she is noted to have a symmetr…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Lymphocytic Vasculitis?

…istopathologic. The quintessential example of leukocytoclastic vasculitis is Henoch-Sch?nlein purpura; that of septic vasculitis, gonococcemia; and that of livedo vasculitis, atrophie blanche. When sections of tissue of biopsy specimens of the three…