Therapeutic Strategies in Dermatology

Lupus: Key Points

…stemic lupus include chilblains (pernio), livedo reticularis, vasculitis, and other (non-oral) ulcerations. Cutaneous lupus erythematosus (CLE) may be divided into four subtypes: discoid lupus, subacute cutaneous lupus, lupus profundus, and bullous l…

Therapeutic Strategies in Dermatology

Urticaria: Key Points

…rs is suggestive of a different diagnosis, such as urticarial vasculitis. Urticaria (“hives”) may be an acute (less than 6 weeks) or chronic (more than 6 weeks) skin condition. Acute urticaria is commonly an allergic or IgE-mediated react…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vasculitis

…roughout the entire course of the process of leukocytoclastic vasculitis, including very early lesions of manifestations of it as disparate as Henoch-Sch√∂nlein purpura (Fig. 5.225 A&B) and granuloma faciale (Fig. 5.226 A&B) /erythema elevatum…

Therapeutic Strategies in Dermatology

Pernio/Chilblains: Key Points

…lain lupus erythematosus. The presence of angulated, retiform purpura, or nonblanching sharply angled distal lesions, may prompt a consideration of a systemic thromboembolic disease, including cryoglobulinemia or anti-phospholipid antibody syndrome….

Therapeutic Strategies in Dermatology

Pernio/Chilblains: Treatment

…tems and targeted laboratory workup. The presence of retiform purpura or nonblanching purpuric lesions should prompt consideration for a thrombotic process such as cryoglobulinemia or anti-phospholipid antibody syndrome Chronic myelomonocytic leukemi…

Therapeutic Strategies in Dermatology

Leukocytoclastic Vasculitis: Treatment

…n to refer to a dermatologist When the diagnosis of palpable purpura is not clear. For skin biopsy of lesions to confirm the diagnosis. A biopsy for direct immunofluorescence (which reveals deposition at cutaneous superficial dermal vessels), in add…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Lymphocytic Vasculitis?

…stopathologic. 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 m…

Histologic Diagnosis of Inflammatory Skin Diseases

Leukocytoclastic vasculitis

…999;21(6):532-36. Crowson AN, Mihm MC Jr, Magro CM. Cutaneous vasculitis: a review. J Cutan Pathol 2003;30:161-73. Davin JC, Weening JJ. Diagnosis of Henoch-Schonlein purpura: renal or skin biopsy? Pediatr Nephrol 2003;18(12):1201-3. Epub 2003 Sep 16…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Urticarial Vasculitis?

…s. In short, the range of presentations clinical in cutaneous vasculitis is broad and, therefore, it is parochial in the extreme to describe that process protean by but a single type of lesion, e.g., “palpable purpura.” Nonetheless, derma…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Palpable Purpura?

…0;The major cutaneous manifestation of cutaneous small vessel vasculitis is palpable purpura…” Barham KL, Jorizzo JL, Grattan B, et al. Vasculitis and neutrophilic vascular reactions. In: Burns T, Breathnach S, Cox N, et al., eds. Rook&#…