Vasculitis and Vasculopathy

Vasculitis is characterized by damage to the vascular endothelium and necrosis of the vessel wall; vasculopathy demonstrates intravascular thrombosis often without significant inflammation. Leukocytoclastic vasculitis is characterized by the presence of n

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Vasculitis and Vasculopathy

Vasculitis is characterized by damage to the vascular endothelium and necrosis of the vessel wall; vasculopathy demonstrates intravascular thrombosis often without significant

inflammation. Leukocytoclastic vasculitis is characterized by the presence of neutrophils, nuclear dust (leukocytoclasia) and fibrinoid necrosis of vessel walls.

Table 20.1 Characteristics of vasculitis and vasculopathy

Intraluminal vascular thrombi Vascular wall necrosis Neutrophils, leukocytoclasia Eosinophils Lymphocytes

Mixed cryoglobulinemia, Protein C deficiency, DIC, Sepsis, Lupus anticoagulant −/+

Purpura fulminans, Monoclonal cryoglobulinemia, Coumadin (Warfarin) necrosis +

Lymphocytic vasculitis, Drug-induced +/−

Bechet’s disease, Perniosis −/+

+ +

−/+ –

+/− –

+/− −/+

– –

– –

+/− +

−/+ +

DIC disseminated intravascular coagulopathy

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K.S. Masterpol et al., Atlas of Essential Dermatopathology, DOI 10.1007/978-1-4471-4471-7_20, © Springer-Verlag London 2013

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Vasculitis and Vasculopathy

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Fig. 20.1 Purpura fulminans. The superficial dermal vessels are occluded by microthrombi, there is minimal inflammation

Fig. 20.3 Henoch - Schoenlein purpura (HSP). There is a leukocytoclastic vasculitis, characterized by the presence of nuclear debris and fibrinoid necrosis of the vessel wall

Fig. 20.2 Monoclonal cryoglobulinemia. The superficial dermal vessels are occluded by homogeneous thrombi that may be clefted, there is minimal inflammatory infiltrate

Fig. 20.4 Perniosis. There is a lymphocytic vasculitis without significant neutrophilic infiltrate or intraluminal thrombi