Pathology
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Atlas of dermatopathology
Josef Feit, Hana Jedličková, Günter Burg, Luděk Matyska, Spasoje Radovanovic et al.
Index
Contents
Authors
ExpSys: non-tumors
ExpSys: tumors
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+ Introduction
+ Literature
+ Support
+ Skin biopsy
+ Non-tumorous skin diseases
+ Skin tumors
+ Cysts of the skin and subcutis
+ Soft tissue lesions
+ Some lesions of the oral cavity
+ Dermatovenerology
+ Collection of histological slides by prof. Günter Burg
+ Collection of histological slides by prof. Werner Kempf
+ Collection of histological slides of dr. Ram Chandra Adhikari
Leukocytoclastic vasculitis
Etiology, pathogenesis
  • circulating immune complexes are deposited in the walls of small venules
  • complement activation attracts neutrophils
  • etiology in 50% unknown, infections, allergy, chronic autoimmune diseases
Clinical signs
  • red palpable nodules
  • example: purpura Schönlein-Henoch
  • usually heals, severe vasculitis can cause ischemic damage of the epidermis
Pictures

Vasculitis allergica: Vasculitis, Clinical picture (1144)

Vasculitis, diabetes: Vasculitis, Clinical picture (1146)

Morbus Schönlein-Henoch: Purpura Schönlein Henoch, Clinical picture (901)

Vasculitis: Idiopathic vasculitis, Clinical picture (5980)

Further examples of allergic vasculitis:

Histology

Neutrophils enter the walls of small venules, small fragments of nuclear debris are present (nuclear dust). Direct immunofluorescence: IgM, IgG, c3 within vascular walls, IgA perivascularly in purpura of Schönlein-Henoch.

Pictures

Leukocytoclastic vasculitis: Leukocytoclastic vasculitis, HE 10x (438) Leukocytoclastic vasculitis, HE 40x (439)

Another case: Leukocytoclastic vasculitis, HE 20x (440) Leukocytoclastic vasculitis, HE 40x (441) Leukocytoclastic vasculitis, blue trichrome 40x (442)

Leukocytoclastic vasculitis, prominent exudation of fibrin: Vasculitis leukocytoclastic, HE 40x (4305)

Leukocytoclastic vasculitis in a case of mixed cryoglobulinemia in a patient with C hepatitis: Vasculitis leukocytoclastic, HE 40x (2511) Vasculitis leukocytoclastic, HE 100x (2447)

Neutrophils are scarce sometimes: Purpura of Schönlein-Henoch, HE 40x (379) Purpura of Schönlein-Henoch, blue trichrome 40x (380)

“Smudgy” appearance of the tissue (caused by nuclear dust) is conspicuous in typical cases of leukocytoclastic vasculitis: Purpura of Schönlein-Henoch, HE 20x (381) Purpura of Schönlein-Henoch, HE 40x (382)

Another case, (blue trichome): Leukocytoclastic vasculitis, blue trichrome 10x (297)

Another case: Vasculitis leukocytoclastic, HE 10x (617) Vasculitis leukocytoclastic, HE 40x (618)

Another case: Vasculitis leukocytoclastic, HE 40x (3997)

Leukocytoclastic vasculitis: Vasculitis leukocytoclastic, HE 20x (4636)

Leukocytoclastic vasculitis: Vasculitis leukocytoclastic, HE 60x (13192)

Leukocytoclastic vasculitis: Leukocytoclastic vasculitis, HE 60x (10681)

Leukocytoclastic vasculitis: Leukocytoclastic vasculitis, HE 60x (10682)

Leukocytoclastic vasculitis: Vasculitis leukocytoclastic, HE 60x (13270)

Leukocytoclastic vasculitis: Vasculitis leukocytoclastic, HE 40x (12635)

Leukocytoclastic vasculitis: Vasculitis leukocytoclastic, HE 40x (12636) Vasculitis leukocytoclastic, HE 40x (12637)

Leukocytoklastic vasculitis: Vasculitis leukocytoclastic, HE 60x (14292)

Necrotizing vasculitis: Vasculitis leukocytoclastic, HE 20x (4637)

Sometimes the inflammatory reaction is inconspicuous and hemorrhage dominates the picture (anticoagulation therapy, sometimes in combination with stasis, like this purpura located on the shins): Purpura pigmentosa chronica, HE 20x (347) Purpura pigmentosa chronica, HE 40x (348)

Case of slight vasculitic changes and prominent hemorrage in a patient with Warfarin anticoagulation therapy: Vasculitis leukocytoclastic, HE 40x (4009)

Residual leukocytoclastic vasculitis: Vasculitis leukocytoclastic, HE 40x (2373)

Immunofluorescence: Vasculitis leukocytoclastic, anti-fibrin, FITC 40x (619) Vasculitis leukocytoclastic, anti-fibrin, FITC 10x (620) Vasculitis leukocytoclastic, anti-fibrin, FITC 40x (621)

Purpura Schönlein-Henoch: Purpura of Schönlein Henoch, HE 100x (6111)

Purpura Schönlein-Henoch: Purpura of Schönlein Henoch, HE 20x (5289)

Severe vasculitis, bullous: Vasculitis bullous, HE 20x (5053)