Pathology
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Atlas of dermatopathology
Josef Feit, Hana Jedličková, Günter Burg, Luděk Matyska, Spasoje Radovanovic et al.
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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
Wegener's granulomatosis
Introduction

Systemic disease affecting the blood vessels of the respiratory tract, kidneys, skin and sometimes of other organs as well. The process is characterized by necrotizing vasculitis with later formation of granulomas and ischemia of supplied tissues.

Clinical signs
  • upper and lower respiratory pathways
  • glomelulonefritis
  • skin is affected at about half of patients
  • papulonecrotic lesions, especially above large joints
  • purpura, subcutaneos nodules, necrotizing granulomas and other
  • lethal without therapy
Etiology, pathogenesis

Circulating ANCA antibodies (especially c-ANCA).

Histology

Necrosis, perivascular fibrinoid degeneration, leukocytoclasia. Necrotizing vasculitis affecting small and medium dermal blood vessels. Bleeding. Later palisading granulomas with giant cells are formed.

Variable: neutrophils, sometimes eosinophils, thrombi, intimal proliferation in later stages.

Diagnosis is easier if the data of affected organs are available and laboratory examination confirms increased ANCA levels.