Carlson JA, Ng BT, Chen KR, et al.
The American Journal of dermatopathology. Date of publication 2005 Dec 1;volume 27(6):504-28.
1. Am J Dermatopathol. 2005 Dec;27(6):504-28.
Cutaneous vasculitis update: diagnostic criteria, classification, epidemiology,
etiology, pathogenesis, evaluation and prognosis.
Carlson JA(1), Ng BT, Chen KR.
Author information:
(1)Division of Dermatology, Albany Medical College, Albany, New York 12208, USA.
carlsoa@mail.amc.edu
Vasculitis, inflammation of the vessel wall, can result in mural destruction with
hemorrhage, aneurysm formation, and infarction, or intimal-medial hyperplasia and
subsequent stenosis leading to tissue ischemia. The skin, in part due to its
large vascular bed, exposure to cold temperatures, and frequent presence of
stasis, is involved in many distinct as well as un-named vasculitic syndromes
that vary from localized and self-limited to generalized and life-threatening
with multi-organ disease. To exclude mimics of vasculitis, diagnosis of cutaneous
vasculitis requires biopsy confirmation where its acute signs (fibrinoid
necrosis), chronic signs (endarteritis obliterans), or past signs (acellular scar
of healed arteritis) must be recognized and presence of extravascular findings
such as patterned fibrosis or collagenolytic granulomas noted. Although
vasculitis can be classified by etiology, many cases have no identifiable cause,
and a single etiologic agent can elicit several distinct clinicopathologic
expressions of vasculitis. Therefore, the classification of cutaneous vasculitis
is best approached morphologically by determining vessel size and principal
inflammatory response. These histologic patterns roughly correlate with
pathogenic mechanisms that, when coupled with direct immunofluorescent
examination, anti-neutrophil cytoplasmic antibody (ANCA) status, and findings
from work-up for systemic disease, allow for specific diagnosis, and ultimately,
more effective therapy. Herein, we review cutaneous vasculitis focusing on
diagnostic criteria, classification, epidemiology, etiology, pathogenesis, and
evaluation of the cutaneous vasculitis patient.
PMID: 16314707 [Indexed for MEDLINE]
