By L. Amezcua-Guerra

ISBN-10: 9533077867

ISBN-13: 9789533077864

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24. Necrotizing dermal arteriolitis with a mixed infiltrate of neutrophils and eosinophils from a lesion of palpable purpura in Churg-Strauss syndrome. Note the remaining disrupted internal elastic lamina of the affected arteriole (arrow at right figure: elastic tissue stain). , leukocytoclastic) vasculitis (Figures. 8, 9, 10, 11, and 26C).  Eosinophilic vasculitis (Figure 27C). 15,16,17,18,19  Lymphocytic vasculitis(Figure 28). , granulomatous vasculitis)(Figures 29 and 30). 12,18,20,21 Nuclear dust found in and around the affected vessels is a feature of neutrophilic vasculitis (also known as leukocytoclastic vasculitis).

Note the predominate infiltrate of lymphocytes and histiocytes; the neovascularization in and around the vessels; and luminal fibrous occlusion. A B Fig. 14. (A) Arteritis at the healed stage. (B) phlebitis at the healed stage. There is scant inflammation with marked fibrous proliferation and neovascularization in and around the affected artery and vein, with the resultant luminal occlusion. (A) Note the marked disruption of the internal elastic lamina (arrows) at the healed stage of arteritis (elastic hematoxylin and eosin stain).

Rheumatoid arthritis, systemic lupus erythematosus, Sjögren disease); and HenochSchönlein purpura. It is therefore difficult to make a distinction just based on the cutaneous manifestations and histopathologic findings. However, the absence of immune complexes, the so-called pauci-immune vasculitis, is an expected finding in Churg-Strauss syndrome, Wegener’s granulomatosis, and microscopic polyangiitis. By contrast, deposition of IgM, and/or C3 in or around the vessels characterizes immune complex-mediated vasculitis, as found in cryoglobulinemic vasculitis, rheumatoid vasculitis,9 and systemic lupus erythematosus.

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Advances in the Diag. and Trtmt. of Vasculitis by L. Amezcua-Guerra

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