Vasculitis and Vasculopathy

Abstract

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.

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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

Fig. 20.1

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

Fig. 20.2

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

Fig. 20.3

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

Fig. 20.4

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