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 © 2001-2009, DermAtlas | Image Name: | Thromboangiitisobliterans_1_090304 | File Type: | jpg | |
| Diagnosis: | THROMBOANGIITIS OBLITERANS / BUERGER DISEASE | Category: | vasculopathy / ulcer | ||
| Body Site: | hand | Age: | 21 years | ||
| Contributor: | Brock Andersen, MD | ||||
| Description: | symmetric red patches with scattered ulcerated papules | ||||
| Comments: | This 21-year-old Marine with a 4-pack-year history of smoking cigarettes complained of recurrent numbness and tingling in his hands when exposed to cold (Raynaud phenomenon), and recurrent ulcerations on the dorsal surface of the hands. Biopsy confirmed thromboangiitis obliterans. All lesions resolved within 4 months of smoking cessation and avoidance of cold exposure. | ||||
 © 2001-2009, DermAtlas | Image Name: | Palpable_Purpura_Small_Vessel_Vasculitis_1_080714 | File Type: | jpg | |
| Diagnosis: | VASCULITIS, LEUKOCYTOCLASTIC / PURPURA | Category: | vasculopathy | ||
| Body Site: | leg / foot / knee | Age: | 56 years | ||
| Contributor: | Eric Nou | ||||
| Description: | symmetric discrete and confluent purpuric papules and plaques | ||||
| Comments: | This 56-year-old man with a longstanding history of peripheral neuropathy, Hepatitis C virus infection, coronary heart disease, type 2 diabetes, andchronic obstructive pulmonary disease developed discrete and confluent purpuric papules on his legs. | ||||
 © 2001-2009, DermAtlas | Image Name: | leg_varicose_vein_1_080714 | File Type: | jpg | |
| Diagnosis: | VASCULAR MALFORMATION, VENOUS / VASCULAR MALFORMATION / VARICOSE VEIN | Category: | vasculopathy / vascular malformation | ||
| Body Site: | leg | Age: | 37 years | ||
| Contributor: | Javad Khodadoust, MD | ||||
| Description: | varicosity | ||||
| Comments: | A 37-year-old man with severe varicosity of the lesser saphenous vein complained of pain, fatigability, and heaviness especially while standing. Elastic compression did not improve symptoms. | ||||
 © 2001-2009, DermAtlas | Image Name: | Thromboangitis_obliterans_1_071119 | File Type: | jpg | |
| Diagnosis: | THROMBOANGIITIS OBLITERANS / BUERGER DISEASE | Category: | vasculopathy | ||
| Body Site: | finger / hand | Age: | 33 years | ||
| Contributor: | Jerzy Pawlak, MSc,PhD | ||||
| Description: | multiple finger amputations | ||||
| Comments: | This 33-year-old man was a heavy cigarette smoker with a history of numerous amputations to his fingers not related trauma. On examination a radial pulse was barely palpable.Thromboangitis obliterans or Buerger disease is an episodic inflammatory condition of unknown etiology which results in thrombosis and occlusion of peripheral arteries and veins. It principally affects the small vessels of the extremities distal to the brachial and/or popliteal arteries. Smoking exacerbates the disease, but if the patient stops smoking the disease will usually stabilise. Continued smoking results in relentless progression. | ||||
 © 2001-2009, DermAtlas | Image Name: | septic_vasculitis_2_070201 | File Type: | jpg | |
| Diagnosis: | NEISSERIA MENINGITIDIS INFECTION / VASCULITIS, SEPTIC | Category: | infections and infestations / vasculopathy | ||
| Body Site: | trunk / leg arm | Age: | 11 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | Small vessels in the superficial vascular plexus show evidence of damage, including focal necrosis and microthrombi. Scattered neutrophils and extravasated red blood cells are also noted. Close inspection of the vessels reveals small coccal organisms, best highlighted by special stains (not shown). | ||||
| Comments: | This young girl developed disseminated meningococcus (N. meningitidis) following a bout of meningitis. Histologically there is acute vasculitis, a reaction pattern which can have many etiologies. One must always exclude an infectious cause to the vasculitis as the treatment strategy is obviously very different. The organisms are often tough to see in disseminated Neisseria infections and may require special stains or just a reliance on the history. | ||||
| Related Images: | septic_vasculitis_1_070201 | ||||
 © 2001-2009, DermAtlas | Image Name: | septic_vasculitis_1_070201 | File Type: | jpg | |
| Diagnosis: | NEISSERIA MENINGITIDIS INFECTION / VASCULITIS, SEPTIC | Category: | infections and infestations / vasculopathy | ||
| Body Site: | trunk / leg arm | Age: | 11 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is a relatively sparse inflammatory infiltrate concentrated around vessels. Extravasated red blood cells are visible, in association with the vessels. The epidermis is unremarkable. | ||||
| Comments: | This young girl developed disseminated meningococcus (N. meningitidis) following a bout of meningitis. Histologically there is acute vasculitis, a reaction pattern which can have many etiologies. One must always exclude an infectious cause to the vasculitis as the treatment strategy is obviously very different. The organisms are often tough to see in disseminated Neisseria infections and may require special stains or just a reliance on the history. | ||||
| Related Images: | septic_vasculitis_2_070201 | ||||
 © 2001-2009, DermAtlas | Image Name: | PAN_2_070201 | File Type: | jpg | |
| Diagnosis: | POLYARTERITIS NODOSA / VASCULITIS | Category: | vasculopathy / cutaneous sign of systemic disease | ||
| Body Site: | arm | Age: | 34 years | ||
| Contributor: | Bernard Cohen, MD | ||||
| Description: | The vessel shows fibrinoid necrosis of its wall. The wall contains numerous traversing neutrophils, which spill into the adjacent soft tissue. | ||||
| Comments: | This young man developed painful nodules on his upper arm, which eventually broke down and ulcerated. He has a complicated medical history including inflammatory bowel disease and renal failure. Polyarteritis nodosa is a medium-sized vasculitis. There is a primary cutaneous form and a systemic form, which can be fatal. The histologic differential diagnosis includes infectious vasculitis and members of the ANCA+ disorders, including Wegener granulomatosis and Churg-Strauss syndrome. Clinical correlation is required for separation. | ||||
| Related Images: | PAN_1_070201 | ||||
 © 2001-2009, DermAtlas | Image Name: | PAN_1_070201 | File Type: | jpg | |
| Diagnosis: | POLYARTERITIS NODOSA / VASCULITIS | Category: | vasculopathy / cutaneous sign of systemic disease | ||
| Body Site: | arm | Age: | 34 years | ||
| Contributor: | Bernard Cohen, MD | ||||
| Description: | There is a discrete inflammatory infiltrate centered on a deep vessel within the dermis. | ||||
| Comments: | This young man developed painful nodules on his upper arm, which eventually broke down and ulcerated. He has a complicated medical history including inflammatory bowel disease and renal failure. Polyarteritis nodosa is a medium-sized vasculitis. There is a primary cutaneous form and a systemic form, which can be fatal. The histologic differential diagnosis includes infectious vasculitis and members of the ANCA+ disorders, including Wegener granulomatosis and Churg-Strauss syndrome. Clinical correlation is required for separation. | ||||
| Related Images: | PAN_2_070201 | ||||
 © 2001-2009, DermAtlas | Image Name: | nodular_vasculitis_2_070201 | File Type: | jpg | |
| Diagnosis: | VASCULITIS, NODULAR | Category: | vasculopathy / cutaneous sign of systemic disease | ||
| Body Site: | leg | Age: | 46 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is destruction of a medium-sized vessel at the interface of the dermis with the subcutis. The panniculitis involves both the septa and lobules and contains a mixed infiltrate of neutrophils, lymphocytes and histiocytes. | ||||
| Comments: | This woman developed painful nodules on the posterior aspect of her lower extremities over the course of a few months. A subset of these patients will have positive PPD tests (erythema induratum) but this was not the case here. The histologic differential diagnosis would include polyarteritis nodosa, but PAN typically lacks the associated panniculitis. | ||||
| Related Images: | nodular_vasculitis_1_070201 | ||||
 © 2001-2009, DermAtlas | Image Name: | nodular_vasculitis_1_070201 | File Type: | jpg | |
| Diagnosis: | VASCULITIS, NODULAR | Category: | vasculopathy / cutaneous sign of systemic disease | ||
| Body Site: | leg | Age: | 46 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The low power view of this biopsy shows a vasculocentric inflammatory reaction in the superficial-to-mid dermis and a panniculitis deep. The epidermis is uninvolved. | ||||
| Comments: | This woman developed painful nodules on the posterior aspect of her lower extremities over the course of a few months. A subset of these patients will have positive PPD tests (erythema induratum) but this was not the case here. The histologic differential diagnosis would include polyarteritis nodosa, but PAN typically lacks the associated panniculitis. | ||||
| Related Images: | nodular_vasculitis_2_070201 | ||||
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