Abstract
Background: Vasculitides comprise a group of disorders characterized by inflammation directed at blood vessels, identified by histologic examination. Biopsy is the gold standard for the diagnosis of cutaneous vasculitis.
Aims:1) to study in detail, the classic histopathological features of cutaneous vasculitis and correlate them with the clinical features for the emergence of a composite diagnosis of cutaneous vasculitis.2) to evaluate the role of Direct Immunofluorescence in the diagnosis of cutaneous vasculitis.
Materials and Method: this cross sectional descriptive study was conducted in the Department of Pathology, Government Medical College, Thiruvananthapuram, during a period of 2 years in 90 cases having a clinical diagnosis of cutaneous vasculitis. Histopathological findings of the skin biopsy specimens were noted. Direct Immunofluorescence was done in a selected number of cases. Data was analyzed using SPSS software. For all statistical evaluations, a 2-tailed probability of value, <0.05 was considered significant.
Results: This study shows good correlation between clinical and histopathological diagnosis (93.3% of cases) and is statistically significant. DIF acts as an adjuvant investigation in cases suspected to be immunologically mediated.
Keywords: Cutaneous vasculitis, histopathology, Direct immunofluorescence.
References
- Zeek PM. Periarteritis nodosa; A Critical Review. Am J Clin Path 1952; 22:777-90.
- Jennette CJ, Milling DM, Falk RJ. Vasculitis affecting the skin. A Arch Dermatol.l994;130:899-906.
- Churg-Strauss syndrome Association Website. Dr Andrew Churg, in The American Thoracic society. 2004.
- Cutaneous vasculitis from Hand book of Dermatology & Venereology, 2nd Chapter 8, Dr Pedro Sa Cabral.
- Palit A, Inamadar AC. Vasculitis:Approach to diagnosis and therapy. Indian J Dermatol Venereol Leprol.2006;72:334-44.
- Jennette JC, Falk RJ, Andrassy K, Bacon PA et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum1994; 37: 187–92.
- Barnhill RL, Nousari CH, Xu X, Barksdale SK. Vascular diseases. In: Elder DE, Elenitsas R, Johnson BL, Murphy GF, Xu X, editors. Lever's Histopathology of the Skin. 10 th Philadelphia: Lippincott Williams and Wilkins; 2009. p. 205-34
- Luqmani RA, Bacon PA, Moots RJ, Janssen BA Birmingham vasculitid activity score in systemic necrotizing vasculitis. QJM 1994;87; 671-78.
- Carlson JA, Ng BT, Chen KR. Cutaneous vasculitis update: diagnostic criteria, classification, epidemiology, etiology, pathogenesis, evaluation and prognosis. Am. J. Dermatopathol. 2005; 27; 504–28.
- Tsai CC, Giangiacomo J, Zuckner J: Dermal IgA deposits in
Henoch Schonlein purpura & Berger's nephritis (Letter). Lancet 1975; 1: 342-43.
- Van Hale HM, Gibson LE, Schroeter AL, Rochester Henoch-Schönlein vasculitis: direct immunofluorescence study of uninvoived skin. J Am Acad Dermatol. 1986;15:665–70.
- Barnadas MA, Perez E, Gich I, Llobet JM et al. Diagnostic, prognostic and pathogenic value of the direct immunofluorescence test in cutaneous leukocytoclastic vasculitis. Int J Dermatol .2004; 43:19-26.
- Khetan P, Sethuraman G, Khaitan BK, Sharma VK etal. An aetiological and clinicopathological study on cutaneous vasculitis. Indian J Med Res.2012; 135:107-113.
Corresponding Author
Twinkle S Prasad
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.118
