Case Number : Case 393 Posted By: Guest

Phillip McKee - Overseas Consultations (Cave Creek, Arizona, USA) Wrote:

Well done Marcela. This is just an extreeme example of LCV with epidermal necrosis giving rise to a blister. PCT is invariably cell poor/free and does not show vasculitis.

Submitted on 12/12/2011 22:45
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Peter Karolyi - () Wrote:

Leucocytoclasic vasculitis, I think the best alternative that can be based on the available clinical data and pictures.

Submitted on 12/12/2011 22:12
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Diva Uribe Cordova - Hospital de Clínicas (La Paz) Wrote:

Hypersensitivity Vasculitis (Leukocytoclastic Vasculitis)

Submitted on 12/12/2011 20:11
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Rodrigo Restrepo - UPB/CES (Mdlln/Col) Wrote:

Small vessell vasculitis

Submitted on 12/12/2011 19:21
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Mona Abdel Hali - Dermatology Dept. Cairo Univ. (Egypt) Wrote:

I thought of vasculitis, clinical information and laboratory investigations are needed to establish a definite cause, deep extension will make me think of microscopic polyangiitis, the associated thrombosis could be a clue also to septic vasculitis,,

Submitted on 12/12/2011 18:33
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Sasi Attili - () Wrote:

This I think might be tricky. There is a sub-epidermal re-epithelialising blister with festooning of dermal papillae. A follicular unit lies free in the blister suggesting adnexal extension. There is definite small vessel vasculitis with vessel wall necrosis and extravasation of RBC. I can understand why colleagues were thinking of PCT and I did consider this. However I think the pink stuff around the vessels might just be fibrin as vasculitis is not usually a feature of PCT and also the clinical does not quite fit. I would like to see the character of the inflammatory cells. If the figure on the bottom left is deep i.e fat, then there does appear to be a panniculitis too, associated with the vasculitis. In the middle there is a large cell with a coffee bean shaped nucleus. However I am not convinced the histo is anything like LCH described in books. So in summary I think the biopsy shows a small vessel vasculitis. CPC needed to look for systemic infective, drug and neoplastic causes

Submitted on 12/12/2011 18:12
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Rok Kokol - (Graz) Wrote:

PCT

Submitted on 12/12/2011 16:15
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Marcela Saeb Lima - INCMNSZ (Mexico City) Wrote:

small vessell necrotizing vasculitis superficial and deep with epidermal necrosis the differential diagnosis includes a list of entities which needs clinicopath correlation

Submitted on 12/12/2011 15:51
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Hazem Hamed - Department of Histopathology, Imperial College (London) Wrote:

Porphyria cutanea tarda

Submitted on 12/12/2011 15:44
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I. Abdul-kadir - SJUH (Leeds, UK) Wrote:

Porphyria

Submitted on 12/12/2011 14:55
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