Case Number : Case 2535 - 25 March 2020 Posted By: Dr. Hafeez Diwan

An angiomatous growth in a actinic skin, with elastic damage, could lead to thinking of an acquired elastic hemangioma, but this lesion show vascular channels not horizontally oriented, and with fibrinous microtrombosis. There is erythrocytic extravasation, also. So favor a stasis dermatitis, interviewing in a actinic skin.

Or lividoid vasculopathy? 

There is epidermal atrophy with mild atypia, probably due to dermal changes, where we can see extravasated RBCs, vascular congestion, width vascular walls, fibrinoid material on them and a few thrombus. Agree with Mona, I would prefer to call this Livedoid Vasculopathy.

Yes, Mona. I was off road. Livedoid Vasculopathy is the right diagnosis. 

Lividoid vasculopathy.

There is a mucin in the dermis.Better to exclude lupus.

livedoid vasculopathy

I would suggest stasis, as it is ankle; epidermis is hyperkeratotic; there is lobular small vessel hyperplasia with fibrin thrombi, probably focal fibrinoid necrosis and extravasation of erytrocytes. There are neutrofiles within stratum corneum, and I would do PAS. There is severe solar damage. But I wonder, if something even more important is hiding.

Atrophie blanche/livedoid vasculopathy.  There is a background of stasis.

Agree with stasis - severe. Needs CPC of course.