1/58. A Japanese case of dengue fever with lymphocytic vasculitis: diagnosis by polymerase chain reaction.A 37-year-old Japanese male was admitted to Nagasaki University Hospital with abrupt onset of biphasic fever, general malaise and myalgia 9 days after coming back to japan from Manila. He developed a rubella like erythematous rash 3 days after admission and purpuric eruption one week after admission. A biopsied specimen from the purpura revealed lymphocytic vasculitis with T cell dominance and without immunoglobulin or complement deposition around the blood vessels. RT-PCR analysis on peripheral blood mononuclear cells using dengue virus specific primers confirmed the diagnosis of type 3 dengue fever. PCR analysis using virus specific primers is a rapid and valuable method for making a correct diagnosis of dengue fever.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
2/58. Livedoid vasculitis: a manifestation of the antiphospholipid syndrome?Livedoid vasculitis, otherwise known as segmental hyalinizing vasculitis or livedo reticularis with summer ulceration, is a chronic disease with lesions affecting the feet and lower legs. Early lesions show petechiae, but characteristic features are recurrent, bizarrely shaped ulcers that heal to leave hyperpigmentation and atrophie blanche. The aetiology of the disorder is unknown, but the histology shows fibrin deposition within both the wall and lumen of affected vessels. The absence of a sufficient perivascular infiltrate or leucocytoclasia argues against a vasculitis, being more in keeping with a thrombo-occlusive process. Four patients with livedoid vasculitis with ulceration are described, all of whom had associated raised anticardiolipin antibodies but no other evidence of systemic disease. We suggest that livedoid vasculitis may be a manifestation of the antiphospholipid syndrome and recommend that all patients are screened for this. We also discuss treatment options for this often resistant condition.- - - - - - - - - - ranking = 0.079103350499901keywords = vessel (Clic here for more details about this article) |
3/58. Cutaneous papules and nodules in the diagnosis of the antiphospholipid syndrome.Of 11 patients with primary or secondary antiphospholipid syndrome (APS), four exhibited papules or nodules on the finger, sole or leg as the initial cutaneous manifestation. Histological examination demonstrated thrombosed vessels or vessels containing organized thrombi in the dermis or in the subcutaneous fat tissue. Cutaneous papules and nodules should be recognized as skin manifestations of APS. Screening tests for antiphospholipid antibodies and lupus anticoagulant are required in patients with cutaneous papules or nodules of unknown aetiology. In cases of positive antiphospholipid antibodies and/or lupus anticoagulant, histological examination is critical in the establishment of the diagnosis of APS.- - - - - - - - - - ranking = 0.1582067009998keywords = vessel (Clic here for more details about this article) |
4/58. Intravascular and diffuse dermal reactive angioendotheliomatosis secondary to iatrogenic arteriovenous fistulas.Reactive angioendotheliomatosis is a rare benign process that has been mainly described in patients with systemic infections, such as subacute bacterial endocarditis or tuberculosis, and in association with intravascular deposition of cryoproteins. Histopathologically, it is characterized by a proliferation of endothelial cells within vascular lumina resulting in the obliteration of the involved vessels. Another rare variant of reactive angioendotheliomatosis has been described in the lower extremities of patients with severe peripheral vascular atherosclerotic disease. It consists of violaceous and purpuric plaques histopathologically characterized by diffuse proliferation of endothelial cells interstitially arranged between collagen bundles of the reticular dermis. This second variant has been named diffuse dermal reactive angioendotheliomatosis. We report two patients with reactive cutaneous angioendotheliomatosis appearing distally to arteriovenous fistulas used for hemodialysis because of chronic renal failure. The first patient showed intravascular reactive angioendotheliomatosis, while the second one had purpuric plaques that were characterized histopathologically by diffuse dermal angioendotheliomatosis. Both patients showed an arteriovenous "steal" syndrome with distal ischemia, and it is possible that a local increase of vascular endothelial growth factor, as is the case in hypoxia situations, induces the endothelial proliferation. To the best of our knowledge, cutaneous reactive angioendotheliomatosis has not been previously described in association with arteriovenous shunts.- - - - - - - - - - ranking = 0.079103350499901keywords = vessel (Clic here for more details about this article) |
5/58. angiomatosis of skin with local intravascular immunoglobulin deposits, associated with monoclonal gammopathy. A potential cutaneous marker for B-chronic lymphocytic leukemia. A report of unusual case with immunohistochemical and immunofluorescence correlation and review of the literature.Reactive cutaneous vascular proliferation or angiomatosis is associated with various conditions, but is rarely seen secondary to vascular occlusion. We report an unusual case of a 79-year-old female who presented with 8 month history of purpuric facial plaques, with painful crusted ulceration of the nose, later developing similar eruptions on hands, thighs and trunk. Biopsies showed marked angioproliferation, with intravascular (IV) hyaline deposits (PAS , fibrin /-; IgM , fibrinogen , and C3 ), associated with endothelial hyperplasia (factor viii , vimentin ). Immunofluorescence showed IV IgM, fibrinogen, and granular C3 deposits within vessel walls. Initially, extensive investigations only showed minimal monoclonal gammopathy of undetermined significance (MGUS) and repeatedly negative cryoglobulins. After a 3-year follow-up, the patient developed chronic lymphocytic leukemia (B-CLL). This case illustrates a difficult diagnostic challenge. Although this condition resembles other forms of reactive angiomatosis, it shows distinct features and should be considered in the differential diagnosis of unusual vascular proliferations of the skin. The cutaneous lesions are also considered a potential marker for an underlying systemic condition, which may require prolonged clinical follow-up. We believe this condition to be related to other rare cutaneous vascular proliferations associated with plasma cell and lymphoproliferative disorders. Furthermore, we suggest a common pathogenetic pathway resulting from the IV immunoglobulin deposits causing vascular injury, finally leading to the angiomatosis.- - - - - - - - - - ranking = 0.079103350499901keywords = vessel (Clic here for more details about this article) |
6/58. Acute infantile hemorrhagic oedema.Acute infantile hemorrhagic oedema (AIHO) was first described in 1913 but, despite frequent reports in the European literature, it is not well recognized in the English language literature. It is considered by many to be a variant of Henoch Schonlein purpura (HSP) because of similarities in cause and histopathology. However, because of the benign nature of this condition and frequent absence of IgA associated with HSP, it may be sensible to consider this as a distinct variety of cutaneous small vessel vasculitis (CSVV). We report this case to highlight the condition and emphasize its benign nature.- - - - - - - - - - ranking = 0.079103350499901keywords = vessel (Clic here for more details about this article) |
7/58. Cutaneous manifestation of left atrial myxoma.A 53-year-old woman had a left hemiplegia with suspicion of cerebral metastases. Thoracic and abdominal computed tomography revealed renal and splenic infarction features and she presented violaceous papulosis on her fingers corresponding to thrombosis of dermal vessels. echocardiography showed a left atrial tumor evoking myxoma. The clinical features of left atrial myxomas are intracardiac obstruction, extracardiac embolism and general symptoms. Cutaneous manifestations are frequently reported and can correspond to cutaneous manifestations of emboli, symptoms related to auto-immune disorders and specific cutaneous findings that suggest atrial myxoma as part of more complex syndromes.- - - - - - - - - - ranking = 0.079103350499901keywords = vessel (Clic here for more details about this article) |
8/58. Angioma serpiginosum with extensive cutaneous involvement.Angioma serpiginosum is a rare condition that involves both the proliferation and dilatation of superficial blood vessels in the skin. It classically begins in childhood, is more common in females, and is asymptomatic. Typical lesions appear on the extremities and are often asymmetric. We report a case of angioma serpiginosum involving extensive areas of the extremities and the trunk to emphasize that extensive cutaneous involvement must be included in the clinical spectrum of this condition.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
9/58. Livedo vasculitis associated with regional cytophagic histiocytoses.We report a 70-year-old woman who developed recurrent multiple ulcers and residual atrophic scars on her legs and feet. The histology showed fibrinoid material in the dermal vessel walls causing partial to complete occlusion of the lumina. Capillary tufting and dilatation were also noted in the dermis. There was no vasculitis or panniculitis. Extravasated red blood cells were seen throughout the dermis; these were engulfed by benign-appearing histiocytes around the dermal-fat junction. As she was generally well and there was no evidence of the presence of cytophagic cells in her extracutaneous organs, she was diagnosed with regional phagocytic histiocytoses supposedly triggered by extravasated red blood cells.- - - - - - - - - - ranking = 0.079103350499901keywords = vessel (Clic here for more details about this article) |
10/58. takayasu arteritis and cutaneous necrotizing vasculitis.takayasu arteritis (TA) is an inflammatory arteriopathy involving predominantly the aorta and its main branches. The disease evolves in two phases: a first, nonspecific inflammatory stage and a late 'pulseless' stage, in which complications related to arterial stenosis and aneurysm formation predominate. In both phases, skin manifestations, such as inflammatory nodules, erythema-nodosum- and pyoderma-gangrenosum-like ulcers, have been described. We report 2 patients with TA, who had cutaneous necrotizing vasculitis as presenting manifestation of the disease. A review of the literature revealed 8 similar cases. TA does not only involve large arteries, but also small blood vessels. The observation that in TA the inflammatory process of the large arteries affects regions of the walls supplied by the vasa vasorum, the anatomy of which bears resemblance to the cutaneous vessel system, suggests that primary involvement of small vessels contributes to the development of the clinicopathological features of TA. knowledge of the skin manifestations associated with TA remains important for its diagnosis and prompt instauration of life-saving treatment.- - - - - - - - - - ranking = 1.1582067009998keywords = blood vessel, vessel (Clic here for more details about this article) |
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