Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
J Cutan Pathol. 2024 Feb;51(2):155-162. doi: 10.1111/cup.14546. Epub 2023 Oct 13.
Livedoid vasculopathy (LV) is characterized by fibrin deposition and thrombosis in the small vessels of the superficial dermis. It is widely recognized as an occlusive disease, which is primarily treated with anticoagulation therapy.
We retrospectively analyzed the clinical and histopathological characteristics of patients diagnosed with LV at a tertiary dermatology department to explore the characteristics of lymphocytic vasculitis in LV. The frequency of vasculitis and the types of vessels involved were examined based on the diameters and elastic fiber distribution of the involved vessels. In addition, the immunophenotypes of infiltrating lymphocytes were analyzed.
In a large retrospective series including 358 LV cases, we identified 137 (38.3%) cases of lymphocytic vasculitis. Among them, 48 cases involved medium-sized vessels, including arterioles and venules, whereas 89 cases involved only small vessels. In addition, 12 cases displayed a segmental distribution of vasculitis. The infiltrating lymphocytes were mainly T cells, with dominant cells stained positive for CD4.
Lymphocytic vasculitis forms part of the histological spectrum of LV, affecting both medium-sized and small vessels. It is possible that the occlusion of small vessels may represent a phenomenon secondary to lymphocytic vasculitis.
皮肤小血管纤维蛋白沉积和血栓形成的皮肤血管病，被广泛认为是一种闭塞性疾病，主要采用抗凝治疗。
我们回顾性分析了一家三级皮肤科诊断为皮肤血管病的患者的临床和组织病理学特征，以探讨皮肤血管病中淋巴细胞血管炎的特征。根据受累血管的直径和弹性纤维分布，检查血管炎的频率和受累血管的类型。此外，还分析了浸润淋巴细胞的免疫表型。
在包括 358 例皮肤血管病的大型回顾性系列中，我们确定了 137 例（38.3%）例淋巴细胞血管炎。其中，48 例涉及中等大小的血管，包括小动脉和小静脉，而 89 例仅涉及小血管。此外，12 例显示血管炎呈节段性分布。浸润的淋巴细胞主要是 T 细胞，CD4 染色阳性的细胞占优势。
淋巴细胞血管炎是皮肤血管病组织学谱的一部分，影响中小血管。小血管闭塞可能是淋巴细胞血管炎的继发现象。
