Podcast
Questions and Answers
What is a common clinical manifestation associated with IgA vasculitis?
What is a common clinical manifestation associated with IgA vasculitis?
Which type of cryoglobulinemic vasculitis is characterized by Raynaud’s phenomenon in about 30% of patients?
Which type of cryoglobulinemic vasculitis is characterized by Raynaud’s phenomenon in about 30% of patients?
What histological feature is observed in IgA vasculitis?
What histological feature is observed in IgA vasculitis?
What is the typical age demographic for patients with IgA vasculitis?
What is the typical age demographic for patients with IgA vasculitis?
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What does the direct immunofluorescence test reveal in IgA vasculitis?
What does the direct immunofluorescence test reveal in IgA vasculitis?
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Which disorders are associated with Churg-Strauss granulomas?
Which disorders are associated with Churg-Strauss granulomas?
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Which type of vasculitis is classified as a hypersensitivity vasculitis?
Which type of vasculitis is classified as a hypersensitivity vasculitis?
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What distinguishes deep dermal necrobiosis in vasculitis cases?
What distinguishes deep dermal necrobiosis in vasculitis cases?
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Which of the following is associated with Microscopic Polyangiitis?
Which of the following is associated with Microscopic Polyangiitis?
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What percentage of cases for Microscopic Polyangiitis show positive ANCA?
What percentage of cases for Microscopic Polyangiitis show positive ANCA?
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Which clinical manifestation is NOT typically associated with Eosinophilic Granulomatosis with Polyangiitis?
Which clinical manifestation is NOT typically associated with Eosinophilic Granulomatosis with Polyangiitis?
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In which demographic is Macular Lymphocytic Arteritis (MLA) most commonly observed?
In which demographic is Macular Lymphocytic Arteritis (MLA) most commonly observed?
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Which of the following symptoms is characteristic of Eosinophilic Granulomatosis with Polyangiitis?
Which of the following symptoms is characteristic of Eosinophilic Granulomatosis with Polyangiitis?
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What is a common skin manifestation observed in Eosinophilic Granulomatosis with Polyangiitis?
What is a common skin manifestation observed in Eosinophilic Granulomatosis with Polyangiitis?
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Which of the following conditions is triggered by mycobacterial infection?
Which of the following conditions is triggered by mycobacterial infection?
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What type of lesions are typical of Eosinophilic Granulomatosis with Polyangiitis in terms of location?
What type of lesions are typical of Eosinophilic Granulomatosis with Polyangiitis in terms of location?
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What is a common presenting sign of Escherichia coli sepsis in newborns?
What is a common presenting sign of Escherichia coli sepsis in newborns?
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Which of the following conditions is related to neutrophilic vasculitis syndromes?
Which of the following conditions is related to neutrophilic vasculitis syndromes?
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Amantadine is linked to which dermatological condition?
Amantadine is linked to which dermatological condition?
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What condition was observed in a case involving gemcitabine?
What condition was observed in a case involving gemcitabine?
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What significant clinical feature is discussed in relation to 64 cases of cryoglobulinaemia?
What significant clinical feature is discussed in relation to 64 cases of cryoglobulinaemia?
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Nicolau syndrome can be caused by which of the following medications?
Nicolau syndrome can be caused by which of the following medications?
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In the context of antineutrophil cytoplasmic antibody-associated vasculitis, which condition is highlighted?
In the context of antineutrophil cytoplasmic antibody-associated vasculitis, which condition is highlighted?
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Which of the following studies involves clinical findings in association with vasculitis?
Which of the following studies involves clinical findings in association with vasculitis?
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What criteria did the American College of Rheumatology establish in 1990 regarding giant cell arteritis?
What criteria did the American College of Rheumatology establish in 1990 regarding giant cell arteritis?
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Which condition was specifically classified by the American College of Rheumatology in 1990 aside from giant cell arteritis?
Which condition was specifically classified by the American College of Rheumatology in 1990 aside from giant cell arteritis?
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Which of the following authors published work on hypersensitivity vasculitis in 1990?
Which of the following authors published work on hypersensitivity vasculitis in 1990?
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In which publication can the 1990 criteria for the classification of henoch-Schönlein purpura be found?
In which publication can the 1990 criteria for the classification of henoch-Schönlein purpura be found?
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What skin condition was investigated in a two-year-old child due to pellagra?
What skin condition was investigated in a two-year-old child due to pellagra?
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What treatment showed a prompt response in a reported case of Susac syndrome with dermatological findings?
What treatment showed a prompt response in a reported case of Susac syndrome with dermatological findings?
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Which authors collaborated on the criteria for Henoch-Schönlein purpura classification in 1990?
Which authors collaborated on the criteria for Henoch-Schönlein purpura classification in 1990?
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What is the main focus of the classification criteria established by the American College of Rheumatology in 1990?
What is the main focus of the classification criteria established by the American College of Rheumatology in 1990?
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What term describes the cone-shaped zone formed by nourishing arteries of the skin?
What term describes the cone-shaped zone formed by nourishing arteries of the skin?
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Where are the nourishing arteries of the skin located?
Where are the nourishing arteries of the skin located?
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Which vascular plexus is also referred to as the cutaneous plexus?
Which vascular plexus is also referred to as the cutaneous plexus?
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What clinical aspect can be explained by the obstruction of the nourishing artery?
What clinical aspect can be explained by the obstruction of the nourishing artery?
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What describes the arrangement of arterioles and venules in the superficial dermis?
What describes the arrangement of arterioles and venules in the superficial dermis?
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What is a key finding for diagnosing cutaneous vasculitis?
What is a key finding for diagnosing cutaneous vasculitis?
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Which anatomical structures are primarily irrigated by the branches of the deep plexus?
Which anatomical structures are primarily irrigated by the branches of the deep plexus?
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How do arterioles from the superficial plexus interact with the dermal papillae?
How do arterioles from the superficial plexus interact with the dermal papillae?
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Study Notes
Skin Vascular Anatomy
- Two interconnected plexuses: a deep and a superficial plexus.
- Deep plexus (cutaneous plexus) located at the dermohypodermic junction; nourishes the hypodermis, deep dermis, and structures like hair follicles and glands.
- Superficial (subpapillary) plexus in the superficial dermis; arterioles ascend to the dermal papillae and descend.
- Cutaneous functional vascular unit: cone-shaped zone from epidermis surface to nourishing artery at the dermohypodermic junction. Obstruction of the nourishing artery (e.g., in livedo) causes venous stasis, creating a reticulated appearance.
Cutaneous Vasculitis: Histologic Features
- Inflammatory Infiltrate: A key diagnostic feature.
- Deep dermal necrobiosis: foci affecting collagen bundles, surrounded by histiocytes in rosettes; associated with conditions like GEPA, MPA, rheumatoid arthritis, lupus, and adult-onset Still's disease.
Cutaneous Vasculitis: Specific Types
- Cutaneous Leukocytoclastic Angiitis (Hypersensitivity Vasculitis): Individualized in CHCC 1994 and CHCC 2012; classified as single-organ vasculitis.
- Microscopic Polyangiitis: Segmental and focal necrotizing glomerulonephritis, extracapillary proliferation, no extra-vascular granuloma; ANCA positive in over 80% of cases (anti-myeloperoxidase). Associated with glomerulonephritis, neuropathy, hemorrhage, and gastrointestinal issues.
- IgA Vasculitis: 87% accuracy in classification with criteria including palpable purpura (excluding thrombocytopenia), post-prandial abdominal pain, bloody diarrhea, GI hemorrhage, hematuria, age <20, and absence of precipitating drugs. Histologically non-specific leukocytoclastic vasculitis, but direct immunofluorescence shows predominant IgA deposits (though not specific). May present with atrophie blanche, Raynaud's, and inflammatory plaques/nodules.
- Macular Lymphocytic Arteritis (MLA): Macular and pigmented rash, lymphocytic arteritis in the hypodermis/deep dermis; no destruction/necrosis. Affects lower limbs predominantly, women (70-80%), median age 40.
- Eosinophilic Granulomatosis with Polyangiitis (EGPA): Necrotizing vasculitis, asthma, blood and tissue eosinophilia, systemic vasculitis; manifestations include mononeuropathy/polyneuropathy, pulmonary infiltrates, sino-nasal abnormalities, cardiomyopathy and cutaneous purpura, nodules, and urticaria (up to 50% of patients).
Livedo Reticularis
- Can be caused by various factors including infection (bacterial, viral, mycobacterial), inflammatory bowel disease, or drugs (e.g., minocycline, amantadine, norepinephrine). Also linked to conditions like pellagra, sarcoidosis, and Escherichia Coli sepsis. Associated with cryoglobulinemia.
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Description
Explore the complexities of skin vascular anatomy and the histological features of cutaneous vasculitis. This quiz covers the anatomical structures, pathological conditions, and specific types of cutaneous vasculitis you need to know for a deeper understanding of dermatological health.
