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Palpable Purpur...ack

Palpable Purpura: Back

This photograph demonstrates palpable purpura. Note the linear lesions that develop after pressure or scratching. This is a form of small-vessel vasculitis that is nonspecific and may occur in various rheumatologic, infectious, and allergic diseases.


Leucocytoclastic Vasculitis: Skin, Legs

19 year–old woman with leukocytoclastic vasculitis (LCV) of her lower extremities. LCV was biopsy-proven and was associated with her Crohn’s disease. Picture shows clusters of palpable purpura and petechiae.


Henoch-Schönlein Syndrome: Purpura, Legs

Diffuse erythematous palpable purpuric lesions are seen on the legs of this adult with Henoch-Schönlein syndrome. The patient’s skin biopsy shows immunoflourescent staining positive for IgA deposition in the walls of cutaneous vessels.

Vasculitis: Pur...eet

Vasculitis: Purpuric Eruption, Feet

Purpuric lesions are seen on the distal lower extremities of this patient. Less frequently, similar lesions are found on the palms, soles, and mucosal surfaces. Both recent purple lesions and older reddish-brown lesions are present. Biopsy specimens may r


Henoch-Schönlein Syndrome: Purpura, Legs

This patient's legs are covered by slightly raised, palpable, purpuric lesions. In Henoch-Schönlein syndrome the lesions are characteristically more prominent distally in the lower half of the body.

Hemorrhagic Les...oot

Hemorrhagic Lesions, Ankle and Foot

Multiple hemorrhagic and necrotic lesions on this leg are all approximately the same age. Blisters and ulcers may develop from these lesions. Note the vesicular lesion on the lower tibia and the ulcerated lesion on the dorsum of the foot.


Hypocomplementemic Urticarial Vasculitis: Skin

Urticarial lesions are evident on the back and left arm of a woman with hypocomplementemia (A). On skin biopsy, there is an interstitial mixed inflammatory infiltrate composed of neutrophils and lymphocytes (B). The high power view shows superficial der


Cryoglobulinemia: Digital Gangrene, Hands

This sequence of images shows progression of gangrene due to cyroglobulinemia. The right image was obtained 10 days after the initial presentation (top left). The bottom left image was taken one year later, after autoamputation and cosmetic surgery.


Hypocomplementemic Urticarial Vasculitis: Thigh

This 50 year-old woman presented with painful erythematous plaques resembling urticaria. However, the lesions lasted for more than 48 hours and did not blanch completely with pressure, indicating cutaneous hemorrhage. These two features help differentiate


Cryoglobulinemia: Vasculitis, Legs

Note the reticular pattern of erythema indicative of deep dermal vasculitis. Cryoglobulinemia is often associated with hepatitis C infection and certain paraproteins.


Cryoglobulinemia: Ulcer, Dorsum of Foot

Note the ulcer within an area of retiform purpura. This lacy, non-blanching eruption is due to small-vessel vasculitis within the deeper dermis.

Dermal Vasculit...oot

Dermal Vasculitis: Ankle and Foot

Vasculitic involvement of small cutaneous vessels may produce a variety of lesions, ranging from macular erythema or purpura to elevated papules, nodules, vesicles, and ulcers. Several hemorrhagic lesions are present here, the central one perhaps on the v

Livedo Reticularis

Livedo Reticularis

Livedo reticularis, a reticulate erythematous mottling of the skin, may be associated with systemic vasculitides such as lupus and polyarteritis nodosa. In these disorders, livedo usually appears as a broad-based, interrupted pattern, in contrast to the t


Cryoglobulinemia: Palatal Vasculitis

Although mucous membrane involvement is not common in systemic vasculitis, certain lesions are occasionally found. In this patient with cryoglobulinemia, petechiae and hemorrhagic areas are prominent. A small, shallow ulcer is present just above the light

Polyarteritis N...and

Polyarteritis Nodosa: Subcutaneous Nodules, Hand

This 12-year-old boy developed a febrile illness simulating rheumatic fever. Multiple subcutaneous nodules developed. A biopsy of one nodule from the thigh revealed necrotizing arteritis of a subcutaneous vessel.

Polyarteritis N...rop

Polyarteritis Nodosa: Wrist Drop

Wrist drop in a patient with polyarteritis nodosa is demonstrated. This neuropathy is due to vasculitis of the vasa nervorum.

Wegener’s Granu...ace

Wegener’s Granulomatosis: Saddle Nose Deformity, Face

This patient with Wegener’s granulomatosis developed a saddle nose deformity with destruction of the dorsal nasal cartilage. Other nasal complications in Wegener’s granulomatosis include perforated nasal septum, mucosal ulceration, epistaxis, and boggy na

Wegener’s Granu...ace

Wegener’s Granulomatosis: Face

Deformity of the nose secondary to granulomatous disease is demonstrated in this patient with Wegener's granulomatosis. Necrotizing granulomatous lesions may form in the upper respiratory tract, producing destruction and ulceration. These patients often c

Wegener’s Granu...ity

Wegener’s Granulomatosis: Progressive Saddlenose Deformity

This 23-year-old woman with Wegener’s granulomatosis has a typical saddlenose deformity (left). This deformity has progressed with further cartilaginous destruction (right). Inflammation in the nasal area often leads to septal destruction with collapse of

Wegener’s Granu...psy

Wegener’s Granulomatosis: Saddle Nose, Strawberry Gums, Nasal Biopsy

19 year old man who presented with antibiotic refractory sinusitis. Examination revealed saddle nose and strawberry gums characteristic of Wegener’s granulomatosis. Diagnosis was confirmed by the presence of necrotizing granulomas on nasal biopsy.

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