Small vessel vasculitis, cutaneous L95.5

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 16.03.2023

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CSVV; cutaneous leukocytclastic vasculitis; cutaneous necrotizing venulitis; cutaneous small vessel vasculitis; hypersensitivity angiitis; Hypersensitivity angiitis; LcV; leukocytoclastic vasculitis; Small vessel vasculits; Vasculitis leukocytoclastic

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Classification according to vessel size and type of inflammation: This classification subdivides vasculitides according to objectifiable histopathological criteria that take into account, on the one hand, the size of the vessels (small, medium, and large) and the type and composition of the infiltrate (e.g., the significant criterion of leukocytoclasia). "Small vessel" refers to capillaries, arterioles, and venules; "medium-sized vessel" refers to middle arterial and venous vessels; and "large vessel" refers to the aorta and its direct branches or its branches (e.g., temporal artery). Even with this primarily histomorphologic classification, there are uncertainties and overlaps, especially when clinical and histologic entities are used synonymously. For example, multiple clinical entities underlie leukocytoclastic vasculitis (LcV). The common feature of this group is the exclusively histologically detectable pathologic substrate, namely vasculitis with neutrophil leukocyte decay, leukocytoclasia. Thus, even this classification is ultimately unsatisfactory from a clinical point of view.

Histopathological and immunological classification and assignment of clinical entities (based on Sundkötter). It has been shown that the occurrence of IgA-containing immune complexes (detection by DIF) has a significant prognostic (rather unfavorable prognosis) and therapeutic significance.

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Last updated on: 16.03.2023