Diagnostik und histologische Besonderheiten der kutanen Vaskulitiden/Vaskulopathien – Teil 1

 

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Zusammenfassung

Vaskulitiden der Haut treten im dermatologischen Patientengut häufig auf und führen immer wieder zu Konsultationen auch aus benachbarten Fachdisziplinen, wie Rheumatologie und Pädiatrie. Die unscharfe Definition einer Vaskulitis sowie vielfältige klinische Verläufe der kutanen Vaskulitiden (mit benignen, selbstlimitierenden Erkrankungen eines einzelnen Organs bis zu Multisystembeteiligungen mit schweren Verläufen und fatalem Ausgang) kennzeichnen die Thematik der Vaskulitiden. Überlappungen hin zu Systemvaskulitiden mit Beteiligung mittelgroßer bis großer Gefäße erfordern eine enge interdisziplinäre Zusammenarbeit mit den entsprechenden Disziplinen und den Allgemeinpathologen. Der folgende Artikel fasst die aktualisierte Klassifikation der kutanen Vaskulitiden zusammen, erläutert wichtige histologische Befunde sowie charakterisierende klinische Merkmale. Im ersten Teil dieser Weiterbildungsreihe werden die verschiedenen Entitäten der leukozytoklastischen und nodulären Vaskulitis, die Livedovaskulopathie, Urtikariavaskulitis, Embolia cutis medicamentosa, septische Vaskulitiden und auch Thrombophlebitiden sowie Pseudovaskulitiden vorgestellt.

Abstract

Vasculitis of the skin is frequently found in dermatologic patients and requires interdisciplinary teamwork with other areas of expertise such as rheumatology or pediatrics. The vague definition of a vasculitis together with a multiplicity of clinical courses reaching from benign, self-limiting disease involving only a single organ to a disease involving multiple organs that leads to dramatic courses with fatal outcome are characteristic for the topic “vasculitis”. Vasculitis of the skin overlapping to systemic vasculitis with involvement of medium-sized to large vessels requires a close interdisciplinary teamwork with other disciplines and pathologists. This article sums up the current classification of cutaneous vasculitis and illustrates important histological and characteristic clinical features. The first part of this training course portrays the following entities: leucocytoclastic and nodular vasculitis, livedovasculopathy, urticariavasculitis, embolia cutis medicamentosa, septic vasculitis, thrombophlebitis and pseudovasculitis.

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