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Serial Histopathologic Evaluation Demonstrates the Dynamic Nature of the Infiltrate

Robert H. Zax, MD; Steven J. Hodge, MD; Jeffrey P. Callen, MD

Arch Dermatol. 1990;126(1):69-72.

Abstract
• Data from experimentally induced cutaneous vasculitis have suggested that the inflammatory infiltrate is dynamic. In contrast, data from humans with cutaneous vasculitis have suggested that two distinct patterns of cellular infiltrate exist, a mononuclear-predominant and a neutrophilic-predominant type. There are little data regarding the temporal evolution of spontaneously occurring cutaneous vasculitis in humans. A patient with a cutaneous leukocytoclastic vasculitis manifest as palpable purpura had four lesions encircled on the day of presentation. Biopsies of these lesions were obtained sequentially at 0, 24, 48, and 120 hours. The histopathologic specimens were graded without knowledge of the timing of the biopsy. The character of the infiltrate progressively changed from a neutrophilic-predominant to a mononuclear-predominant infiltrate supporting the theory of a dynamic process in cutaneous vasculitis. The previous reports that suggest that there are two distinct inflammatory cell types may be the result of performing the biopsy at one point in time during this transitory process.

(Arch Dermatol. 1990;126:69-72)

Author Affiliations
From the Division of Dermatology, University of Louisville (Ky).

Footnotes
Accepted for publication June 19, 1989.

Presented in part at the Society of Investigative Dermatology, Washington, DC, April 30,1989; the American Rheumatism Association annual meeting, Cincinnati, Ohio, June 14, 1989; and the American Academy of Dermatology summer session, San Diego, Calif, June 15, 1989.

Reprint requests to 310 E Broadway, Louisville, KY 40202 (Dr Callen).

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