THE TELL-TALE SAGA OF PAVING TRANSFIGURATION OF CUTANEOUS VASCULOPATHIES IN CONCORDANCE WITH IMMUNOFLORESCENCE -A THREE YEAR CLINICOHISTOPATHOLOGICAL STUDY

Abstract

Introduction: Vasculopathies of cutaneous origin are a complex and incongruous group of inflammatory disorders affecting cutaneous vessels. Several factors such as infections, drugs, connective tissue diseases or malignancies can lead to activation of pathways of vasculopathies. Aim: The aim of the study was to carry out a histopathological study and classify cutaneous vasculopathies. Materials And Methods: It was a cross sectional descriptive study done in Armed forces medical services Base Hospital Delhi from June 2014- June 2017) where the cutaneous vasculopathies histopathology analysis with immunofluorescence concordance was done. Results: Total of 106 cases of clinically suspected vasculopathies were enrolled in the study. In our study the highest frequency of cutaneous vasculopathies was among the patients between the age group of 31- 40 years (n=33) followed by 41-50 years age group (n=25).  The most common dermatological manifestations were palpable purpura (n=54, %), followed by petechiae (n=18), plaques, (n=07), ulcers (n= 03), vesicles (n=2), pustules (n=02) and necrosis (n=02).Arthralgia was the most common extracutaneous manifestation in our study followed by pain in the lesions. Pain in abdomen (n=10), fever (n=09), diarrhea (n=03), malena and hemoptysis (02 each) and oral ulcers (01) were seen. ANCA (Anti neutrophil cytoplasmic antibody) was done in 18 patients and only 01 was found to be positive for c ANC.DIF (Direct immunofluorescence) study was done in 88 patients. 53 patients revealed the presence of at least one of the immune complexes deposited in the vessel walls. 35 repondents showed no deposits. C3 was the most common immunoreactant seen in 36 patients followed by IgA in 25(%) of the cases. Conclusion: The study showed that Careful clinical examination and correlation with laboratory findings, histopathological findings and immunofluorescence should be done in vasculopathies. If one fails to recognize this, it may result in significant patient morbidity and mortality.