PMC4485669_01
Showing the malar rash in the patient with leukocytoclastic vasculitis an hepatitis.
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Fig1
Rashes were present over the trunk and all four extremities along with a malar rash over her face (Figure 1).
Showing the lesions in the upper limbs which have coalesced into large blackish deep purple patches.
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Fig2
Initially the rash was erythematous in the form of a palpable purpura and the lesions were small and punctate, but later on the lesions increased in size and coalesced to form extensive large blackish deep purple patches in both upper limbs (Figure 2).
Showing the digital infarcts of the toes of both lower limbs.
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Fig3
There were small digital infarcts of her toes bilaterally (Figures 3, 4).
Showing the digital infarcts of the toes of both lower limbs.
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Fig4
There were small digital infarcts of her toes bilaterally (Figures 3, 4).
Histopathological examination of biopsy of the skin lesion from the upper arm showing leukocytoclastic reaction. a, b Hematoxylin and Eosin staining showing the epidermis lined by keratinizing stratified squamous epithelium with evidence of spongiosis. Most of the blood vessels in underlying dermis showing thrombus formation along with necrosis in the vascular wall and neutrophilic infiltration. c, d Periodic acid schiff staining of the same skin lesions showing amorphus PAS positive material deposits (red arrows) in form of intramural and intravascular thrombus.
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Fig5
Biopsy from the skin lesions of the upper limb showed features of LCV (Figures 5, 6, 7, 8, 9).
Hematoxylin and eosin staining showing the epidermis lined by keratinizing stratified squamous epithelium with evidence of spongiosis and neutrophilic infiltration (low magnification x4).
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Fig6
Biopsy from the skin lesions of the upper limb showed features of LCV (Figures 5, 6, 7, 8, 9).
Hematoxylin and eosin staining showing the epidermis lined by keratinizing stratified squamous epithelium with evidence of spongiosis. Most of the blood vessels in underlying dermis showing thrombus formation along with necrosis in the vascular wall and neutrophilic infiltration (high magnification x10).
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PMC4485669_01_40064_2015_1081_Fig7_HTML.jpg
Fig7
Biopsy from the skin lesions of the upper limb showed features of LCV (Figures 5, 6, 7, 8, 9).
Periodic acid schiff staining of the same skin lesions showing amorphus PAS positive material deposits (red arrows) in form of intramural and intravascular thrombus (low magnification x4).
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PMC4485669_01_40064_2015_1081_Fig8_HTML.jpg
Fig8
Biopsy from the skin lesions of the upper limb showed features of LCV (Figures 5, 6, 7, 8, 9).
Periodic acid schiff staining of the same skin lesions showing amorphus PAS positive material deposits (red arrow) in form of intramural and intravascular thrombus (high magnification x20).
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PMC4485669_01_40064_2015_1081_Fig9_HTML.jpg
Fig9
Biopsy from the skin lesions of the upper limb showed features of LCV (Figures 5, 6, 7, 8, 9).
Showing improvement and gradual resolution of the skin lesions in the upper limbs of the patient.
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Fig10
Gradually there was improvement with disappearance of the skin lesions (Figure 10) and healing of the digital infarcts.