title: Histopathological findings in cutaneous small-vessel vasculitis associated with solid-organ malignancy.
abstract: BACKGROUND
  Histopathological findings in biopsy specimens from patients with cutaneous small-vessel vasculitis (CSVV) secondary to solid-organ malignancy have not been previously reported.
  
  
  OBJECTIVE
  We aimed to understand better the differences in histopathological findings between biopsy specimens from patients with CSVV associated with solid-organ malignancies and patients with CSVV secondary to other causes.
  
  
  METHODS
  From a previously published group of patients with CSVV and solid-organ malignancy, we identified patients with available histopathology slides of biopsy specimens. We compared histopathological findings from these patients with those from 68 previously published patients with Henoch-Schönlein purpura not associated with solid-organ malignancy (60% male).
  
  
  RESULTS
  We identified 15 patients (eight male, 53%) with available slides from biopsy specimens. The mean age of these patients with solid-organ malignancy-associated CSVV was 66·6 years, compared with 45·8 years in the Henoch-Schönlein purpura cases not associated with solid-organ malignancy (P < 0·001). Solid-organ malignancy-associated CSVV was less likely to demonstrate papillary dermal oedema (P = 0·04), papillary dermal inflammation (P < 0·001) and lymphocytes (P < 0·001), and more likely to have plasma cells (P = 0·02). Additionally, we detected nonsignificant differences in the presence of histiocytes (P = 0·05), intravascular thrombosis (P = 0·052) and microabscess formation (P = 0·06).
  
  
  CONCLUSIONS
  CSVV associated with solid-organ malignancies tended to have deeper dermal involvement and a different cellular milieu from cases not associated with solid-organ malignancies. In addition, the patients with CSVV with solid-organ malignancies were significantly older than those without. Prospective studies with age-matched controls are needed to determine the clinical significance of the histopathological differences in solid-organ malignancy-associated CSVV.
authors: Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, U.S.A.
authors: J O
authors: JO
authors: Podjasek
authors: D A
authors: DA
authors: Wetter
authors: C N
authors: CN
authors: Wieland
authors: M J
authors: MJ
authors: Camilleri
authors: C M
authors: CM
authors: Lohse
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology*; D012867:Skin / Q000098:blood supply / Q000473:pathology*; D017445:Skin Diseases, Vascular / Q000473:pathology*; D014657:Vasculitis / Q000473:pathology*; D055815:Young Adult