Stasis dermatitis and pigmented purpuric dermatoses: Histological characterization and review of literature

JEADV clinical practice Pub Date : 2024-12-15 DOI:10.1002/jvc2.569

M. S. Hoffet, D. L. Perruchoud, K. Gadaldi, K. Heidemeyer, S. Bossart, L. Borradori, A. A. Ramelet, L. Feldmeyer

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Abstract

Background

Stasis dermatitis and pigmented purpuric dermatoses can both manifest as hyperpigmentation, petechiae and/or purpura on the lower extremities, posing a challenge for macroscopic differentiation. We investigated the histological differences in these two conditions.

Objectives

To determine the histological characteristics of stasis dermatitis and pigmented purpuric dermatosis.

Methods

Skin biopsy specimens were obtained from seven patients with stasis dermatitis, 15 with pigmented purpuric dermatosis, and three control patients. The samples were analysed for histological changes (hematoxylin-eosin), melanin (silver nitrate), iron, elastic stain, and with an immunohistochemistry for melanocytes (Melan-A).

Results

The predominant histological features of stasis dermatitis were hemosiderin deposits, eosinophils and telangiectasias. Pigmented purpuric dermatosis was characterized by extensive erythrocyte extravasation, interface changes and spongiosis.

Conclusions

The distinct histological characteristics of stasis dermatitis and pigmented purpuric dermatosis can improve the diagnostic classification of these entities.

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背景瘀积性皮炎和色素性紫癜性皮肤病均可表现为下肢色素沉着、瘀斑和/或紫癜，这给宏观鉴别带来了挑战。我们对这两种疾病的组织学差异进行了研究。目的确定瘀积性皮炎和色素性紫癜性皮肤病的组织学特征。方法从 7 名瘀积性皮炎患者、15 名色素性紫癜皮病患者和 3 名对照组患者身上获取皮肤活检标本。对标本进行组织学变化（苏木精-伊红）、黑色素（硝酸银）、铁、弹性染色和黑色素细胞免疫组化（Melan-A）分析。结果瘀积性皮炎的主要组织学特征是血色素沉积、嗜酸性粒细胞和毛细血管扩张。色素性紫癜性皮炎的特点是广泛的红细胞外渗、界面变化和海绵状增生。结论瘀积性皮炎和色素性紫癜皮肤病的不同组织学特征可改进对这些实体的诊断分类。

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来源期刊

JEADV clinical practice

CiteScore

0.30

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0.00%

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