S8C29P15Angiodermatitis

S8C29P15-2: The vascular patterns in this example of granulation tissue are clearly different from those of angiodermatitis. The matrix is inflamed. Granulation tissue can be manifested in lobular arrays of newly formed vessels and then differentiation between granulation tissue and angiodermatitis may be difficult.

S8C29P15-3: The epidermis is necrotic; it has partially separated from the dermis. The papillary dermis and the upper portion of the reticular dermis are fibrotic and show ischemic changes. Nuclear debris is present in the areas of necrosis. The patterns are those of a small, superficial zone of necrosis.


S8C29P15-1: This ulcer of the skin shows a superficial layer of granulation tissue. A myxoid matrix forms a uniform layer along the floor of the ulcer. Vessels are regularly spaced. They are perpendicular to the surface of the skin and form parallel arrays. These patterns of granulation tissue should be compared with the lobules which characterize angiodermatitis.

S8C29P15-4 (same lesion as S8C29P15-3): Small vessels in the lower portion of the dermis are occluded by thrombi in the absence of significant infiltrates of inflammatory cells, particularly neutrophils. This is the pattern of a thrombotic angiopathy; livedo “vasculitis” would be considered in the differential diagnosis. Other coagulopathies should be ruled out.

S8C29P15-5: This small muscular vessel contains a platelet and fibrin thrombus; the lesion is representative of a coagulapathy. Although there are a few fragments of nuclear debris, this is not a leukocytoclastic angiitis. In contrast to the changes in leukocytoclastic angiitis in which endothelial cells are usually preserved, in this disorder, the endothelial cells often are not preserved.

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