ABSTRACT
To determine the frequency-based value of various histological features seen in skin biopsies of patients with vessel thrombosis or embolism. This was a descriptive study; carried out in the Department of Pathology Pakistan Institute of Medical Sciences. The duration of study was 2 years. The total number of cases was 20, selected by convenience non-probability sampling. Skin biopsies of subjects suspected of thromboembolic disorder were collected and reviewed. A fixed scoring criterion ranging from 0 to 4 was used to score the degree of damage to the various components of skin and vessel involvement. Thrombosis of small vessels in the skin resulted in damage to the collagen and atrophy of the skin and later its ulceration. These changes correlated well with the degree of blockage of the vessels and degree of ischemia. Thromboembolic conditions may lead to formation of thrombi or shower of emboli in the microvessels of skin which may lead to discoloration, petichea, or even ulceration of the skin. Clinically, when the coagulation profile of the patient is not done or it is normal such lesions may be confused by the dermatologists with other dermatological diseases and the lesions may be biopsied.The biopsy of such lesions can reveal an underlying thromboembolic phenomenon and a high index of suspicion may lead to early diagnosis of such cases and in turn institution of prompt management. Epidermal atrophy, ulceration and/or collagen damage progressing towards necrosis are the features which can alert the pathologist of such a condition. Meticulous examination of the microvasculature of the skin biopsy is essential to not miss these conditions