Varied presentations of cutaneous vasculitis: a case series

Vasculitis involves a wide spectrum of clinicopathological process with reactive damage to the involved blood vessels. There is loss of vessel integrity instigating haemorrhage & luminal compromise leading to ischemia and necrosis of the tissue supplied by the involved vessels. It may affect varied size and type of blood vessels at different locations. It may be primary or secondary to systemic disease. It may involve a single organ like skin or may involve different organ systems at the same time. This case series include six cases of cutaneous vasculitis affecting different organs with varied presentations. Skin biopsies of six patients with unusual presentations were studied. Their complete history, physical examinations, laboratory investigations including serology were analysed and correlated with histopathological findings. The patients presented with different duration of symptoms varying from as short as 15 days to 1 year. Skin lesions were present in all cases while cardiac manifestation was seen in one. Serology and autoimmune disease markers were negative in all cases except one. However, histopathological features were in concordance with the clinical diagnosis of vasculitis. They were further classified as vasculitis secondary to Churg Strauss syndrome, venous stasis, Henoch Schonlein purpura or leucocytoclastic vasculitis.Vasculitis though a rare disease may manifest as an acute or chronic condition. It needs timely diagnosis by histopathological examination to aid in further management. It is important to assess the clinical severity in primary and secondary vasculitis, as it determines morbidity and mortality.

Scar endometriosis: pre-operative diagnosis by fine needle aspiration cytology

Scar endometriosis is a rare entity commonly observed after obstetrical and gynaecological procedures. The diagnosis is often delayed due to the non-specific nature of symptoms. Detailed clinical history of cyclical pain, location in proximity to a surgical scar and a suspicion of this rare entity in women of childbearing age are key to preoperative diagnosis. This is a case of a patient who presented with a troublesome scar after Caesarean section. On Fine needle aspiration cytology (FNAC) a diagnosis of scar endometriosis was provided which was further confirmed on histopathology. Herein we discuss the cytomorphological features of this rare entity and also emphasize the importance of its diagnosis on FNAC which is a rapid and cost-effective method.