Immunofluorescent Studies of Various Cutaneous Vasculitides

Lee, Jai Jo; Chun, Inn Ki; Kim, Young Pio

Abstract

Vascular tissue presumed to be the most sensitive target tissue of the immune and toxic reactions. Most of the vasculitides can be directly or indirectly associated with immunopathogenic rnechanisms. In this regards, the purpose of the study is to understand imrnunopathogenic mechanism of various cutaneous vasculitides by comparing their immunopathologic patterns. Imrnunopathologic studies were carried out on the blood vessel of various skin diseases by means of the direct immunofluorescent technique using FITC conjugated rabbit antihurnan IgG, IgA, IgM, C3 C1q, C4 and fibrinogen)(F). The results obtained were as follows : 16 patients with leukocytoclastic vasculitis out of 19 showed deposition of irnmune complex in the small upper dermal vessels and had positive reaction for F, 8 for IgA, 5 for C3 and 2 for IgM. Of the 6 patients with chronic pigmented purpura studied, 2 had IgM, 3 had Ca and all of these had F in small upper or middle dermal vessels. Immunopathologic patterns of livedo vasculitis were similar to those of chronic pigmented purpurs, except mainly affected in upper dermis. Nodular vasculitis and Behqets syndrome had deposits of F, C and IgM in medium or large vessels of the middle or lower dermis. Simultaneously, Cs in 2 patients with nodular vnsculitis and IgM in one patient with Behqets syndrorne were also noted along the basement mernbrane zone. In a patient with pityriasis lichenoides et varioliformis acuta, IgM and F were noted on the samll upper dermal vessels. With these results, the immune complex mechanism could be closly related the pathogenesis of most of cutaneous vasculitis. And various clinical manifestations or expression of vasculitis appear to be dependent upon 1) type of imrnune reaction, 2) size of blood vessels, 3) location and depth of blood vessels, 4) extend of affected areas and 5) involvement of other organs.