By applying strict diagnostic criteria and a standardized classification (Chapel Hill 1994) an attempt has been made to shed some light on the varying and sometimes puzzling information concerning the quantity and quality of skin lesions with
systemic vasculitis or
vasculitis associated with certain types of
dermatitis. It has to be emphasized that associated skin lesions are hereby non-specific. However, a palpable
purpura with a predeliction for the lower extremities is considered to be quite typical. The same diagnostic criteria as for
systemic vasculitis should also be applied to
dermatitis with associated
vasculitis. It also has to be stressed that not all patients with a certain type of
dermatitis necessarily show a
vasculitis. However, if present, an associated
vasculitis does not always involve all blood vessels, therefore it may not show up in each histological section examined. The gold standard of diagnosis of a
vasculitis is a biopsy with
hematoxylin staining and in additional van Gieson-
elastica staining may be helpful. According to actual experience gained since their introduction, immunohistochemical and immunological methods play only a supportive role.