In order to standardize the names and definitions of cutaneous vasculitis that are missing from the Chapel Hill consensus conference 2012 (CHCC2012), an article titled "Nomenclature of Cutaneous Vasculitis: Dermatologic Addendum to the CHCC2012" (D-CHCC) was recently published in Arthritis & Rheumatology. The D-CHCC provides a firm framework for both clinicians and investigators. Moreover, it may provide the motive for developing validated classification and diagnostic criteria for cutaneous vasculitis. Thus, it is expected to be widely used in Japan in the near future. This review describes the basic structure of the D-CHCC, elucidates its essence, and indicates subjects to misconstruction in greater detail.
A 90-year-old woman underwent transcatheter aortic valve implantation for aortic stenosis. Immediately after the procedure, livedo racemosa and purpura developed on her bilateral toes and the soles of her feet. Skin biopsy showed intravascular, pale basophilic, and lamellated foreign materials in the upper dermis. These findings led to the diagnosis of cutaneous hydrophilic polymer embolism derived from endovascular device coatings. The skin lesions gradually disappeared within 12 days without treatment. Fifteen cases of cutaneous embolism of hydrophilic polymer coatings, which are used on endovascular devices, have been reported in the literature. This disease can also affect various organs other than skin. Dermatologists should be aware of this disease, as well as cholesterol crystal embolism, as a potential adverse events that can occur after endovascular procedures.