American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of vasculitis is associated with skin biopsy showing leukocytoclastic changes?

1. Granulomatosis with polyangiitis

2. Henoch-Schönlein Purpura

3. Behçet's disease

4. Kawasaki disease

The correct answer is: Henoch-Schönlein Purpura

In this context, the correct identification of Henoch-Schönlein Purpura as the type of vasculitis associated with skin biopsy showing leukocytoclastic changes is based on its characteristic histopathological findings. Leukocytoclastic vasculitis is characterized by the presence of fragmented neutrophils (leukocytoclasis) in small dermal blood vessels, indicative of immune complex deposition and inflammation. Henoch-Schönlein Purpura, also known as IgA vasculitis, is commonly associated with palpable purpura, particularly in the buttocks and legs, along with symptoms affecting the gastrointestinal tract and kidneys. When a skin biopsy is performed on an affected area, the leukocytoclastic vasculitis pattern is often observed, which reflects the underlying immune-mediated process. Other types of vasculitis mentioned typically do not present with leukocytoclastic changes on biopsy. Granulomatosis with polyangiitis is characterized by granuloma formation rather than leukocytoclastic vasculitis. Behçet's disease involves specific types of vasculitis affecting larger vessels and has unique clinical features like oral and genital ulcers, while Kawasaki disease primarily affects coronary arteries and manifests differently in terms of histopathological findings. Therefore