Intravascular histiocytosis of the skin

Intravascular histiocytosis (IH) is a rare skin condition characterized by pathological dilation of blood vessels and the accumulation of histiocytes within their lumen. Despite its rarity, the issue of diagnosing and treating IH remains relevant due to the lack of standardized approaches and limited understanding of its developmental mechanisms. The key factor triggering the development of IH is vascular wall damage, which promotes the migration and proliferation of histiocytes within the vessels. This process may be caused by various factors, including infections, cardiovascular system disorders, and liver or kidney pathology. However, the disease can also occur in individuals without associated conditions, suggesting the presence of unknown triggers or genetic predispositions. The clinical manifestations of IH are diverse but most commonly localized on the trunk and extremities. Lesions often appear as papules and hemorrhagic nodules, complicating differential diagnosis with other dermatological diseases. The uniqueness of the symptoms and the rarity of the pathology often lead to misdiagnoses and inappropriate treatments, exacerbating the course of the disease. This article describes a clinical case of a patient with skin changes observed in the neck and scalp—an atypical site for IH manifestation. The lesions presented as papules and hemorrhagic nodules. The diagnosis was confirmed through dermatoscopy and histological examination of a skin biopsy. The treatment provided led to the complete resolution of clinical manifestations, with no recurrence of the disease observed. Currently, there is no universal protocol for treating IH. Steroidal drugs are often employed as one therapeutic strategy; however, their efficacy and long-term outcomes remain insufficiently studied. The presented case highlights the importance of further research in IH to develop unified diagnostic and therapeutic approaches. Advancing the understanding of the disease mechanisms and creating treatment standards will improve patients' chances of full recovery and enhance prognosis for this pathology.