Cutaneous Pediatric Vasculitis: A Clinico-Histopathological Overview of Common and Novel Entities

Vasculitis encompasses a heterogeneous group of diseases characterized by the inflammation of blood vessels. In children, the diagnosis of vasculitis with cutaneous involvement relies on a combination of clinical evaluation, histopathological examination, and, in some cases, genetic investigations. Diagnosing pediatric vasculitis remains particularly challenging due to overlapping clinical manifestations, variable disease courses, and the evolving nature of histological features. Histopathological assessment aims to confirm inflammation of the vessel walls—either readily visible at low magnification or requiring serial sections—and to characterize the inflammatory infiltrate and other key features that aid in classifying the vasculitis subtype. Accurate diagnosis requires ongoing dialog and collaboration among multiple specialists. In this article, we present the clinical and histopathological features of the most common pediatric vasculitides—including IgA vasculitis and polyarteritis nodosa—as well as newly recognized entities such as COVID-19-associated vasculitis and monogenic vasculitides.