Pathogenesis of hemorrhagic skin lesions in meningococcal disease.

The pathogenesis of purpuric skin lesions in meningococcaemia is still not clear. The histopathology of biopsy specimens from human purpura resembles that of the local Shwartzman reaction in rabbits. However, the early histopathological picture of purpuric lesions shows a resemblance to the experimental epinephrine-endotoxic reaction produced in rabbits. Furthermore, immunological reactions may play an important role in the pathogenesis since deposits of immunoglobulins, complement and fibrinogen can be demonstrated in the walls of capillaries and small vessels in the dermis of patients with acute meningococcaemia.