The superficial dermis is involved by bland vascular thrombi occluding the small vessels. There is no evidence of vasculitis.
Vascular manifestations associated with lupus include vasculitis, vasculopathy, vasospasm, and thromboembolism. In the absence of vessel wall inflammation, there may be accumulation of thromboembolic material, which is often related to lupus anticoagulant/antiphospholipid antibodies.
Lupus with vasculitis is treated with immunosuppressive medications, while vascular thromboembolic disease as in this example is treated with anticoagulation therapy.