cutaneous collagenous vasculopathy associated with intravascular occlusive fibrin thrombi cutaneous collagenous vasculopathy ccv is a rare cutaneous microangiopathy that clinically resembles generalized essential telangiectasia with only 12 cases reported to date the perivascular fibrosis is thought to be due to production of abnormal collagen by veil cells in the outer vessel walls as a result of unknown factors this report is of an 84yearold male with progressive telangiectasia biopsies showed characteristic features of ccv in addition there were multiple intravascular fibrin thrombi some organizing and associated with endothelial cell hyperplasia with recanalization reminiscent of glomeruloid bodies and simulating reactive angioendotheliomatosis rae histochemically and ultrastructurally fibrin was noted within the vessel walls integrating into the fibrous tissue around the vessels however the patient had no evidence of coagulation disorder cryoglobulinemia or cold agglutinemia immunofluorescence showed fibrinogen within the vessel walls but no immunoglobulins or c3 as well there were minimal inflammatory cells this suggests pauciinflammatory injury to the endothelial cells by unknown angiogenic factors causing local intravascular fibrin thrombi with fibrin leaking and incorporating into the vessel walls eventually leading to reparative perivascular fibrosis this case suggests that some cases of ccv are related to a primary local intravascular occlusive thrombotic microangiopathy however the primary triggering factor causing the endothelial cell damage has yet to be elucidated