Alternative pathway complement activation: a possible mechanism inducing skin lesions in benign gonococcal sepsis

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Abstract
To elucidate the pathogenesis of the skin lesions in [human] benign gonococcal sepsis, direct immunofluorescence of an early macular lesion and routine histopathology of a mature papulopustular lesion in a patient with septic gonococcal dermatitis were performed. Histopathology of the mature skin lesion revealed a pattern of allergic vasculitis. Direct immunofluorescence showed exclusively deposits of [complement] C3 around and within the capillaries and in the basement membrane zone. No specific IgG [immunoglobulin G], IgM, IgA or C4 deposits could be demonstrated. The serological findings and reports from the literature also suggests an important pathogenetic function for complement, activated through the alternative pathway by means of [Neisseria gonorrhoeae] gonococcal endotoxic lipopolysaccharide, in the pathogenesis of the skin lesions in benign gonococcal sepsis.