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Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Nodular and Diffuse Dermatitis

…oma. Figure 5.175 A&B. A nodule made up of epithelioid histiocytes: sarcoidosis. The nodular infiltrate throughout the dermis and in subcutaneous fat is composed mostly of epithelioid histiocytes, which qualifies this process as granulomatous,…

Histologic Diagnosis of Inflammatory Skin Diseases

Cells That Mediate Inflammation (Inflammatory Cells)

Neutrophils, eosinophils, lymphocytes, plasma cells, and histiocytes are called inflammatory cells because they enter tissue during the process of inflammation. A more exact designation for them is “cells of an inflammatory process”; the…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ulomatous + 10.43.1B: Interstitial and palisaded array of histiocytes around loci of deposits of mucin and degeneration of collagen = Granuloma annulare This is a presentation stereotypical of granuloma annulare showing both the palisaded and int…

Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

…+ Perivascular and/or nodular infiltrate of lymphocytes and histiocytes in the dermis and subcutaneous tissue, the macrophages containing nuclear debris = Kikuchi”s disease + Sparse superficial perivascular infiltrate of lymphocytes, edema…

Histologic Diagnosis of Inflammatory Skin Diseases

Applicable Terms

…(granule) + -oma (the result of an action)]: A collection of histiocytes, usually epithelioid ones (Fig. 3.17). Epithelioid histiocytes (Fig. 3.18) (so termed because of their resemblance to epithelial cells, namely, oval nuclei, readily discernable…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

….57.1B: Lymphocytes among dense infiltrates of slightly foamy histiocytes, some of them having a bluish cast + 10.57.1C + 10.57.1D = Leprosy, lepromatous When slightly foamy histiocytes have a bluish hue, it means that their cytoplasm ho…

Histologic Diagnosis of Inflammatory Skin Diseases

Xanthogranuloma

…Moderately dense perivascular and interstitial infiltrates of histiocytes, few if any of which have foamy cytoplasm and none of which are multinucleate; formation of a sheet of histiocytes in the upper half of the dermis sometimes Some nuclei of hist…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…10.67.1A: Panniculitis, septal mostly + 10.67.1B: Histiocytes in palisaded array around large foci of degenerated collagen in the reticular dermis + 10.67.1C + 10.67.1D = Necrobiosis lipoidica Vasculitis, as can be seen in a…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Eosinophilic Cellulitis (Wells’ Syndrome)?

…Histologically the dermis is infiltrated with eosinophils and histiocytes. Foci of phagocytosis of eosinophilic debris produce the characteristic flame figures.” Wells GC. Recurrent granulomatous dermatitis with eosinophilia. Trans St John&#82…

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