Histologic Diagnosis of Inflammatory Skin Diseases

Applicable Terms

…the seven basic patterns of inflammatory disease in the skin. KARYOLYSIS [Gk. karyon (nut) + lysis (to loosen)]: Disappearance of nuclei from cells during the process of cell death. Karyolysis (ghosts of nuclei), karyorrhexis (fragmentation of nucle…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.23.1A: Perivascular dermatitis, psoriasiform + 10.23.1B: Orthokeratosis, hypergranulosis, acanthosis, proliferation of infundibular and eccrine ductal keratocytes, and coarse bundles of collagen in vertical streaks = Lichen simp…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Apoptosis?

“… this distinctive type of necrosis (apoptosis)…has previously been called shrinkage necrosis on morphological grounds.” Kerr JFR. Wyllie AH, Currie AR. Apoptosis: a basic biological phenomenon with wide ranging implicatio…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Subcutaneous Fat: Panniculitis

See Fig. 5.385 A-C. Figure 5.385 Patterns of panniculitis. A. Septal mostly. B. Lobular mostly. C. Septal and lobular “equally.” At scanning magnification, the normal subcutaneous fat is seen to be segregated by struts of fibrous tiss…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vesicular Dermatitis

See Fig. 5.239 A-C. Figure 5.239 A-C. Patterns of vesiculation: intraepidermal, subepidermal, and intra- and subepidermal. “Blister” and “vesiculobullous” are terms generic for lesions of the skin that usually are elevated…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

Error: Abortive is an accurate modifier of particular pathologic processes, e.g., abortive dermatofibroma, abortive morphea, and abortive T-cell lymphoma. Reason: The idea itself is abortive! For example, what is called “abortive T-cell lympho…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Perivascular Dermatitis

See Figs. 5.16 A&B, 5.17 A&B, 5.18 A&B, 5.19 A&B, 5.20 A&B, 5.21 A&B, and 5.22 A&B Figure 5.16 A. Perivascular dermatitis, perivascular only, superficial. B. Perivascular dermatitis, perivascular only, superficial and…

Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

In this section, algorithms used to reach specific diagnosis are predicated on “nonspecific” findings recognized best at higher magnification. Other changes requisite for specific diagnoses, i.e., denominators that are essential, then ar…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 11.6.1A: Vesicular dermatosis, subepidermal + 11.6.1B: Necrosis of eccrine glands + 11.6.1C + 11.6.1D = Blister secondary to the effects combined of hypoxemia and local pressure ┬áThe infiltrate of inflammatory cells is…