Diff Dx Cover

Erythema multiforme vs. Graft-versus-host disease, acute phase

Differential Diagnosis

Erythema multiforme Graft-versus-host disease, acute phase
1. Cornified layer normal 1. Cornified layer abnormal (basket-woven, laminate, and compact orthokeratosis)
2. Intra-epidermal vesiculation 2. No intra-epidermal vesiculation
3. Ballooning of keratocytes 3. No ballooning of keratocytes
4. Reticular alteration of the epidermis 4. No reticular alteration
5. Confluent necrosis of epidermal keratocytes 5. No confluent necrosis of keratocytes
6. Neutrophils in zones of marked epidermal necrosis 6. No neutrophils in the epidermis
7. Melanin in necrotic keratocytes often striking in dark-skinned persons 7. Melanin not prominent in necrotic keratocytes of dark-skinned persons
8. No nuclear abnormalities of keratocytes 8. Nuclear abnormalities of some keratocytes
9. Edema of the papillary dermis 9. No edema of the papillary dermis
10. Erythrocytes extravasated in the papillary dermis common 10. Erythrocytes extravasated in the papillary dermis uncommon