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Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Nodular and Diffuse Dermatitis

…homa. 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)

…nd spleen, microglial cells in the central nervous system, and histiocytes and Langerhans” cells in the skin. Histiocytes are mononuclear cells that range in size from 15 to 25 μm. Their nuclei, in general, are larger and paler than those of ly…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…10.43.2A: Nodular dermatitis, granulomatous + 10.43.2B: Histiocytes in a palisade around a focus of both abundant mucin and degeneration of collagen = Granuloma annulare The nuclear “dust” in the center of the palisade of histiocyt…

Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

…the reticular dermis in association with either lymphocytes or histiocytes or both. Click image to enlarge. In foci: + Histiocytes in palisaded or interstitial array in discrete foci = Granuloma annulare Diffuse: + Smudged appearance of t…

Histologic Diagnosis of Inflammatory Skin Diseases

Applicable Terms

…m (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 discernabl…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…0.57.1B: 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 h…

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 his…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…7.4A: Perivascular and interstitial dermatitis + 10.67.4B: Histiocytes, some multinucleate, in patchy distribution along vascular plexuses = Necrobiosis lipoidica The infiltrate of histiocytes in necrobiosis lipoidica tends to be arranged in dist…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Eosinophilic Cellulitis (Wells’ Syndrome)?

…osinophils, some of them clustered as flame figures, and large histiocytes, some of them multinucleate, arranged in a palisade around flame figures. In the third and last stage, the slate-gray atrophic skin housed histiocytes, some multinucleate, int…

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