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Dermatology Practical & Conceptual

Large cell acanthoma: a debate throughout the decades

…idy [1]. LCA presents sharply demarcated hyperorthokeratosis, hypergranulosis, and enlarged keratinocytes without signs of atypical mitoses or nuclear dysplasia. Pinkus separated actinic keratosis from LCA by its tendency towards invasion, and postul…

Histologic Diagnosis of Inflammatory Skin Diseases

Lupus erythematosus

…butes of lupus erythematosus. Moreover, wedge-shaped zones of hypergranulosis in repeatable pattern typical of lichen planus are not met with as a rule in classic discoid lupus erythematosus. Parakeratosis is common in classic discoid lupus erythemat…

Differential Diagnosis in Dermatopathology

Discussions

…hokeratosis devoid of parakeratosis and wedge-shaped zones of hypergranulosis that form in structures that pass through the epidermis, i.e., acrosyringia and “acrotrichia.” Clinically, lichen planus is characterized by flat-topped, polygo…

Differential Diagnosis in Dermatopathology

Discussions

…osis; dilatation of infundibula by a plug of cornified cells; hypergranulosis of infundibula; uneven psoriasiform acanthosis, coarse bundles of collagen arranged in vertical streaks in a thickened papillary dermis; a superficial perivascular infiltra…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen striatus

…ogic Lichen planus displays compact orthokeratosis, V-shaped hypergranulosis, and jagged acanthosis; only in lichen planopilaris are infiltrates of lymphocytes distributed along the course of adnexal structures in the reticular dermis and then along…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen nitidus

…n planus is characterized by compact orthokeratosis, V-shaped hypergranulosis, jagged acanthosis, a lichenoid infiltrate of lymphocytes that obscures the dermoepidermal interface, and necrotic keratocytes. Histiocytes never predominate. Lichen striat…

Differential Diagnosis in Dermatopathology

Keratoacanthomatous verruca vulgaris vs. Verrucous keratoacanthoma

Papules on skin and mucous membranes that result from infection of keratinocytes by different types of papillomavirus and classified according to their silhouettes, to wit, papillated (verrucae vulgares on different sites such as volar skin, i.e., v…

Differential Diagnosis in Dermatopathology

Discussions

…The evidence for that is prominent compact orthokeratosis and hypergranulosis in virtually all lesions of lichen amyloidosis, signs incontrovertible of persistent, prolonged rubbing. Macular amyloidosis that has not been rubbed and, therefore, not th…

Histologic Diagnosis of Inflammatory Skin Diseases

Psoriasis

…qual lengths Suprapapillary plates thin slightly Wedge-shaped hypergranulosis, especially in infundibula Compact orthokeratosis Correlation clinicopathologic Papules of psoriasis are smooth when mounds of parakeratosis are covered by the original co…

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