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Differential Diagnosis in Dermatopathology

Pemphigus vulgaris vs. Grover’s disease, pemphigus vulgaris-like

…ory disease characterized by lesions with arcuate, annular, and serpiginous outlines and by collarettes of scale on the inner margin of lesions that extend outward in centrifugal fashion, disappearing in months as a rule in the absence of treatment….

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vasculitis

…ons, as well as characteristics of individual lesions, such as quality of scale, the least beneficial is color. The thorny issue of diagnosis of small- and large-vessel vasculitis should be less vexing when the following algorithm is employed:…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Pustular Dermatitis

…ture of them histopathologically, e.g., “collarettes of scale” are indicative of parakeratosis propelled into being by spongiosis and having been shed, leaving behind only a tiny bit of it at the periphery, “apple jelly nodules&#822…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…e, it could be that of acne vulgaris or of rosacea. Mounds of scale-crust at the lips of an infundibular ostium indicate that seborrheic dermatitis is concurrent in this patient. 10.37.8A: Peri-infundibulitis and perifolliculitis, granulomatous…

Histologic Diagnosis of Inflammatory Skin Diseases

"Folliculitis" (Infundibulitis)

…n of women. Seborrheic dermatitis is accompanied by mounds of scale-crust at the lips of infundibular ostia. Rosacea, and its variants, perioral and periocular dermatitis, is affiliated often with small nodular infiltrates, sometimes granulomatous, i…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Cutaneous T-cell Lymphoma?

…iolaceous, or orange; the patches may be surmounted by a fine scale. A somewhat irregular or notched border may help differentiate early CTCL from clinically similar benign dermatoses, as may a discrete area of uninvolved skin within a larger lesion…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…osinophilic pustular folliculitis/papular eruption of HIV The scale-crust is situated at a site where a pustule, housed at first in an infundibulum, had been scratched, a discrete ulcer marking that spot. The perivascular and interstitial infiltrate…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Colors Stereotypical for Diseases Specific?

…White lesions are rare excepting in exfoliative diseases, the scales of which are white. They usually result from loss of pigment. White spot disease, morphea, some of the idiopathic atrophies, syphilitic leucoderma, vitiligo, the peculiar whitish bl…

Histologic Diagnosis of Inflammatory Skin Diseases

Erythema marginatum

…esions that, at their periphery, are topped by collarettes of scale. Urticaria consists of evanescent edematous pink papules and/or plaques that usually are distributed widely and are pruritic. Findings histopathologic Fully developed Superficia…

Histologic Diagnosis of Inflammatory Skin Diseases

Pattern Analysis in Historical Perspective

…layer (e.g., parakeratosis in mounds that house neutrophils, scale-crusts, hyphae). In regard to blistering diseases, an algorithm that achieves its purpose of enabling diagnosis accurately and with specificity can lead off with “vesicular der…

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