Histologic Diagnosis of Inflammatory Skin Diseases

Erythema marginatum

Erythema marginatum Synonyms Erythema marginatum rheumaticum Erythema annulare rheumaticum Presentation stereotypical Age and sex Children of both sexes who have rheumatic fever with carditis; rarely in adults Distribution of lesions Localized, es…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Cutaneous T-cell Lymphoma?

“There has been a tendency in recent years to phase out the term ‘mycosis fungoides’ and replace it with peripheral cutaneous T-cell lymphoma (CTCL).” Santa Cruz DJ, Hurt MA. Neoplasms of the skin. In: Sternberg SS, ed. Dia…

Differential Diagnosis in Dermatopathology

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

A blistering inflammatory disease in which acantholysis occurs in the upper part of the spinous zone or granular zone of the epidermis, the result of the process being flaccid blisters that give way to erosions and crusts accompanied by erythema. Wh…

Histologic Diagnosis of Inflammatory Skin Diseases

Pattern Analysis in Historical Perspective

In 1963, the year that one of us (A.B.A.) began a residency in dermatology, Walter Lever’s textbook, Histopathology of the Skin, was in its third edition and was deemed, universally, to be “the bible” of dermatopathology. To a firs…

Clinical Case Studies

Extensive Actinic Damage

INITIAL PRESENTATION A 67-year-old Caucasian male presented with severe photodamage of his face and scalp and a history of multiple nonmelanoma skin cancers. (Figure 1) The patient had been treated with radiation for adolescent acne vulgaris. One ye…

Clinical Case Studies

Palmar Pustulosis

INITIAL PRESENTATION A 67-year-old otherwise healthy Filipino male with a history of episodic “scaling palms” presented with a bilaterally symmetric palmar pustular eruption that was unresponsive to oral antibiotics. The lesions started…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Pustular Dermatitis

See Fig. 5.307 A&B. Figure 5.307 Pustular dermatitis. A. Infundibular. B. Surface epidermal. Although most pustules in skin are housed in infundibular epidermis (Fig. 5.308 A&B), many are lodged in surface epidermis (Fig. 5.309 A&B)….

Differential Diagnosis in Dermatopathology

Psoriasis vs. Nummular dermatitis

A blistering inflammatory disease in which acantholysis occurs in the upper part of the spinous zone or granular zone of the epidermis, the result of the process being flaccid blisters that give way to erosions and crusts accompanied by erythema. Wh…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

Psoriasis Nummular Dermatitis 1. Confluent parakeratosis 1. Focal scale-crust 2. Granular zone mostly absent 2. Granular zone mostly present 3. Psoriasiform acanthosis with rete ridges of even length; some rete ridges thinned and some of th…

Histologic Diagnosis of Inflammatory Skin Diseases

Fixed drug eruption

Fixed drug eruption Synonyms Fixed toxic exanthem Presentation stereotypical Age and sex Adults of both sexes Distribution of lesions Lips, genital region, and limbs especially Configuration of lesions Round Arrangement of lesions Solitary or few, d…