Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Perivascular Dermatitis

…e inflammatory cells then being insinuated between bundles of collagen. When, at scanning magnification, a superficial and deep perivascular infiltrate of lymphocytes is decidedly “bottom heavy,” it is likely to be a manifestation of a ly…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Acquired Epidermolysis Bullosa?

…gly suggest that autoantibodies that recognize human type VII collagen in EBA [epidermolysis bullosa acquisita] are pathogenic. This murine model, with features similar to the clinical, histological, and immunological features of EBA, will be useful…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Necrobiosis?

…ecise word, referring to homogenization or smudging of dermal collagen. …The necrobiotic area contains prominent mucin in granuloma annulare, fibrin in rheumatoid nodule, and degenerated collagen in necrobiosis lipoidica.” Warschaw KE, C…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Sclerotic Fibroma?

…racterized by an organized pattern of interwoven fascicles of collagen bundles with a laminated or tortuous appearance, embedded in abundant mucin. A number of fibromas showed striking hyalinization; these may represent a second microscopic hallmark…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Reactive Perforating Collagenosis?

…Mehregan AH, Schwartz OD, Livingood CS. Reactive perforating collagenosis. Arch Dermatol 1967;96:277–82. “Reactive perforating collagenosis (RPC) is a rare disorder characterized by the transepidermal elimination of altered collagen. T…

Differential Diagnosis in Dermatopathology

Keloid vs. Hypertrophic scar

…n hardening of the skin by virtue of thickening of bundles of collagen in the dermis and subcutis. One of those diseases manifests itself as localized or widespread patches and plaques (morphea) and by localized linear lesions (linear scleroderma), w…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…stiocytes in palisaded array around large foci of degenerated collagen in the reticular dermis + 10.67.1C + 10.67.1D = Necrobiosis lipoidica¬†Vasculitis, as can be seen in a fibrous septum, probably is common to all lesions of necrobiosis…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…tanding inflammatory process, i.e., before any alterations in collagen bundles have become recognizable. When, after years, the process nears completion, no infiltrate of inflammatory cells remains, only bundles of collagen that are crowded and thick…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…sing dermatitis + 10.54.1B: Markedly thickened bundles of collagen accompanied by plump fibrocytes, both of them in haphazard array = Keloid In the evolution of a keloid, the thick collagen bundles shown follow on formation of fibrillary collagen