Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Perivascular Dermatitis

…oined by epithelioid histiocytes insinuated between bundles of collagen in the reticular dermis is characteristic of granuloma annulare. Figure 5.34 A&B. Diagnosis with specificity. Fibrocytes splayed between collagen bundles throughout the re…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Acquired Epidermolysis Bullosa?

…has the same distribution as the carboxy terminus of type VII collagen.” The antigen of acquired epidermolysis bullosa subsequently was found to be the NC–1 domain of collagen type VII. The discovery of this antigen, however, did not pro…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Necrobiosis?

…recise 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,…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Sclerotic Fibroma?

…gated fibrocytes positioned as solitary units among bundles of collagen, whereas the other lesion showed a proliferation of plump fibrocytes among bundles of collagen. Some giant cells resembled the “monster” cells encountered episodicall…

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….

Differential Diagnosis in Dermatopathology

Keloid vs. Hypertrophic scar

A generic term for at least two different inflammatory diseases that have in common 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 pa…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…tinucleate, in a palisade around thickened, crowded bundles of collagen in the reticular dermis = Necrobiosis lipoidica¬†Early in the course of this disease, collagen bundles in the center of palisades of histiocytes shown signs of degeneration. Later…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…standing 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 thic…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…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 col…