Therapeutic Strategies in Dermatology

Actinic Keratosis (a.k.a. Solar Keratosis): Clinical Cases

…lesions on the dorsal hands She reports increasing scale and crusting of the lesions, noting that the crusting sloughs intermittently (but then recurs) No prior history of skin cancer History of extensive sun exposure during her youth and early adul…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Perivascular Dermatitis

…uteness. Eruptive psoriasis, characterized by mounds of scale-crust that house neutrophils at the summit of them, is affiliated, consistently, with erythrocytes extravasated in the upper part of the dermis and, often, in the epidermis. Figure 5.38…

Histologic Diagnosis of Inflammatory Skin Diseases

Applicable Terms

…of corticosteroids systemically or by application topically. CRUST [L. crusta (crust)]: A collection of serum that contains white blood cells, red blood cells, or both (Fig. 3.12). The honey-colored crusts of impetigo consist of serum and leukocytes…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ngiotic + 10.98.1B: Predominance of lymphocytes and scale-crusts at lips of infundibular ostia = Seborrheic dermatitis ¬†Mounds of scale-crust at lips of infundibular ostia are an important clue to diagnosis of seborrheic dermatitis. Spongiosis in…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…cratching (erosion and ulceration). 10.23.9A: Ulcer and crust, well circumscribed + 10.23.9B: Degeneration of bundles of collagen both in the upper part of the dermis and in a huge scale-crust that houses countless neutrophils = Response to…

Histologic Diagnosis of Inflammatory Skin Diseases

Arthropod assaults

…ons Papules, papulovesicles, vesicles, and, at times, bullae; crusts form consequent to resolution of vesicles and/or the effects of excoriation Course Usually resolve without treatment in a matter of a few weeks Variations clinical Vesicles and bul…

Histologic Diagnosis of Inflammatory Skin Diseases

Reactive perforating collagenosis

…May be linear Individual lesions Ulcerated papules topped by crusts Course Dependent on whether or not the trauma external continues; lesions heal with scar if the trauma ceases, but persist if it does not Differential diagnosis clinical Perforatin…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…d granular zones, acantholytic parakeratotic cells, and scale-crust = Grover’s disease The presence of many eosinophils in the papillary dermis indicates that this lesion must have been exceedingly pruritic. A nearly direct relationship exists…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…giosis, ballooning, pallor across viable epidermis, and scale-crusts = Mucha-Habermann disease, acute ¬†All the changes pictured have occurred beneath the original normal cornified layer, an indication that this process is of very recent onset. Other…