Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

…lar dermis and lymphocytes around venules = Cellulitis, e.g., erysipelas + Neutrophils and nuclear “dust” of neutrophils in a nodular infiltrate = Sweet”s syndrome + Atypical mononuclear cells in a dense diffuse infiltrate = Leu…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Perivascular Dermatitis

…the interstitium), which is very common, for most examples of erysipelas (a phlegmonous dermatitis), which is uncommon, and in all examples of evolving cutis laxa (Fig. 5.31 A&B) (in which the polymorphonuclear leukocytes are aligned along elasti…

Histologic Diagnosis of Inflammatory Skin Diseases

Arthropod assaults

…hous light eruption, dermatophytosis, Sweet’s syndrome, erysipelas, and several other “acute” inflammatory conditions that are either devoid of eosinophils or sport relatively few of them. An infiltrate of inflammatory cells in the…

Histologic Diagnosis of Inflammatory Skin Diseases

Lymphedema

…gical resection of them for the purpose of staging of cancer. Erysipelas that relapses repeatedly is one cause of chronic lymphedema Comment Lymphedema, if longstanding, is replaced invariably by fibrosis. The scar that develops in chronic lymphedem…

Histologic Diagnosis of Inflammatory Skin Diseases

The Algorithmic Method

…infundibulum has been breached (see Fig. 5.313), urtica, and erysipelas. When eosinophils predominate in the interstitium, the leading cause is the “bite” of an insect, but other possibilities range from pruritic urticarial papules and p…

Histologic Diagnosis of Inflammatory Skin Diseases

Study By Disease

…ruptive capillary hemangioma (pyogenic granuloma) (Quiz #887) Erysipelas (Quiz #38) Erysipelas (Quiz #251) Erythema annular centrifugum (Quiz #505) Erythema annulare centrifugum (Quiz #56) Erythema annulare centrifugum (Quiz #212) Erythema annulare c…

Histologic Diagnosis of Inflammatory Skin Diseases

Thrombophlebitis

…eriosclerosis of young men who smoke cigarettes inordinately. Erysipelas manifests itself as a plaque associated at times with vesicles, rather than as a cord. Findings histopathologic Early Neutrophils in the wall of a large vein in the subcutaneo…

Histologic Diagnosis of Inflammatory Skin Diseases

Cells That Mediate Inflammation (Inflammatory Cells)

…Examples are the perivascular and interstitial dermatitis of erysipelas induced by streptococci, the nodular dermatitis formed by abscesses consequent to staphylococcal infundibulitis, the vesiculopustular dermatitis associated with impetigo occasio…

Histologic Diagnosis of Inflammatory Skin Diseases

Applicable Terms

…y displaying sparse polymorphs in diffuse distribution, as in erysipelas, rather than a dense discrete collection of them. PLAQUE [Fr. plaque (flat disc)]: An elevated, broad, i.e., more than 1.0 cm in diameter, lesion (Fig. 3.27). A plaque of psoria…

Histologic Diagnosis of Inflammatory Skin Diseases

Acrodermatitis chronica atrophicans

…s hardly ever are confined to the distal part of extremities. Erysipelas is warmer than the adjacent skin and painful, too. Findings histopathologic Early Sparse superficial perivascular infiltrate of lymphocytes and plasma cells Interstitial infil…