Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Reactive Perforating Collagenosis?

…external injury, usually in the form of unrestrained intense excoriation. Most authors who have written about the subject of reactive perforating collagenosis emphasize how superficial is the trauma that induces the lesions. That assessment is belie…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen simplex chronicus/Prurigo nodularis/Picker’s nodule/Erosions/Ulcers

…laris (nodular lichenification) Erosions and ulcers (neurotic excoriations) Presentation stereotypical Age and sex Any age and both sexes Distribution of lesions Localized or widespread; predilection of lichen simplex chronicus for the back and side…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Fibrosing Dermatitis

…nails as they are employed like talons in the act of animated excoriation, those defects healing with a scar (Fig. 5.352 A&B). Injury also may be wrought by punctures, lacerations, burns of various kinds, and surgical procedures (Fig. 5.353), as…

Histologic Diagnosis of Inflammatory Skin Diseases

Atopic dermatitis

…ules, and fissures in plaques at times; hemorrhagic crusts of excoriations often are disposed in linear array Course Lesions subside when rubbing and scratching is stopped, otherwise they persist and new ones develop Variations clinical Infantile at…

Histologic Diagnosis of Inflammatory Skin Diseases

Reactive perforating collagenosis

…a response to severe trauma external, usually in the form of excoriation furiously, in which bundles of degenerated collagen are gouged and become housed temporarily in a crust atop an ulcer. The changes histopathologic are indicative of severe inju…

Histologic Diagnosis of Inflammatory Skin Diseases

Selection of the Site

…uritic, scratching is an inevitable consequence, and signs of excoriation are nearly invariable. Excoriation produces erosions, ulcerations, and crusts, and, sometimes, is followed by evidences of impetiginization. Ulcers may heal with scar. Clinicia…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Primary and Secondary Lesions?

…by contrast, are said to be scales, crusts, erosions, ulcers, excoriations, lichenification, and fissures. Regrettably, the concept of primary and secondary lesions is flawed beyond redemption. All so-called primary lesions of the skin can be induced…

Histologic Diagnosis of Inflammatory Skin Diseases

Macular and papular (lichenoid) amyloidosis-Cutaneous solely

…ar inflammatory disease on which is imposed signs dramatic of excoriation furious. Effects of excoriation alone are not affiliated with a net-like or rippled pattern; either is lichen simplex chronicus alone. Miscue clinical as clue to diagnosis hist…

Histologic Diagnosis of Inflammatory Skin Diseases

Study By Disease

…t rubbing (lichen simplex chronicus) and vigorous scratching (excoriations)] (Quiz #578) Allergic contact dermatitis, long-standing, rubbed and scratched (Quiz #559) Alopecia Universalis (Quiz #7) Amalgam tattoo (Quiz #853) Anaplastic large-cell lymp…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…icles can be seen at the sides of an ulcer that resulted from excoriation animatedly of the pruritic lesion. 10.5.10A: Vesicular dermatitis, intraepidermal, spongiotic and ballooned + 10.5.10B: Many eosinophils in a circumscribed intraepide…