Histologic Diagnosis of Inflammatory Skin Diseases

Images

…y + 10.63.29B: Edema of the papillary dermis, subepidermal fibrin, an epidermis thinned focally, and ortho- and parakeratosis = Lupus erythematosus, discoid  The prominent edema and the fibrin are unusual in discoid lupus erythematosus, but they…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vesicular Dermatitis

See Fig. 5.239 A-C. Figure 5.239 A-C. Patterns of vesiculation: intraepidermal, subepidermal, and intra- and subepidermal. “Blister” and “vesiculobullous” are terms generic for lesions of the skin that usually are elevated…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…thin nuclei in palisaded arrangement around a huge deposit of fibrin = Rheumatoid nodule  Neutrophils and nuclear “dust” of neutrophils scattered in the zone encircled by histiocytes in palisaded array, it being replete with fibrin, is t…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Nodular and Diffuse Dermatitis

…detectable of indubitable vasculitis of small vessels, to wit, fibrin in the wall of venules and/or thrombi within lumen of them. Signs of leukocytoclastic vasculitis in a nodular dermatitis, namely, fibrin in the wall of venules and nuclear “d…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…istiocytes in a palisade around deposits of mucin and hints of fibrin, as well as lymphocytes around venules = Granuloma annulare Mucin is detectable in sections stained by hematoxylin and eosin by its granular, lightly basophilic appearance. Fibrin

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

…artifactual character are recognizable morphologically. Error: Fibrinoid necrosis, fibrinoid degeneration, and fibrinoid are accurate characterizations of a particular finding by conventional microscopy. Reason: Fibrinoid simply is fibrin. Error: Fib…

Histologic Diagnosis of Inflammatory Skin Diseases

Applicable Terms

ABSCESS [L. abscessus (a going away)]: Clinically, a circumscribed collection of pus and histopathologically a localized collection of neutrophils. An abscess may form in the epidermis, both surface and infundibular, eccrine ducts, dermis, and subcu…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.35.1A: Nodular dermatitis, granulomatous and suppurative + 10.35.1B: Countless neutrophils in the interstitium + 10.35.1C + 10.35.1D = Factitious dermatitis Each focus of fibrin represents a site where a needle pene…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.102.1A: Perivascular and interstitial dermatitis, neutrophils mostly + 10.102.1B: Neutrophils accompanied by scant nuclear “dust” but by edema marked in the papillary dermis = Sweet’s syndrome  This can be judg…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…62.2A: Vasculitis, small-vessel, neutrophilic + 10.62.2B : Fibrin in the wall of some venules, thrombi in the lumen of others, and fibrin and thrombi together in still others; perivascular and interstitial infiltrate of neutrophils mostly = Lived…