Histologic Diagnosis of Inflammatory Skin Diseases

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

…embles the normal stratum corneum of a palm or sole Prominent hypergranulosis that resembles the normal stratum granulosum of a palm or sole Acanthosis Follicles (and sometimes sebaceous lobules) present in the section of tissue “Epidermal and…

Histologic Diagnosis of Inflammatory Skin Diseases

Graft-versus-host disease/Eruption of lymphocyte recovery

…atocytes scattered as solitary units throughout the epidermis Hypergranulosis, at least in foci Parakeratosis, focal or confluent, and sometimes compact orthokeratosis Late Infiltrate of lymphocytes and plasma cells around venules throughout the de…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…pidermal junction, many necrotic keratocytes, thin epidermis, hypergranulosis, and orthokeratosis = Drug eruption The differential diagnosis includes (1) atrophic lichen planus, but the infiltrate of lymphocytes is more dense than in the atrophic sta…

Differential Diagnosis in Dermatopathology

Lichen planus vs. Lichenoid secondary syphilis

Loss of hair attributable either to the effects of inflammatory cells on follicles or to physiological or mechanical factors in which inflammatory cells play no role. Although the scalp is the site most often affected, any region of the skin that be…

Differential Diagnosis in Dermatopathology

Atrophic lichen planus vs. Atrophic discoid lupus erythematosus

Loss of hair attributable either to the effects of inflammatory cells on follicles or to physiological or mechanical factors in which inflammatory cells play no role. Although the scalp is the site most often affected, any region of the skin that be…

Histologic Diagnosis of Inflammatory Skin Diseases

Atopic dermatitis

…hokeratosis like that seen normally on palms and soles Marked hypergranulosis like that seen normally on palms and soles Acanthosis Presence of follicles and, sometimes, sebaceous lobules in the section of tissue “Epidermal and dermal” t…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen planus-like keratosis

…times in association with foci in which the epidermis is thin Hypergranulosis in some foci and hypogranulosis in others Ortho- and parakeratosis to variable extent Residual solar lentigo obscured partially by infiltrates of lymphocytes or present, un…

Differential Diagnosis in Dermatopathology

Lichen planus vs. lichenoid drug eruption

Loss of hair attributable either to the effects of inflammatory cells on follicles or to physiological or mechanical factors in which inflammatory cells play no role. Although the scalp is the site most often affected, any region of the skin that be…