Histologic Diagnosis of Inflammatory Skin Diseases

Necrobiosis lipoidica

A granulomatous inflammatory process characterized clinically by patches that become yellowish plaques and that in time resolve with atrophy and telangiectases. The condition usually occurs in persons with diabetes….

Therapeutic Strategies in Dermatology

Granuloma Annulare: Key Points

Key Points Granuloma annulare is a reactive inflammatory skin condition, which commonly presents as annular pink, erythematous thin plaques on the distal extremities. Granuloma annulare usually presents as localized disease, generalized plaques or…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…in the reticular dermis + 10.67.1C + 10.67.1D = Necrobiosis lipoidica¬†Vasculitis, as can be seen in a fibrous septum, probably is common to all lesions of necrobiosis lipoidica at an early stage of that process, seemingly being fundamen…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Subcutaneous Fat: Panniculitis

…“septal” panniculitis, namely, erythema nodosum, necrobiosis lipoidica, and morphea in its many expressions, from linear scleroderma to fasciitis with eosinophils. In some instances, e.g., in exceptional, fully developed lesions of eryth…

Differential Diagnosis in Dermatopathology

Discussions

Necrobiosis lipoidica (diabeticorum) and necrobiotic xanthogranuloma are granulomatous diseases marked by widespread changes in the dermis and the panniculus adiposus. The processes pathologic spare the upper part of the dermis and may extend as dee…

Histologic Diagnosis of Inflammatory Skin Diseases

Confusing Terms (to be Avoided Scrupulously)

…ces, therefore, to refer simply to abscess, vesicle, or cyst. NECROBIOSIS [Gk. nekros (dead body) + bios (life)]: Nonspecific connective tissue alterations, different in kind from one another, associated with various palisaded granulomatous inflammat…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Fibrosing Dermatitis

…thema elevatum diutinum, acrodermatitis chronica atrophicans, necrobiosis lipoidica (Fig. 3.359 A&B), and morphea (Fig. 5.360 A&B). At a late stage in the life of a lesion of necrobiosis lipoidica, collagen bundles may be thickened and crowde…

Differential Diagnosis in Dermatopathology

Discussions

Granuloma annulare and necrobiosis lipoidica are characterized by palisaded (and sometimes interstitial) granulomatous dermatitis, associated with superficial and deep perivascular infiltrates of mononuclear cells, and some degeneration of bundles o…

Histologic Diagnosis of Inflammatory Skin Diseases

Necrobiotic xanthogranuloma

…esions that eventually become stationary and do not ulcerate. Necrobiosis lipoidica rarely affects the face. Findings histopathologic Fully developed Superficial and deep perivascular lymphoplasmacytic infiltrate; lymphocytes and plasma cells also…

Histologic Diagnosis of Inflammatory Skin Diseases

Limitations of the Algorithmic Method

…exceptions to that general rule are morphea (see Fig. 5.32), necrobiosis lipoidica, and interstitial granulomatous dermatitis with arthritis, many examples of those three conditions being “bottom heavy,” consisting as they do of pannicul…