Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vesicular Dermatitis

…extensive ballooning or those that have become acantholytic; necrosis of severely ballooned keratocytes and of acantholytic keratocytes is a certainty, unlike the situation for keratocytes caught up in extensive spongiosis. When a tense spongiotic v…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Subcutaneous Fat: Panniculitis

…and granulomatous inflammation associated with membranous fat necrosis and fibrosis are present in the center of those trabeculae. Figure 5.391 A&B. A distinctive septal panniculitis: morphea. The fenestrated pattern formed by widened septa an…

Histologic Diagnosis of Inflammatory Skin Diseases

Poststeroid panniculitis

…en of both sexes, in contrast to newborns in subcutaneous fat necrosis. Distribution of lesions Cheeks, arms, and trunk Arrangement of lesions Scattered Individual lesions Plaques and nodules Differential diagnosis clinical Erythema nodosum present…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

…lagen, is responsible for anetoderma. Error: Apoptosis is not necrosis. Reason: In classic Virchowian pathology, necrosis is characterized cytopathologically by three signs, namely, pyknosis, karyorrhexis, and karyolysis; apoptosis is typified by pyk…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…atitis, spongiotic and psoriasiform + 10.23.7B: Confluent necrosis with a ragged base in the upper part of the viable epidermis = Response to excoriation The character of the necrosis in the upper part of the epidermis is a sure sign of a reactio…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Necrobiosis?

…gradual decay and death, a dissolution we might almost say, a necrosis.” Virchow R. Activity and irritability of cellular elements. Cellular Pathology. London, England: John Churchill, 1860:318. “Necrobiosis: The death of cells or tissu…

Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

…an epidermis devoid of rete ridges = Blister above a scar + Necrosis of epithelial structures of adnexa, especially sweat glands and ducts = Blister due to hypoxemia and local pressure + Strikingly elongated thin nuclei of epidermal keratocytes o…

Histologic Diagnosis of Inflammatory Skin Diseases

Sclerema neonatorum

…eks of life. Differential diagnosis clinical Subcutaneous fat necrosis of the newborn is associated with lesions that remain localized, affected neonates enjoying a favorable prognosis, i.e., lesions resolve without treatment. Findings histopathologi…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Necrotizing Vasculitis?

…which the fully developed stage is characterized by fibrinoid necrosis and inflammation involving all three layers of vessel walls. Five distinct types of lesions of this nature are now recognized and can be differentiated morphologically and clinica…