Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vasculitis

…inflammatory cell that predominates in the infiltrate, i.e., neutrophils or lymphocytes. Small-vessel vasculitis that involves venules is incomparably more common than that which affects arterioles, and small-vessel vasculitis in which neutrophils d…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Pustular Dermatitis

…e situated in infundibular epidermis or in surface epidermis, neutrophils that compose it emerge from capillaries of the superficial plexus and from them migrate to, and through, epidermal epithelium. It is inaccurate, therefore, to characterize a pu…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Nodular and Diffuse Dermatitis

…s and/or plasma cells (Fig. 5.179 A&B) and, episodically, neutrophils mostly. On occasion a nodular dermatitis (or panniculitis) may consist of but a single large nodule made up of neutrophils almost exclusively (an abscess) (Fig. 5.180 A&B)…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…cular and interstitial dermatitis + 10.63.14B: Scatter of neutrophils and nuclear “dust” of neutrophils in the upper part of the dermis, edema of the papillary dermis, and a smudged appearance, in foci, of the dermoepidermal junction…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.88.1A: Perivascular dermatitis, neutrophils predominant + 10.88.1B: Neutrophils in edematous dermal papillae = Prurigo pigmentosa  Findings similar to these may be seen in dermatitis herpetiformis at a very early stage of the pr…

Histologic Diagnosis of Inflammatory Skin Diseases

Dermatitis herpetiformis

…filtrate of lymphocytes mostly and interstitial infiltrate of neutrophils mostly Edema of the papillary dermis Neutrophils, nuclear bands of neutrophils, and nuclear “dust” of neutrophils in linear array immediately beneath the dermoepide…

Histologic Diagnosis of Inflammatory Skin Diseases

"Folliculitis" (Infundibulitis)

…s) are infundibulitides in which eosinophils predominate over neutrophils in the infundibula and the contiguous dermis. Non-infectious infundibulitis: spongiotic Disseminate and recurrent infundibulofolliculitis consists of pinpoint papules in youn…

Histologic Diagnosis of Inflammatory Skin Diseases

Fixed drug eruption

…l mixed-cell infiltrate of lymphocytes around venules mostly; neutrophils and eosinophils scattered interstitially especially Edema of the papillary dermis Lymphocytes in company with neutrophils and/or eosinophils sprinkled along the dermoepidermal…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…um, bacteria, sebum, squames, and cornified cells, as well as neutrophils of a suppurative infundibulitis are sent flying into the dermis on rupture of the infundibulum, the result being suppurative peri-infundibulitis in addition to infundibulitis….

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…s 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 judged to…