Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Perivascular Dermatitis

…typical of phototoxic dermatitis and its lookalike, namely, a sunburn. Figure 5.172 A&B. A distinctive sign of injury from within the skin (interface dermatitis, vacuolar): necrotic keratocytes in the lower part of the epidermis especially. Ne…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

…often. Error: Civatte bodies, colloid bodies, hyaline bodies, sunburn cells, satellite cells, and apoptotic cells are something other than necrotic keratocytes. Reason: Each of those terms is synonymous with keratocytes that have undergone necrosis….

Differential Diagnosis in Dermatopathology

Discussions

…itis is like that of irritant contact dermatitis or of “sunburn.” Lesions vary from subtle erythema to large bullae that may resolve with changes that range from hyperpigmentation to ulceration and scars. Lesions are confined strictly to…

Histologic Diagnosis of Inflammatory Skin Diseases

Photoallergic dermatitis

…and telangiectases. Phototoxic reaction resembles a severe sunburn and is confined to sites exposed to ultraviolet light. Seborrheic dermatitis affects sites other than those exposed to ultraviolet light, e.g., the retroauricular, is scaly, and…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…oxic dermatitis The changes pictured are just like those of a sunburn. The position of the necrotic keratocytes, i.e., mostly in the upper part of the epidermis indicates that the injury to the skin came from outside it, rather than from within it. I…

Differential Diagnosis in Dermatopathology

Photoallergic dermatitis vs. Phototoxic dermatitis

An inflammatory process that expresses itself in the skin in protean ways that are variations on a basic pathologic theme, and includes evanescent patches on the face (“butterfly blush”), scaly papules and plaques that resolve with atrop…

Histologic Diagnosis of Inflammatory Skin Diseases

Miliaria crystallina

…esions Localized or widespread, especially at sites of recent sunburn Individual lesions Tense clear vesicles of relatively uniform size that resemble dewdrops in repose on otherwise normal skin Course Vesicles disappear within the few days that it t…

Histologic Diagnosis of Inflammatory Skin Diseases

Toxic shock syndrome

…ginning as patches that resemble those of scarlet fever or of sunburn and that soon peel with scales; plaques sometimes Course Fatal in some persons if untreated Variations clinical Signs and symptoms systemic include fever, disorientation, hypotensi…

Differential Diagnosis in Dermatopathology

Erythema multiforme vs. Graft-versus-host disease, acute phase

An inflammatory process that expresses itself in the skin in protean ways that are variations on a basic pathologic theme, and includes evanescent patches on the face (“butterfly blush”), scaly papules and plaques that resolve with atrop…