Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Subcutaneous Fat: Panniculitis

…fat, calling forth an infiltrate there, first of neutrophils (suppuration), then largely of histiocytes (granulomatous inflammation) (Fig. 5.399 A&B), and, last, of fibrocytes (fibrosis). Any one of a constellation of findings, or any combination…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…by rupture of an infundibular cyst. That event set in motion suppuration, then granulomatous inflammation, and later fibrosis, which is the finding dominant now. 10.38.4A: Pustular dermatitis, infundibular + 10.38.4B: Granulomatous inflamm…

Histologic Diagnosis of Inflammatory Skin Diseases

Applicable Terms

…joined by products of necrosis and degeneration, it is termed suppuration. The abscess most often recognizable clinically results from rupture of an infundibular cyst and the circumstance in which that develops most often is “cystic” acne…

Histologic Diagnosis of Inflammatory Skin Diseases

a-1 antitrypsin deficiency

…reticular dermis Patchy lobular panniculitis with extensive suppuration and granulomatous inflammation Large zones of fat necrosis in lobules of subcutaneous tissue Late Ulceration deep Fibrosis in the panniculus adiposus Correlation clinicopath…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

…y virtue of those organisms simply being present in a zone of suppuration; Pityrosporum and Demodex are commensals and, therefore, are findings expected in diseases that affect the infundibulum, and, therefore, rather than being conceived of as causa…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…and thrombi in lumen of them. In addition, there are signs of suppuration, ulceration, and scale-crust. This is but one of several cutaneous manifestations of Crohn’s disease, another being suppurative (infundibulitis) and still another granulo…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…magnification by identification of foreign bodies in zones of suppuration. Polarized light reveals the distinctive “Maltese cross” appearance of talc. 10.35.3A: Panniculitis, lobular and septal, suppurative + 10.35.3B: Large col…

Histologic Diagnosis of Inflammatory Skin Diseases

Foreign body reaction

…ure of an infundibular cyst. Findings histopathologic Early Suppuration around the foreign object Fully developed Granulomatous inflammation of suppurative, sarcoidal, tuberculoid, or palisaded type Foreign material in the dermis or in the subcu…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…lobular + 10.73.1B: Extensive granular fat necrosis with suppuration contiguous with it = Pancreatic panniculitis, early ┬áLipases released into the blood stream from a diseased pancreas induced the changes shown here. On the basis of findings hi…