Histologic Diagnosis of Inflammatory Skin Diseases

Applicable Terms

…annulare centrifugum, and pityriasis alba, do not progress to vesicles. Practically never does spongiosis in mycosis fungoides culminate in a vesicle. Figure 3.35 Spongiosis (intercellular edema). SUPPURATION [L. suppurare (under) + pus (pus)]: F…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.19.1A: Perivascular and interstitial dermatitis + 10.19.1B: Neutrophils and nuclear “dust” at the tip of edematous dermal papillae, obscuration of the junction by inflammatory cells, and hints of subepidermal fibrin…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vasculitis

…ssions clinical of that vasculitis. Figure 5.231 A&B. A vesicle in leukocytoclastic vasculitis. This vesicle of leukocytoclastic vasculitis began intraepidermal consequent to extraordinary ballooning of keratocytes and ended subepidermal as a…

Histologic Diagnosis of Inflammatory Skin Diseases

Hand-foot-and-mouth disease

…leate and multinucleate cells. Explosion of the intraepidermal vesicle results in formation of a subepidermal vesicle. Rarely is an intact blister of hand-foot-and-mouth disease encountered in the oral cavity. Almost always, by the time a patient see…

Histologic Diagnosis of Inflammatory Skin Diseases

Selection of the Site

Because many inflammatory diseases of the skin, e.g., dermatitis herpetiformis, nummular dermatitis, scabies, Grover’s disease, and eosinophilic folliculitis, are exquisitely pruritic, scratching is an inevitable consequence, and signs of exco…

Histologic Diagnosis of Inflammatory Skin Diseases

Mucha-Habermann disease

…ompanied by reticular alteration; rupture of an intraepidermal vesicle resulting in a subepidermal vesicle Marked pallor at times in the upper part of the epidermis Mounds of parakeratosis and/or scale-crusts usually housing neutrophils Late All th…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen planus

…en beneath a subepidermal blister of lichen planus because the vesicle is the result of acceleration remarkably of the fundamental process pathologic of lichen planus. The lesion evolves so fast from macule to vesicle that the papular stage of the di…

Histologic Diagnosis of Inflammatory Skin Diseases

Confusing Terms (to be Avoided Scrupulously)

…ion” only for a spongiotic dermatitis manifested by tiny vesicles on the hands of patients who have florid dermatophytosis at another site, usually the feet, or for an analogue of that phenomenon such as widespread vesicles that appear subseque…

Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

In this section, algorithms used to reach specific diagnosis are predicated on “nonspecific” findings recognized best at higher magnification. Other changes requisite for specific diagnoses, i.e., denominators that are essential, then ar…