Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Nodular and Diffuse Dermatitis

…ure 5.211 A&B. Specific diagnosis of a diffuse dermatitis: xanthogranuloma. This dense diffuse dermatitis can be recognized as that of xanthogranuloma because it is composed of innumerable foamy histiocytes, many of which are multinucleate of Tou…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Histiocytoses?

…1. Papular 2. Generalized xanthelasma 3. Solitary and eruptive xanthogranuloma 4. Necrobiotic xanthogranuloma 5. Xanthoma disseminatum 6. Subcutaneous xanthomatosis B. Multicentric reticulohistiocytosis C. Generalized eruptive histiocytoma D. Nodular…

Differential Diagnosis in Dermatopathology

Discussions

…riterion for separating necrobiosis lipoidica from necrobiotic xanthogranuloma in sections from a superficial biopsy specimen is the ratio of granulomatous changes to connective tissue ones in the reticular dermis. In lipid-rich necrobiotic xanthogra…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…of collagen and extracellular deposits of lipid = Necrobiotic xanthogranuloma ¬†Necrobiosis lipoidica and necrobiotic xanthogranuloma have features in common, among them lymphoplasmacytic infiltrates, granulomatous inflammation, and degeneration of c…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Necrobiosis?

…frequently, the trunk and extremities. … Histologically, xanthogranulomatous features with hyaline necrosis or necrobiosis are present.” Burdick AE, Sanchez J, Elgart GW. Necrobiotic xanthogranuloma associated with a benign monoclonal ga…

Differential Diagnosis in Dermatopathology

Discussions

…stiocytic granuloma has all of the findings histopathologic of xanthogranuloma. Not surprisingly, some otherwise “stereotypical” examples of xanthogranuloma display some histiocytes with “ground glass” cytoplasm and, in revers…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

…atosus. Error: Reticulohistiocytic granuloma is different from xanthogranuloma. Reason: It is a variant of xanthogranuloma distinguished by a characteristic appearance cytopathologic, namely, the histiocytes, many of which are multinucleate, having a…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…nd a sprinkling of lymphocytes, eosinophils, and neutrophils = Xanthogranuloma, fully developed ¬†Early in its course, xanthogranuloma consists of a monomorphous infiltrate of histiocytes that are nearly devoid of foamy cytoplasm. When fully developed…

Histologic Diagnosis of Inflammatory Skin Diseases

Reticulohistiocytic granuloma

…of inflammatory cells. Differential diagnosis histopathologic Xanthogranuloma may be indistinguishable at times from reticulohistiocytic granuloma. In examples stereotypical of lesions of xanthogranuloma developed fully, however, histiocytes have ab…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Fibrosing Dermatitis

See Fig. 5.350 A&B. Figure 5.350 Fibrosing dermatitis. A. Early. B. Late (sclerosis). Fibrosing dermatitis (as well as fibrosing peri-infundibulitis/perifolliculitis and fibrosing panniculitis) results, in every instance, from injury to nonep…