Histologic Diagnosis of Inflammatory Skin Diseases

Images

…the dermoepidermal junction and in the epidermis, spongiosis, ballooning, pallor across viable epidermis, and scale-crusts = Mucha-Habermann disease, acute ¬†All the changes pictured have occurred beneath the original normal cornified layer, an indica…

Histologic Diagnosis of Inflammatory Skin Diseases

Hand-foot-and-mouth disease

…es mostly Slight edema of the papillary dermis Spongiosis and ballooning in the spinous zone of the epidermis Fully developed All the findings of early lesions plus: Ballooning vesiculation accompanied by marked reticular alteration Intraepidermal…

Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

…all of venules = Leukocytoclastic vasculitis     Ballooning Marked intracellular edema of keratocytes that may result in a netlike pattern of epidermis necrotic invariably. Click image to enlarge. + Individual necrotic keratocytes…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…e often, however, necrosis of the epidermis follows on severe ballooning and reticular alteration that are accompaniments of an intraepidermal vesicle. 10.99.3A: Vasculitis, small vessel, neutrophilic + 10.99.3B: Perivascular and interstiti…

Histologic Diagnosis of Inflammatory Skin Diseases

Erythema multiforme

…r part of the infundibular epidermis and eccrine ducts Slight ballooning of keratocytes and spongiosis Cornified layer maintains its normal basket-weave configuration Eosinophils usually absent or sparse Fully developed Vesicles and bullae, all the…

Differential Diagnosis in Dermatopathology

Photoallergic dermatitis vs. Phototoxic dermatitis

Papules, nodules, vesicles, and sometimes bullae that develop in response to “bites” of arthropods, among the most common offenders being mosquitoes, bedbugs, and mites of scabies….

Histologic Diagnosis of Inflammatory Skin Diseases

Prurigo pigmentosa

…ecrotic keratocytes disposed as solitary units Spongiosis and ballooning Intraepidermal and subepidermal vesiculation Reticular alteration and necrosis en masse in foci Collections of neutrophils often found beneath a normal cornified layer with a ba…

Histologic Diagnosis of Inflammatory Skin Diseases

Burns

…., neutrophils, scant or absent Edema of the papillary dermis Ballooning of epidermal keratocytes Individual necrotic keratocytes in the epidermis Fully developed Sparse perivascular infiltrate of lymphocytes and interstitial infiltrate of neutroph…

Histologic Diagnosis of Inflammatory Skin Diseases

Pellagra

…at results from inadequate intake of dietary protein. Comment Ballooning of keratocytes in linear fashion across the entire front of the upper part of the spinous and granular zones is an aspect distinctive of pellagra, necrolytic migratory erythema,…