Histologic Diagnosis of Inflammatory Skin Diseases

Hair Follicles

…site crucial to a follicle biologically, namely, artifactual clefts that form between an inner sheath about to cornify and a hair about to do the same. Although the process of keratinization proceeds apace in the pyriform bulb of a follicle, complet…

Histologic Diagnosis of Inflammatory Skin Diseases

Langerhans’ Cells

…cells are seen to be separated from adjacent keratocytes by a cleft, just as melanocytes are separated from keratocytes by a space, a finding that for more than a century caused them to be interpreted incorrectly as “high-level melanocytes.&#82…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Perivascular Dermatitis

…on of Grover’s disease, typified by a tiny suprabasilar cleft above which are incipient acantholytic cells, must have been maddeningly pruritic because the ulcer covered by crust shown here is evidence of scratching furiously. Figure 5.161 A…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

…s without a wedge episodic and not in repeatable pattern 3. Cleft between atrophic epidermis and dermis common 3. Cleft between atrophic epidermis and dermis uncommon 4. No thickened epidermal basement membrane 4. Thickened epidermal (surface and…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…atricial pemphigoid. A clue to the diagnosis is the prominent cleft between infundibular epidermis and adjacent dermis. 10.13.2A: Vesicular dermatitis, subepidermal, neutrophils predominant + 10.13.2B: The blister positioned between infundi…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen planus

…s). A distinction must be made between subepidermal spaces or clefts (Max Joseph spaces) that tend to form in sections of specimens removed from papules of conventional lichen planus and blisters that appear in the uncommon vesicular (“bullous&…

Differential Diagnosis in Dermatopathology

Atrophic lichen planus vs. Atrophic discoid lupus erythematosus

A genetically determined disorder in which numerous closely set keratotic papules are present on the skin, especially the trunk, in nail units, and on mucous membranes, particularly the palate, but also rarely in other parts of the gastrointestinal…