Histologic Diagnosis of Inflammatory Skin Diseases

Necrobiosis lipoidica

…ls in the middle and lower part of the dermis Degeneration of collagen bundles in the vicinity of thrombosed vessels Necrosis of some epithelial structures of adnexa and of inflammatory cells in the vicinity of thrombosed vessels Fully developed Su…

Histologic Diagnosis of Inflammatory Skin Diseases

Suggested Readings

…uggiero F, et al. Laminin 5 binds the NC-1 domain of type VII collagen. J Cell Biol 1997;138:719-728. Sakuntabhai A, Burge S, Monk S, Hovnanian A. Spectrum of novel ATP2A2 mutations in patients with Darier”s disease. Hum Mol Genet 1999;8:1611-1…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…dibular and eccrine ductal keratocytes, and coarse bundles of collagen in vertical streaks = Lichen simplex chronicus (“epidermal and dermal” type) These changes were brought about entirely by force external, i.e., rubbing the skin with v…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…cytes, and epithelioid histiocytes splayed between bundles of collagen in the reticular dermis + 11.14.16C + 11.14.16D = Mycosis fungoides, plaque, granulomatous ┬áThis distinctive “interstitial” expression of mycosis fungoide…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen sclerosus et atrophicus

…obscuring the dermoepidermal junction Markedly altered, pale collagen in the papillary dermis resembling extensive edema of the papillary dermis Rete ridges decreased in length Epidermis thinned Cornified layer compactly orthokeratotic Fully develo…

Histologic Diagnosis of Inflammatory Skin Diseases

Cells That Mediate Inflammation (Inflammatory Cells)

…efinition do not contain peroxidase, but house, among others, collagenase, alkaline phosphatase, leukocyte adhesion molecules, and bactericidal enzymes such as lysozymes. Either type of granule may fuse with phagocytic vacuoles called phagosomes, and…

Differential Diagnosis in Dermatopathology

Discussions

…evelopment, i.e., prior to the appearance of thick bundles of collagen. When distinct, brightly eosinophilic, thick bundles of collagen are arrayed haphazardly in a lesion made up entirely of fibroplasia, the diagnosis, by convention, is keloid. No s…

Histologic Diagnosis of Inflammatory Skin Diseases

Keloid

…, an increased number of fibrocytes and fibrillary bundles of collagen seemingly in haphazard array Fully developed Numerous thick, brightly eosinophilic bundles of collagen arranged in vaguely labyrinthine fashion Plump fibrocytes paralleling the…

Histologic Diagnosis of Inflammatory Skin Diseases

Mycosis fungoides

…cytes in a papillary dermis thickened also by wiry bundles of collagen in haphazard array Loss of the usual undulate pattern between dermal papillae and of epidermal rete ridges Lymphocytes disposed as solitary units within the basal layer of the epi…