Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vesicular Dermatitis

…d layer is recognized to be psoriasis because mounds of scale-crust, some them containing neutrophils, are staggered in periodic fashion diagnostic of psoriasis (Fig. 5.262 A&B). Yet another pitfall is posed by vesiculopustular lesions of psorias…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…+ 10.2.1B: Slight edema of the papillary dermis and scale-crust = Nummular dermatitis ¬†Changes such as these are indistinguishable from those of allergic contact dermatitis. The psoriasiform acanthosis is more than usually is seen in pityriasis r…

Dermatology Practical & Conceptual

Saved by step sections: an unusual presentation of basal cell carcinoma

…2A, 2B, 2C) showed a well-demarcated area of ulceration with crust. Adjacent epidermis depicted irregular acanthosis and prominent spongiosis with inflammatory cells in exocytosis; superficial and mid-dermis presented a dense inflammatory infiltrate…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Reactive Perforating Collagenosis?

…ace, where they reside temporarily in a neutrophil-containing crust atop an ulcer. In sections stained by hematoxylin and eosin, degenerated bundles of collagen appear blue rather than the usual red, and are found not only in the upper part of the de…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…dermatitis, psoriasiform + 10.22.2B: Neutrophils in scale-crust and hyphae in the original cornified layer situated above the scale-crust = Dermatophytosis Infection by superficial fungi may simulate psoriasis, as is the case here, the crucial at…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…chenoid + 10.25.4B: Predominance of lymphocytes and scale-crust atop an erosion = Lichenoid drug eruption Even at scanning magnification, a determination can be made that the diagnosis is not lichen planus, the evidence against it being the focus…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…te ridges of about equal length, marked spongiosis, and scale-crusts arrayed in staggered fashion = Psoriasis, fully developed ¬†On volar skin, psoriasis often is associated with prominent spongiosis and, sometimes, spongiotic vesicles that release la…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Primary and Secondary Lesions?

…ullae. Secondary lesions, by contrast, are said to be scales, crusts, erosions, ulcers, excoriations, lichenification, and fissures. Regrettably, the concept of primary and secondary lesions is flawed beyond redemption. All so-called primary lesions…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…va = Scabies Even at low magnification, an ulcer covered by a crust rich in neutrophils, an evidence of excoriation vigorously, is apparent. Also discernible at low power is a “flame figure” that resides in the upper half of the dermis an…