Histologic Diagnosis of Inflammatory Skin Diseases

Leprosy

Leprosy Synonyms Hansen’s disease Lepra Presentation stereotypical Age and sex Young adults of both sexes who live in endemic areas Distribution of lesions Localized in indeterminate and tuberculoid types; widespread and symmetrical in lepro…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Eosinophilic Cellulitis (Wells’ Syndrome)?

…ified a lesion as being eosinophilic cellulitis were edema and diffuse infiltration of the dermis with eosinophils and histiocytes in conjunction with flame figures. Apart from blood eosinophilia, the patients had no notable systemic signs or symptom…

Histologic Diagnosis of Inflammatory Skin Diseases

Erythema nodosum leprosum

…e, clinically, of painful and tender nodules in a patient with diffuse or nodular lepromatous leprosy, whereas a diagnosis of Lucio’s phenomenon is established clinically on the basis of hemorrhagic infarcts in a patient with diffuse lepromatou…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Scleroderma?

…(en coup de sabre and facial hemiatrophy) Both cutaneous and systemic Progressive systemic sclerosis Diffuse systemic sclerosis CREST syndrome Chemically induced, e.g., l-tryptophan-related eosinophilia-myalgia syndrome, toxic oil syndrome, exposu…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.17.1A: Nodular dermatitis, granulomatous + 10.17.1B: Collections of histiocytes enveloped by lymphocytes and plasma cells, and brown spores in a multinucleate macrophage = Chromomycosis In a fully developed lesion o…

Histologic Diagnosis of Inflammatory Skin Diseases

Urticaria pigmentosa

…tases; Darier’s sign can be induced by vigorous rubbing. Diffuse mastocytosis is manifested as thickened, leathery, yellowish skin, whose folds are exaggerated. Systemic mastocytosis involves internal organs by infiltrates of mast cells. Mast c…

Histologic Diagnosis of Inflammatory Skin Diseases

Rheumatoid neutrophilic dermatitis

Rheumatoid neutrophilic dermatitis Presentation stereotypical Age and sex Adults of both sexes with severe rheumatoid arthritis Distribution of lesions Over joints of the elbows and knees Individual lesions Papules and nodules Course Lesions resolvi…

Histologic Diagnosis of Inflammatory Skin Diseases

Erythema elevatum diutinum

…attern at sites where previously there had been nodular and/or diffuse mixed-cell infiltrates. Diffuse, but sparse, infiltrate of neutrophils accompanied by nuclear “dust” of neutrophils throughout the zones of fibroplasia Scattered eosin…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.114.1A: Diffuse dermatitis, granulomatous + 10.114.1B: Foamy histiocytes, many of them multinucleate = Xanthogranuloma, fully developed  Lymphocytes, plasma cells, and eosinophils are scattered among the predominant histiocytes,…

Histologic Diagnosis of Inflammatory Skin Diseases

Nephrogenic fibrosing dermopathy

…f an early stage of the disease. There they found a subtle but diffuse increase in the reticular dermis of spindle cells with ovoid basophilic nuclei. In sections of biopsy specimens obtained from lesional skin they noted a diffuse array throughout t…