Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Fibrosing Dermatitis

…osing dermatitis may result from the effects on fibrocytes of infiltrates of inflammatory cells of long standing, as occurs in diseases as different as lichen planus (especially the infundibulo- and folliculocentric expression of that disease, i.e.,…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vasculitis

…loped lesions of small-vessel vasculitis in the setting of an infiltrate of inflammatory cells are the presence of fibrin in the wall of venules and/or thrombi in the lumen of them. In contrast, there is but a single criterion for recognition by conv…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…at higher magnification by noting abnormal lymphocytes in the infiltrate and too many lymphocytes in league with too little spongiosis in the epidermis, findings diagnostic of mycosis fungoides. 11.14.6A: Perivascular dermatosis, spongiotic pso…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vesicular Dermatitis

…of nucleoplasm in infection by herpesvirus) and character of infiltrates of inflammatory cells (i.e., monomorphous or mixed) are added to location of the blister in the epidermis and to mechanism whereby the blister came into being, the sum should b…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ivascular dermatitis, psoriasiform lichenoid + 10.103.1B: Infiltrate of histiocytes, plasma cells, lymphocytes, and neutrophils, edema of the papillary dermis, and neutrophils in the acanthotic epidermis, including in a broad zone of parakeratosi…

Histologic Diagnosis of Inflammatory Skin Diseases

Xanthogranuloma

…hologic Early Moderately dense perivascular and interstitial infiltrates of histiocytes, few if any of which have foamy cytoplasm and none of which are multinucleate; formation of a sheet of histiocytes in the upper half of the dermis sometimes Some…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ose of an early lesion of lichen planus because the lichenoid infiltrate and the epidermal changes are confined to a tiny focus. 10.60.3A: Perivascular dermatitis, interface, lichenoid + 10.60.3B: Lymphocytes only, edema in a dermal papilla…

Histologic Diagnosis of Inflammatory Skin Diseases

Lymphocytoma cutis

…rs of B-cell lymphoma Fully developed Nodular and/or diffuse infiltrate made up mostly of small lymphocytes in the reticular dermis and, sometimes, in the upper part of the subcutaneous fat Infiltrate usually denser in the upper part (“top hea…

Histologic Diagnosis of Inflammatory Skin Diseases

Graft-versus-host disease/Eruption of lymphocyte recovery

…ndings histopathologic Early Sparse superficial perivascular infiltrate of lymphocytes; eosinophils sometimes and melanophages in variable number, too Epidermis thinned, at least focally Vacuolar alteration in conjunction with a sprinkling of lympho…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…: Perivascular dermatosis, lichenoid + 11.11.3B: Bandlike infiltrate of lymphocytes beneath jagged acanthosis, hypergranulosis, and hyperkeratosis = Lichen planus-like keratosis, fully developed  The overwhelming majority of biopsy specimens of l…