Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Spongiform Pustular Diseases?

…ibed in 1938 by Kogoj, who likened the diffuse collections of neutrophils in the middle and upper parts of the epidermis to the appearance of a sponge. Why he thought that is baffling. In a spongiform pustule, neutrophils in variable number are sprin…

Histologic Diagnosis of Inflammatory Skin Diseases

Behçet’s Disease

…ound venules in the reticular dermis and the subcutaneous fat Neutrophils with variable amounts of nuclear “dust” of neutrophils in perivascular and interstitial location, as well as in infundibular epidermis Fibrin in the wall of venules…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…dermoepidermal junction, ballooned and necrotic keratocytes, neutrophils in a focus of necrosis, and incipient parakeratosis = Mucha-Habermann disease, acute  Neutrophils are seen often in early and fully developed lesions of Mucha-Habermann disease…

Histologic Diagnosis of Inflammatory Skin Diseases

The Algorithmic Method

…itioned at one pole of copious cytoplasm) (Fig. 6.3 A&B); neutrophils resemble specks of salt and pepper (because their cytoplasm is so pale and their polymorphic nuclei look from afar like tiny gray dots) (Fig. 6.4 A&B); and eosinophils are…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…10.5.1B: Lymphocytes and eosinophils around venules, and neutrophils in the interstitium in conjunction with degeneration of bundles of collagen focally = Response to an arthropod assault  Lysosomal enzymes released from eosinophils may cause de…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…xed-cell + 10.111.1B: Lymphocytes, eosinophils, and a few neutrophils around venules = Urtica, early  This is an early stage in the evolution of urticaria because inflammatory cells are huddled around venules; interstitial involvement by eosinoph…

Histologic Diagnosis of Inflammatory Skin Diseases

Prurigo pigmentosa

…histopathologic Early Superficial perivascular infiltrate of neutrophils mostly Edema of the papillary dermis Spongiosis in foci Neutrophils scattered in the epidermis Ill-formed abscesses in the epidermis Necrotic keratocytes in the vicinity of neu…

Histologic Diagnosis of Inflammatory Skin Diseases

Syphilis

…also because of the presence at times, in both conditions, of neutrophils in the epidermis, sometimes in spongiform pustules in the spinous and granular zones, and at summit of mounds of parakeratosis. Psoriasis is typified by a superficial infiltrat…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Lymphocytic Vasculitis?

…d (venules or arterioles) and the type of inflammatory cells (neutrophils or lymphocytes) that predominate. The three most common expressions of small-vessel vasculitis associated with predominance of neutrophils are leukocytoclastic, septic, and liv…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Subcutaneous Fat: Panniculitis

…subcutaneous fat, calling forth an infiltrate there, first of neutrophils (suppuration), then largely of histiocytes (granulomatous inflammation) (Fig. 5.399 A&B), and, last, of fibrocytes (fibrosis). Any one of a constellation of findings, or an…