Histologic Diagnosis of Inflammatory Skin Diseases

Pancreatic panniculitis

An inflammatory process that involves the acra, in particular fingers and toes, and sometimes the thighs with bluish red papules and nodules, which invariably is induced by cold. Chilblain is a synonym for pernio, which usually represents lupus eryt…

Histologic Diagnosis of Inflammatory Skin Diseases

Factitious dermatitis and panniculitis

An inflammatory process that involves the acra, in particular fingers and toes, and sometimes the thighs with bluish red papules and nodules, which invariably is induced by cold. Chilblain is a synonym for pernio, which usually represents lupus eryt…

Histologic Diagnosis of Inflammatory Skin Diseases

a-1 antitrypsin deficiency

…aques and nodules Differential diagnosis clinical Factitious panniculitis is associated often with solitary or multiple nodules and/or ulcers in regions of the body accessible to deliberate injury that has been inflicted by a patient, e.g., injectio…

Histologic Diagnosis of Inflammatory Skin Diseases

Subcutaneous T-cell lymphoma

Subcutaneous T-cell lymphoma Synonyms Subcutaneous panniculitis-like lymphoma Presentation stereotypical Age and sex Mostly women in the third and fourth decades of life Distribution of lesions Extremities, trunk, face, neck, and breasts Arrangement…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…mation and fibrosis. 10.38.3A: Fibrosing dermatitis and panniculitis, septal + 10.38.3B: Increased number of thin fibrocytes, coarse bundles of collagen oriented parallel to the skin surface, and histiocytes, some of them multinucleate, aro…

Histologic Diagnosis of Inflammatory Skin Diseases

Behçet’s Disease

…of lesions Face for acneiform lesions, lower extremities for panniculitis. Also oral cavity, genitalia, eye, and central nervous system. Configuration of lesions Round sometimes Arrangement of lesions None in particular Individual lesions Papules, p…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…secondary to wounds inflicted by the patient. 10.35.2A: Panniculitis, lobular + 10.35.2B: Foreign bodies (talc) in collections of neutrophils disposed in broad bands in fat lobules = Factitious panniculitis The clue to factitious panniculit…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.33.1A: Panniculitis, mostly septal + 10.33.1B: Neutrophils among tiny collections of histiocytes and clefts within those collections = Erythema nodosum These findings represent an early stage in the evolution of erythema nodosum…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

…nt has a systemic disease, it being lupus dermatitis or lupus panniculitis, analogous to lupus carditis, lupus encephalitis, lupus lymphadenitis, lupus nephritis, and lupus serositis. Error: Capillaritis is a valid concept and a sine qua non for diag…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.71.1A: Vasculitis, large-vessel, and panniculitis, lobular mostly + 10.71.1B: Suppurative arteritis = Nodular vasculitis, early  The only condition characterized by suppurative arteritis and extensive panniculitis is nodular vas…