Histologic Diagnosis of Inflammatory Skin Diseases

Herpes gestationis

…Configuration of lesions Arcuate, annular, and serpiginous of urticarial lesions especially Arrangement of lesions Vesicles often in the shape of a cockade Individual lesions Urticarial papules, plaques, vesicles, bullae, and crusts; tense vesicles…

Histologic Diagnosis of Inflammatory Skin Diseases

Arthropod assaults

…nsect “bite” Bug bite Insect bite reaction Papular urticaria Lichen urticatus Strophulus Presentation stereotypical Age and sex Any age and both sexes Distribution of lesions At times only a single lesion and at other times lesions, some…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.31.1A: Perivascular and interstitial dermatitis + 10.31.1B: Lymphocytes and neutrophils in the dermis = Erythema marginatum The changes of erythema marginatum differ from those of urtica developed fully by absence of…

Histologic Diagnosis of Inflammatory Skin Diseases

Selection of the Site

Because many inflammatory diseases of the skin, e.g., dermatitis herpetiformis, nummular dermatitis, scabies, Grover’s disease, and eosinophilic folliculitis, are exquisitely pruritic, scratching is an inevitable consequence, and signs of exco…

Differential Diagnosis in Dermatopathology

Discussions

Urticaria and the urticarial stage of bullous pemphigoid have several findings histopathologic in common, chiefly superficial and mid- or deep dermal perivascular and interstitial mixed-cell infiltrates in which eosinophils are prominent in the inte…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Urticarial Vasculitis?

…vasation of erythrocytes.” Soter NA, Austin F, Gigli I. Urticaria and arthralgias as manifestations of necrotizing angiitis (vasculitis). J Invest Dermatol 1974;63:485–490. “Urticarial vasculitis Some urticarias are considered to…

Differential Diagnosis in Dermatopathology

Discussions

…PUPPP may have some attributes histopathologic in common with urtica, namely, sparse perivascular and interstitial mixed-cell infiltrates of lymphocytes and eosinophils. Unlike the situation in urtica, however, the infiltrate in PUPPP is not joined…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

Urticarial reaction to an arthropod assault Urtica 1. Marked edema of the papillary dermis sometimes 1. No edema noticeable in the papillary dermis 2. Subepidermal vesicle sometimes secondary to marked edema of the papillary dermis 2. No subep…

Differential Diagnosis in Dermatopathology

Images

Urticarial reaction to an arthropod assault Urtica