Differential Diagnosis in Dermatopathology

Discussions

…of an insect “bite” that consists clinically of a vesicle atop an urticarial papule or plaque will reveal a large central intraepidermal vesicle with smaller intraepidermal vesicles that taper progressively in size toward the periphery o…

Histologic Diagnosis of Inflammatory Skin Diseases

Urticaria

Urticaria Synonyms Nettle rash Hives Wheals Presentation stereotypical Age and sex Any age, especially young persons, in both sexes Distribution of lesions Localized, as in cold urticaria, regional as in solar urticaria, or widespread as in urtica…

Histologic Diagnosis of Inflammatory Skin Diseases

Suction blister

Suction blister Presentation stereotypical Individual lesions Vesicles and bullae Findings histopathologic Fully developed Subepidermal blister beneath which dermal papillae are preserved No infiltrate of inflammatory cells Correlation clinicopath…

Histologic Diagnosis of Inflammatory Skin Diseases

Dermoepithelial Interface

The basement membrane was defined first by conventional microscopy as a thin band situated immediately beneath basal keratocytes, a strip that was stained magenta by the periodic acid-Schiff method (Fig. 1.70). In time, with the aid of electron micr…

Differential Diagnosis in Dermatopathology

Urticarial reaction to an arthropod assault vs. Urtica

A blistering inflammatory disease in which acantholysis occurs in the upper part of the spinous zone or granular zone of the epidermis, the result of the process being flaccid blisters that give way to erosions and crusts accompanied by erythema. Wh…

Histologic Diagnosis of Inflammatory Skin Diseases

Selection of the Method for Surgery

Not only the lesion for biopsy but also the method of biopsy must be chosen deliberately. It is obvious that certain methods of biopsy should not be employed when an inflammatory disease is suspected clinically, for example, curettage and electrocau…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…pidermal + 10.10.5B: Many eosinophils in the dermis and in vesicles in the epidermis = Bullous pemphigoid, vesicular Both authentic intraepidermal (spongiotic) vesicles and subepidermal vesicles are present. In addition, some intraepidermal vesic…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Nodular and Diffuse Dermatitis

See Fig. 5.174 A&B. Figure 5.174 A&B. Nodular dermatitis and diffuse dermatitis. Nodular dermatitis is distinguished from perivascular dermatitis (see Fig. 5.16 A&B) by the density of the infiltrate of inflammatory cells. In the periv…

Histologic Diagnosis of Inflammatory Skin Diseases

Fixation of the Specimen

The usual fixative for skin specimens is 10% buffered formalin. The amount of formalin should be approximately 20 times by volume that of the specimen. A surgeon, not an assistant, should be responsible for ensuring that the specimen is prevented fr…