Differential Diagnosis in Dermatopathology

Discussions

…skin head-on.. A discrete focus of spongiosis or a spongiotic vesicle marks the actual site of the “bite.” In contrast, spongiosis in PUPPP is slight and multifocal. Episodically, neutrophils may be found in mounds of scale-crusts in a re…

Dermatology Practical & Conceptual

Epidermal multinucleated giant cells are not always a histopathologic clue to a herpes virus infection: multinucleated epithelial giant cells in the epidermis of lesional skin biopsies from patients with acantholytic dermatoses can histologically mimic a herpes virus infection

…cal mucosa and the mucosa of the gingiva and labia. Pustules, vesicles, and bullae were observed within the right axillae (Figure 1) and the labia majora. A lesional skin biopsy from the right axilla was performed; specimens for bacterial culture, di…

Histologic Diagnosis of Inflammatory Skin Diseases

Urticaria

…the papillary dermis and spongiosis (sometimes, a spongiotic vesicle) in the epidermis at the site of the “bite.” Laboratory confirmation None exists. Cause and mechanism Causes are varied and mechanisms are different, but denominators i…

Histologic Diagnosis of Inflammatory Skin Diseases

Dermoepithelial Interface

…ensa; LL, lamina lucida; PM, plasma membrane; PV, pinocytotic vesicle. (x67,500) (Courtesy of Stephen Katz, M.D.) The plasma membrane of basal keratocytes forms the roof of the structurally integrated unit known as the dermoepidermal junction. Hemide…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…cular alteration that are accompaniments of an intraepidermal vesicle. 10.99.3A: Vasculitis, small vessel, neutrophilic + 10.99.3B: Perivascular and interstitial mixed-cell infiltrate with thrombi in the lumen of venules = Septic vasculitis…

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

…atologic surgery has neared epidemic proportions. In general, vesicles and bullae should be excised with a scalpel rather than removed by punch or shave, including saucerization procedure. This precept applies particularly to bullae that are flaccid,…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

…ical (others being purpuric macules, purpuric and nonpurpuric vesicles, and ulcers), and, moreover, diseases unrelated to leukocytoclastic vasculitis (lichenoid purpura of Gougerot and Blum, the pityriasis lichenoides acuta expression of Mucha-Haberm…