Histologic Diagnosis of Inflammatory Skin Diseases

Herpes gestationis

…y dermis and, often, by variable numbers of eosinophils in the epidermis. Sometimes no eosinophils are present in the epidermis, whereas at other times many are there. Irrespective of the number, eosinophils in the epidermis are accompanied invariabl…

Histologic Diagnosis of Inflammatory Skin Diseases

Introduction

…1.5 mm on the palms of a young adult; the average thickness of epidermis is about 0.4 mm. As is the case for every other part of the skin, as a person ages, the epidermis shrinks, that atrophy being physiologic. The epidermis is a metabolically activ…

Histologic Diagnosis of Inflammatory Skin Diseases

Psoriasis

…th a few lymphocytes in discrete foci in the lower part of the epidermis Spongiform and subcorneal pustules in the epidermis of some lesions Hypogranulosis in some foci Mounds of parakeratosis with neutrophils at their summit staggered in the stratum…

Histologic Diagnosis of Inflammatory Skin Diseases

Pigmented Lesions

…gly consisting of a dermal papilla in caricature covered by an epidermis normal. Slight increase of melanin in the epidermis. Nevoid hyperkeratosis of the nipple¬†(443) Broad mammillations, each formed by a subtly elevated dermal papilla, interrupt…

Histologic Diagnosis of Inflammatory Skin Diseases

Prurigo pigmentosa

…pillary dermis Spongiosis in foci Neutrophils scattered in the epidermis Ill-formed abscesses in the epidermis Necrotic keratocytes in the vicinity of neutrophils Fully developed Patchy lichenoid infiltrate of lymphocytes mostly, but also of neutro…

Histologic Diagnosis of Inflammatory Skin Diseases

Mucha-Habermann disease

…rmal junction Individual necrotic keratocytes scattered in the epidermis, especially the lower half; range from few or many Slight spongiosis and ballooning Slight pallor in the upper part of the epidermis Cornified layer basket-weave in configuratio…

Histologic Diagnosis of Inflammatory Skin Diseases

Pattern Analysis in Historical Perspective

…dibulum is epithelial, being as it is as much a constituent of epidermis as is surface epidermis. Pustular dermatitides, therefore, can be divided rationally into those of infundibular epidermis (e.g., pustules of acne vulgaris, rosacea, and halogeno…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 11.11.1A: Perivascular dermatosis, lichenoid + 11.11.1B: Lymphocytes, many necrotic keratocytes and a subepidermal cleft = Lichen planus-like keratosis, early ¬†Because lichen planus-like keratosis often is misinterpreted clinically…

Histologic Diagnosis of Inflammatory Skin Diseases

Arthropod assaults

…being found fortuitously and rarely) in the lower part of the epidermis, a cercaria of avian schistosomiasis, that organism being discovered by lucky chance in the midspinous layer of the epidermis, and spicules of sponges, those bodies being discer…