Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Cytophagic Panniculitis?

…f the reticuloendothelial system by acidophilic or cytophagic histiocytes could be identified. Progressive changes in liver function and hemorrhagic diathesis occurred in both patients.” Winkelmann RK. Pannikulitis mit Zellphagozytose: eigenst?…

Histologic Diagnosis of Inflammatory Skin Diseases

Rheumatoid nodule

…ils scattered in the mass of fibrin Fibrin surrounded by thin histiocytes aligned in a palisade Fibrosis, sometimes extensive, in the region beyond the histiocytes and in between palisaded granulomas Late Findings like those described in a lesion d…

Histologic Diagnosis of Inflammatory Skin Diseases

Dermatofibroma

…Findings histopathologic Early Dense diffuse infiltrate of histiocytes mostly (often both lipophages and siderophages) in conjunction with innumerable erythrocytes extravasated in a nodule in the reticular dermis and, sometimes, in the upper part…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

….1A: Diffuse dermatitis, granulomatous + 10.114.1B: Foamy histiocytes, many of them multinucleate = Xanthogranuloma, fully developed  Lymphocytes, plasma cells, and eosinophils are scattered among the predominant histiocytes, many of which are of…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…10.15.1A: Nodular dermatitis, granulomatous + 10.15.1B: Histiocytes in a palisade in the upper part of the dermis in conjunction with a perivascular lymphoplasmacytic infiltrate = Crohn’s disease The palisaded granulomas in the upper part…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

…eutrophils and eosinophils on one hand and of lymphocytes and histiocytes on the other. Reason: Because neutrophils and eosinophils may be present in large numbers in a long-standing (chronic) inflammatory disease, such as granuloma faciale/erythema…

Histologic Diagnosis of Inflammatory Skin Diseases

Foreign body reaction

…al in the dermis or in the subcutaneous tissue, some of it in histiocytes that often are multinucleate Late Fibrosis Granulomatous inflammation as residuum sometimes Foreign bodies detectable sometimes in zones of fibroplasia Attributes histopatho…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…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. Collections of histiocytes within which neu…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

…hroughout the reticular dermis 2. Infiltrate of epithelioid histiocytes tends to be in discrete loci in the reticular dermis 2. Infiltrate of epithelioid histiocytes tends to be diffuse 3. No band-like character to the infiltrate anywhere in the…