Dermatology Practical & Conceptual

Widespread pruritic papules on the trunk and extremities

…ophilic deposits in the papillary dermis with hyperkeratosis, hypergranulosis, and marked acanthosis. (B) Crystal violet staining highlighted the eosinophilic deposits in the upper dermis. [Copyright: ©2014 Sezer et al.] Answer and explanation Genera…

Differential Diagnosis in Dermatopathology

Discussions

…sence of parakeratosis, the presence of wedge-shaped zones of hypergranulosis at nearly periodic intervals in the epidermis, and, sometimes, signs of having been rubbed persistently, namely, the features additional of lichen simplex chronicus, namely…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

…aper thin 1. Epidermis sometimes paper-thin 2. Wedge-shaped hypergranulosis in foci in repeatable fashion 2. No wedge-shaped hypergranulosis as a rule; hypergranulosis without a wedge episodic and not in repeatable pattern 3. Cleft between atroph…

Histologic Diagnosis of Inflammatory Skin Diseases

Persistent light reaction

…simplex chronicus are recognizable as compact orthokeratosis, hypergranulosis, uneven psoriasiform acanthosis, and a papillary dermis thickened by coarse bundles of collagen arranged in vertical streaks, in conjunction with an increased number of fib…

Differential Diagnosis in Dermatopathology

Lichen sclerosus et atrophicus vs. Superficial morphea

Papules on skin and mucous membranes that result from infection of keratinocytes by different types of papillomavirus and classified according to their silhouettes, to wit, papillated (verrucae vulgares on different sites such as volar skin, i.e., v…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…of a zone of peri-infundibular fibroplasia, and wedge-shaped hypergranulosis in an infundibulum = Traction alopecia  The lichenoid infiltrate of lymphocytes also extends along the isthmus of the follicle. Initially the lichenoid infiltrate hugged in…

Differential Diagnosis in Dermatopathology

Discussions

…findings in common, among them compact orthokeratosis, focal hypergranulosis, epidermis thinned and associated with flat rete ridges and dermal papillae, vacuolar alteration along the dermoepidermal junction, individual necrotic keratocytes, infiltr…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…B: Dull pink globules in clusters in widened dermal papillae, hypergranulosis, and compact orthokeratosis = Amyloidosis, papular (lichen)  The epidermal changes are those of lichen simplex chronicus, a response by rubbing to infuriating pruritis. Amy…

Histologic Diagnosis of Inflammatory Skin Diseases

Nerves

…217;s nodule, which share findings of compact orthokeratosis, hypergranulosis in conjunction with a thickened surface epidermis, pseudocarcinomatous (infundibular and eccrine ductal) proliferation, and coarse bundles of collagen in vertical streaks i…