Dermatology Practical & Conceptual

Widespread pruritic papules on the trunk and extremities

The patient A 42-year-old Caucasian man presented with a 15-year history of a widespread, persistent, pruritic eruption over his trunk and extremities. He was not on medication and had no relevant family history. On physical examination, multiple di…

Differential Diagnosis in Dermatopathology

Discussions

Lichen planus and lichenoid secondary syphilis share several attributes histopathologic, among those being a lichenoid infiltrate composed largely of mononuclear inflammatory cells in company at times with melanophages, vacuolar alteration along the…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

…paper 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 atrop…

Histologic Diagnosis of Inflammatory Skin Diseases

Persistent light reaction

Persistent light reaction Synonyms Actinic reticuloid, chronic actinic dermatitis, chronic photosensitive dermatitis, photosensitive eczema Presentation stereotypical Age and sex Men especially Distribution of lesions Sun-exposed sites, i.e., the fa…

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

Images 10.108.1A: Section of a biopsy specimen from a scalp + 10.108.1B: Fibrous track widened by thickened collagen bundles and situated in the dermis = Traction alopecia ┬áThese changes are specific for effects of traction on hairs, in c…

Differential Diagnosis in Dermatopathology

Discussions

Atrophic lichen planus and atrophic discoid lupus erythematosus pose problems in differential diagnosis histopathologic because they have several findings in common, among them compact orthokeratosis, focal hypergranulosis, epidermis thinned and ass…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 11.3.1A: Perivascular and interstitial dermatosis + 11.3.1B: Numerous melanophages in conjunction with dull, amphophilic, homogeneous globules in the papillary dermis + 11.3.1C + 11.3.1D = Amyloidosis, macular ┬áThe abs…

Histologic Diagnosis of Inflammatory Skin Diseases

Nerves

Both somatic sensory and autonomic motor nerves are present in skin (Fig. 1.82). The somatic sensory system mediates sensations of pain, itch, temperature, light touch, discriminative touch, pressure, vibration, and proprioception. Nerves of the aut…