Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Inverted Follicular Keratosis, Tricholemmoma, and Desmoplastic Tricholemmoma?

“For about the last 8 years my associates and I have been observing a lesion—a keratosis—which occurs mostly on the face: I should say about 90 percent on the face, the remainder on other parts of the body. These lesions are characterized cli…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 11.14.1A: Perivascular dermatosis, psoriasiform lichenoid + 11.14.1B: Lymphocytes, sparse in both the dermis and epidermis, larger in the epidermis than in dermis, solitary in the basal layer in foci, and in association with scant…

Histologic Diagnosis of Inflammatory Skin Diseases

Apocrine Units

…dermis (Fig. 1.54). Figure 1.54 An apocrine duct enters the infundibulum of an epidermis above the entry of a sebaceous duct, which is at the junction of infundibulum and isthmus. The duct then spirals through infundibular epidermis in a fashion s…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Apocrine Miliaria?

…s; spongiosis at the site of entry of an apocrine duct into an infundibulum is a phenomenon secondary, i.e., consequent to an infundibulum blocked by cornified cells. In brief, the essential process pathologic in Fox-Fordyce disease is not seated in…

Differential Diagnosis in Dermatopathology

Perforating folliculitis vs. Elastosis perforans serpiginosa

An inflammatory process in which lesions present themselves clinically as red macules and subtle scaly papules. They soon become so confluent that there is widespread redness and scaling punctuated by islands of skin that ostensibly are spared and b…

Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

In this section, algorithms used to reach specific diagnosis are predicated on “nonspecific” findings recognized best at higher magnification. Other changes requisite for specific diagnoses, i.e., denominators that are essential, then ar…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

Error: Abortive is an accurate modifier of particular pathologic processes, e.g., abortive dermatofibroma, abortive morphea, and abortive T-cell lymphoma. Reason: The idea itself is abortive! For example, what is called “abortive T-cell lympho…

Histologic Diagnosis of Inflammatory Skin Diseases

Arthropod assaults

Arthropod assaults Synonyms Insect “bite” Bug bite Insect bite reaction Papular urticaria Lichen urticatus Strophulus Presentation stereotypical Age and sex Any age and both sexes Distribution of lesions At times only a single lesion a…