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 are added to a particular “nonspecific” finding, beginning with those attributes discernable at moderately high magnification and processing to those visualizable at progressively lower […]

Histologic Diagnosis of Inflammatory Skin Diseases

The Algorithmic Method

…at higher magnification, of the kind or kinds of inflammatory cells (or neoplastic lymphocytes, Langerhanscells, and mast cells that, at first blush, may appear to be inflammatory cells) that make up the infiltrate. Remarkable as it may seem…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vesicular Dermatitis

…s, begins above the basal layer of the epidermis, acantholytic cells coming into being there. Unlike the situation in pemphigus, however, acantholytic cells in Hailey-Hailey disease, at least in loci, tend to be present throughout much of the thicken…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology


…20;histiocytoses” a constellation of diseases made up of cells that are very different from one another, e.g., macrophages, Langerhanscells, fibrocytes, and lymphocytes. Grouping in fashion illogical impedes diagnosis of diseases and th…

Histologic Diagnosis of Inflammatory Skin Diseases

Our Definition of “Inflammation” and “Inflammatory Disease”

…lymphomatous process. Third, there is no agreement about which cells truly are inflammatory ones, e.g., mast cells, basophils, Langerhanscells, dermal dendrocytes, fibrocytes, and platelets. Each of those types of cells contributes to an infl…

Differential Diagnosis in Dermatopathology

Mycosis fungoides, plaque vs. Histiocytosis X, plaque

A proliferation of abnormal Langerhanscells that may affect internal organs, e.g., the spleen, liver, and bone, sometimes with fatal outcome, as well as the skin, where lesions usually manifest themselves as purpuric papules or ulcers that m…

Histologic Diagnosis of Inflammatory Skin Diseases

Mycosis fungoides

…r bridges, the relatively few lymphocytes, and the addition of Langerhanscells. Granuloma annulare, interstitial type is distinguished from interstitial mycosis fungoides by lack of lymphocytes in foci in the interstitium of the reticular der…