Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.103.1A: Perivascular dermatitis, psoriasiform lichenoid + 10.103.1B: Infiltrate of histiocytes, plasma cells, lymphocytes, and neutrophils, edema of the papillary dermis, and neutrophils in the acanthotic epidermis, including in…

Histologic Diagnosis of Inflammatory Skin Diseases

Algorithms Predicated on “Nonspecific” Findings

…ranulosis, lymphocytes along the dermoepidermal interface, and lichenoid infiltrate of lymphocytes = Lichen planus-like drug eruption + Remnant of solar lentigo/seborrheic keratosis and obscuration of the dermoepidermal interface by a lichenoid inf…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Fibrosing Dermatitis

…&B). Those distinctive bundles of collagen are a clue to a lichenoid infiltrate of lymphocytes having been present for years in the upper part of the dermis. Similar changes may be observed in some examples of long-sustained lesions of the lichen…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen planus-like keratosis

Lichen planus-like keratosis Presentation stereotypical Age and sex Older individuals bombarded by rays of the sun for many years Distribution of lesions Sun-exposed sites, especially the chest and shoulders Configuration of lesions Round Individual…

Differential Diagnosis in Dermatopathology

Discussions

…ther histopathologically with certainty. Usually, however, the lichenoid purpura of Gougerot-Blum can be differentiated with facility from the malignant lymphoma. The findings crucial for distinguishing the lichenoid purpura from the plaque stage of…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.61.1A: Perivascular dermatitis, spongiotic lichenoid + 10.61.1B: Lymphocytes mostly, in conjunction with scale-crusts that contain neutrophils = Lichen striatus ┬áThe presence of a lichenoid infiltrate telegraphs that this is not…

Histologic Diagnosis of Inflammatory Skin Diseases

Errors and Reasons

…pidermis, and then, it seems, coincidentally. Error: Keratosis lichenoides chronica is an eruption comparable to pityriasis lichenoides chronica. Reason: The features seen clinically in a classic example of keratosis lichenoides chronica are distinct…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen striatus

…ividual necrotic keratocytes in the epidermis of a spongiotic, lichenoid, or psoriasiform dermatitis. Moreover, if the necrotic keratocytes are present in clusters and a patchy lichenoid infiltrate of lymphocytes is accompanied by histiocytes, someti…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.63.1A: Perivascular dermatitis, interface, vacuolar + 10.63.1B: Smudged appearance of the dermoepidermal junction, focally thinned epidermis, and plentiful mucin throughout the dermis = Lupus erythematosus, discoid ┬áThe presence…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ate qualifies it as granulomatous. The discrete nature of this lichenoid granulomatous process makes this lichen nitidus. 10.59.3A: Perivascular dermatitis, interface, focally lichenoid + 10.59.3B : Beneath a thinned, hyperkeratotic epiderm…