Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.90.1A: Perivascular dermatitis, psoriasiform + 10.90.1B: Lymphocytes and neutrophils around venules, dilated tortuous capillaries in edematous dermal papillae, spongioform pustules, and tiers of neutrophil-containing mounds of p…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.43.1A: Nodular dermatitis, granulomatous + 10.43.1B: Interstitial and palisaded array of histiocytes around loci of deposits of mucin and degeneration of collagen = Granuloma annulare This is a presentation stereotypical of gran…

Histologic Diagnosis of Inflammatory Skin Diseases

Lymphomatoid papulosis

…deep, perivascular and interstitial mixed infiltrate of small lymphocytes, abnormal lymphocytes and, often, plasma cells, neutrophils, and eosinophils Abnormal lymphocytes with notably large pleomorphic nuclei, many with a cerebriform outline Some…

Histologic Diagnosis of Inflammatory Skin Diseases

Syphilis

…sa stain. Secondary syphilis Mycosis fungoides consists of lymphocytes mostly, rather than of histiocytes and plasma cells. Mucha-Habermann disease is composed almost entirely of lymphocytes, rather than mostly of histiocytes and plasma cells….

Histologic Diagnosis of Inflammatory Skin Diseases

Limitations of the Algorithmic Method

…wiry bundles of collagen in company with patchy infiltrates of lymphocytes in the upper part of the dermis, lymphocytes disposed as solitary units in loci of the epidermal basal layer, and lymphocytes in foci of the spinous zone in association with s…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.64.1A: Nodular dermatitis, lymphocytes predominate + 10.64.1B: Small lymphocytes mostly = Lymphocytoma cutis ¬†At scanning magnification, the infiltrate of lymphocytes in the reticular dermis can be told to follow the course of p…

Histologic Diagnosis of Inflammatory Skin Diseases

Lupus erythematosus

…epidermis) plus: Patchy lobular panniculitis made up mostly of lymphocytes but also often of plasma cells; nuclear “dust” of lymphocytes (“tangible bodies”) sometimes prominent Patchy sclerosis in association with the infiltra…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen planus-like keratosis

…ndings histopathologic Superficial perivascular infiltrate of lymphocytes Patchy lichenoid infiltrate of lymphocytes Melanophages and necrotic keratocytes in the upper part of the dermis often Vacuolar alteration at the dermoepidermal junction and i…