Histologic Diagnosis of Inflammatory Skin Diseases

Images

…e spongiosis that, at times, leads to formation of spongiotic vesicles. Uncommonly, a blister in bullous pemphigoid is entirely intraepidermal. 10.10.2A: Perivascular dermatitis, interface, vacuolar, and spongiotic + 10.10.2B: Countless eos…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Nodular and Diffuse Dermatitis

…fection by herpesvirus, not necessarily one concurrent with a vesicle of that eruption, but in a papule prodromal to it and devoid of any of the usual cytopathic effects of the virus. In the latter circumstances, however, the infiltrates that house a…

Histologic Diagnosis of Inflammatory Skin Diseases

Fixation of the Specimen

…vesicular. With rare exceptions, a biopsy specimen of a frank vesicle is useless for interpretation by direct immunofluorescence. In contrast, a biopsy performed for direct immunofluorescence of a lesion suspected of being vasculitis may be taken of…

Histologic Diagnosis of Inflammatory Skin Diseases

Suction blister

…Suction blister Presentation stereotypical Individual lesions Vesicles and bullae Findings histopathologic Fully developed Subepidermal blister beneath which dermal papillae are preserved No infiltrate of inflammatory cells Correlation clinicopatho…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…phils beneath the cornified layer at the side of a spongiotic vesicle. + 10.88.6C + 10.88.6D: = Prurigo pigmentosa  Vesicles in prurigo pigmentosa may come into being by virtue of extensive spongiosis, early in the process, or by balloon…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…interrupted by biopsy, the tension within the intraepidermal vesicle would have caused it to burst and to become subepidermal, too; only a single layer of basal keratocytes remains at the floor of the blister. Note the infiltrate of neutrophils most…

Histologic Diagnosis of Inflammatory Skin Diseases

Pattern Analysis in Historical Perspective

…matitis” and because a pustule is very different from a vesicle, both morphologically and conceptually, “pustular dermatitis” now is given its due as a separate, but equal, fundamental pattern. Combining the two different sets of pa…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ame into being as a result of rupture of tense intraepidermal vesicles. The intraepidermal vesicles developed mostly as a consequence of ballooning of keratocytes, rather than of spongiosis. 10.32.4A: Vesicular dermatitis, subepidermal, lymphoc…