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Differential Diagnosis in Dermatopathology

Discussions

…e as baffling and frustrating to dermatopathologists than the alopecias. Those aberrations are rivaled in difficulty only by diseases of nail units. Why do those subjects prove to be so recondite? Because biopsies of alopecias and disorders of nail u…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ate of small lymphocytes and eosinophils = Mycosis fungoides, alopecia mucinosa expression ┬áThe infiltrate is present not only in the dermis, but also in infundibula and follicles, both of which house deposits of mucin. Infundibula are dilated and pl…

Differential Diagnosis in Dermatopathology

Discussions

The alopecias of discoid lupus erythematosus and of lichen planus share several findings histopathologic, among them being perivascular, peri-infundibular, and perifollicular infiltrates of lymphocytes, vacuolar alteration at the junction between in…

Differential Diagnosis in Dermatopathology

Discussions

Alopecia areata and trichotillomania have several attributes histopathologic in common, namely, some follicles in catagen and often in telogen, long fibrous tracks behind shortened follicles and, in sections from some specimens, and hardly any periv…

Histologic Diagnosis of Inflammatory Skin Diseases

Trichotillomania

…twists hairs back and forth Differential diagnosis clinical Alopecia areata consists of well-defined patches of complete hair loss. Tinea capitis is usually associated with scales, crusts, or pustules. Findings histopathologic Fully developed Cru…

Histologic Diagnosis of Inflammatory Skin Diseases

Hair Follicles

…ar. Epithelial mucinosis is the sine qua non for diagnosis of alopecia mucinosa, which is but one of many variants morphologic of mycosis fungoides. Epithelial mucinosis also is encountered often in “folliculitis” with eosinophils (badly…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ckened collagen bundles and situated in the dermis = Traction alopecia ┬áThese changes are specific for effects of traction on hairs, in contrast to finding that result from twisting hairs back and forth, to wit, trichomalacia, the most common sign hi…

Histologic Diagnosis of Inflammatory Skin Diseases

Syphilis

…infundibula, sometimes forming spongiform pustules there. An alopecia that occurs in secondary syphilis is accompanied by changes typical of secondary syphilis in the dermis, at the dermoepidermal junction, and in the epidermis. In addition, the inf…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…t peri-infundibulitis and perifolliculitis presages permanent alopecia consequent to destruction of infundibular and follicular epithelium. 10.63.8A: Perivascular dermatitis, interface, vacuolar + 10.63.8B: Sclerosis of the papillary dermis…

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