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Histologic Diagnosis of Inflammatory Skin Diseases

Cells That Mediate Inflammation (Inflammatory Cells)

…activation of the coagulation cascade results in formation of fibrin, which then casts a net at the surface of a wound, platelets attach to that network, thereby contributing to closure of the defect. The role of platelets in inflammation is coming t…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ause thrombi are present in the lumen of venules, rather than fibrin in the wall of them. 10.8.3A: Vesicular dermatitis, intraepidermal, ballooned + 10.8.3B: Neutrophils and eosinophils in the epidermis = Behçet’s disease Intraepiderm…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

… Unlike the situation in leukocytoclastic vasculitis in which fibrin is present in the wall of venules, in septic vasculitis thrombi are present in lumen of them. That occlusion results in infarction with subsequent severe ballooning, intraepidermal…

Histologic Diagnosis of Inflammatory Skin Diseases

Cat-scratch disease

…indings histopathologic Fully developed Zone of necrosis and fibrin in the upper part of the reticular dermis surrounded by a mantle of macrophages, lymphocytes, and plasma cells Granulomas of stellate shape often joined by neutrophils in number in…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…10.7.4B: Lymphocytes, plasma cells, histiocytes, necrosis, fibrin, fragments of necrotic inflammatory cells and pseudocarcinomatous (infundibular) proliferation + 10.7.4C + 10.7.4D = Cat-scratch diseaseThis pattern, namely, a zone of…

Histologic Diagnosis of Inflammatory Skin Diseases

Arthropod assaults

…the form of thrombi in the lumen of venules, but sometimes of fibrin deposited in the wall of venules. Findings of small-vessel vasculitis are seen in less than 15% of all biopsy specimens of a response to an arthropod assault. The vasculitis seems t…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Capillaritis?

…zed by (1) an infiltrate of inflammatory cells and (2) either fibrin in the wall of vessels or thrombi in the lumen of them, or both of those findings together. The papillary dermis and the periadnexal dermis, both of which house capillaries, are spa…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…B: Neutrophils, eosinophils, and lymphocytes, in company with fibrin, in the subepidermal blister = Acquired epidermolysis bullosa Changes like those pictured do not conform to one of the well-established common blistering diseases of the skin. That…

Histologic Diagnosis of Inflammatory Skin Diseases

Necrobiosis lipoidica

…al fashion. Rheumatoid nodule consists largely of deposits of fibrin that are rimmed by thin histiocytes arrayed in a palisade. Interstitial granulomatous dermatitis with arthritis tends to be marked by “bottom-heavy” infiltrates of histi…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Churg-Strauss Granuloma and Allergic Granulomatosis?

…ed, comprised necrosis of eosinophilic exudate, severe “fibrinoid” collagen change, and granulomatous proliferation of epithelioid and giant cells. This is considered a histopathologic entity termed “allergic granuloma.” Chur…

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