Histologic Diagnosis of Inflammatory Skin Diseases

Impetigo contagiosa

…simplex may mimic impetigo, particularly when the contents of vesicles become turbid, but lesions tend to be vesicles rather than bullae, and they do not assume figurate outlines. Tinea corporis usually is scaly, not simply crusted, and vesicles, wh…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…cells in the spinous layer = Grover’s disease A distinct vesicle in Grover’s disease, like the one shown here, is exceptional. It began intraepidermal and was so tense that it ruptured to become subepidermal, too. Hardly ever do vesicles…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Primary and Secondary Lesions?

“Some of the appearances observed in cutaneous diseases are caused directly by the deposition of morbid products in the skin. These bear the name of Primary symptoms or eruptions, Efflorescentiae cutaneae primariae. But these eruptions often…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.50.1A: Perivascular dermatitis, interface, and vesicular dermatitis, intraepidermal, spongiotic + 10.50.1B: Eosinophils in contiguity with numerous necrotic keratocytes = Incontinentia pigmenti, vesicular stage Inflammatory cell…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.60.1A: Perivascular dermatitis, interface, focally lichenoid + 10.60.1B: Obscuration of the dermoepidermal junction by lymphocytes, jagged acanthosis, wedge-shaped hypergranulosis, and compact orthokeratosis = Lichen planus, ear…

Histologic Diagnosis of Inflammatory Skin Diseases

Leukocytoclastic vasculitis

…, or both together in the same section of tissue. Subepidermal vesicles alone occur almost always as a consequence of extensive edema of the papillary dermis and intraepidermal vesicles from a combination of spongiosis and ballooning. A tense intraep…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.58.1A: Perivascular and interstitial dermatitis + 10.58.1B: Neutrophils and copious quantities of nuclear “dust” of neutrophils in association with many extravasated erythrocytes = Leukocytoclastic vasculitis, early…

Histologic Diagnosis of Inflammatory Skin Diseases

Fixed drug eruption

…extensive, eventuates in subepidermal clefts and subepidermal vesicles Marked spongiosis and ballooning; if ballooning extensive sufficiently, reticular alteration and intraepidermal vesicles ensue Intraepidermal and subepidermal vesiculation may oc…

Differential Diagnosis in Dermatopathology

Discussions

Darier’s disease and Grover’s disease have several findings histopathologic in common, among them foci of acantholytic dyskeratotic cells in the epidermis and a superficial perivascular infiltrate of inflammatory cells, usually lymphocyt…