Histologic Diagnosis of Inflammatory Skin Diseases

Impetigo contagiosa

…Arrangement of lesions Grouped or figurate Individual lesions Vesicles that rapidly become pustules; honey-colored crusts as pustules resolve; bullae rarely Course Lesions resolve in weeks Variations clinical Nonbullous impetigo Bullous impetigo (st…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…rising, therefore, that sometimes it presents itself as papulovesicles in addition to papules. In the latter circumstance, crust, as well as scale, may form, as pictured here. 10.44.10A: Perivascular dermatitis, lymphocytes predominant + 10…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Primary and Secondary Lesions?

…include macules, patches, papules, plaques, nodules, tumors, vesicles, pustules, and bullae. Secondary lesions, by contrast, are said to be scales, crusts, erosions, ulcers, excoriations, lichenification, and fissures. Regrettably, the concept of pr…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…dermal necrosis = Incontinentia pigmenti, vesicular stage The vesicle in incontinentia pigmenti comes into being as a rule solely by spongiosis. This example is exceptional; ballooning is present as well as spongiosis. 10.50.5A: Perivascular de…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ullous” lichen planus  The tiny blister shown here is a vesicle, not a bulla, and it came into being by virtue of the process of lichen planus being accelerated greatly, analogous to the blister that forms in lupus erythematosus and the pustule…

Histologic Diagnosis of Inflammatory Skin Diseases

Leukocytoclastic vasculitis

…ons Macules, edematous papules, purpuric papules, hemorrhagic vesicles, vesiculopustules, ulcers, and, sometimes, scars Course Lesions usually disappear in a few weeks Variations clinical Henoch-Schönlein purpura is a particular expression of leukoc…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ndition as a consequence of rupture of a tense intraepidermal vesicle. 10.58.4A: Vasculitis, small-vessel, neutrophilic + 10.58.4B: Neutrophils and nuclear “dust” of neutrophils in perivascular and interstitial array in company…

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 occ…

Differential Diagnosis in Dermatopathology

Discussions

…ranes and nail units. Darier’s disease does not exhibit vesicles clinically or histopathologically. Prior to the use of retinoids, Darier’s disease was largely refractory to treatment. The term “keratosis follicularis” as a sy…