Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Perivasculitis?

…necrobiotic areas in all 3 cases. . . . We propose that both necrobiosis and granulomatous perivasculitis be added to the histopathologic characteristics of metastatic Crohn’s disease.” Hackzell-Bradley M. Hedblad MA, Stephansson EA. Me…

Histologic Diagnosis of Inflammatory Skin Diseases

Livedo vasculitis

…athy because it is bereft of meaning as terms such as eczema, necrobiosis, hyalin, “dysplasia,” “architectural disorder,” and “neoplasm of uncertain biologic potential.” Moreover, livedo vasculitis fulfills criteri…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Perforating Diseases?

…ed to occur in dermal diseases, including granuloma annulare, necrobiosis lipoidica diabeticorum, and pseudoxanthoma elasticum.” Turkington C, Dover JS, eds. The Encyclopedia of Skin and Skin Disorders, 2nd ed. New York: Facts On File, Inc, 20…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

Granuloma annulare Necrobiosis lipoidica 1. Epidermis not thinned 1. Epidermis usually thinned with effacement of rete ridges 2. Upper part of the reticular dermis usually more involved than the lower part; subcutaneous fat spared in papules 2…

Differential Diagnosis in Dermatopathology

Images

Necrobiosis lipoidica Necrobiotic xanthogranuloma…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

Necrobiosis lipoidica Necrobiotic xanthogranuloma 1. Infiltrates of inflammatory cells equally dense throughout the dermis or “top-heavy” 1. Infiltrates of inflammatory cells “bottom-heavy” 2. Septal panniculitis with s…

Differential Diagnosis in Dermatopathology

Images

Granuloma annulare Necrobiosis lipoidica…

Histologic Diagnosis of Inflammatory Skin Diseases

Hypodermitis sclerodermiformis

…swollen leg, but often by an indurated cord that is palpable. Necrobiosis lipoidica involves predominantly the region of anterior tibiae and is typified by a yellow cast surrounded by an erythematous rim that often is elevated above the skin surface….

Histologic Diagnosis of Inflammatory Skin Diseases

Granuloma annulare

…present around palisaded granulomas of longstanding lesions. Necrobiosis lipoidica, in early lesions, exhibits degenerated collagen bundles in the center of palisaded granulomas and in late lesions displays thickened collagen bundles in the center o…