Differential Diagnosis in Dermatopathology

Discussions

Staphylococcal scalded skin syndrome and severe erythema multiforme are blistering dermatitides that Lyell, a Scotch dermatologist, in 1956, considered to be a single disease because they both can resemble scalded skin clinically. He designated that…

Histologic Diagnosis of Inflammatory Skin Diseases

The Algorithmic Method

An algorithm is a method for calculation based on logical thought and orderly sequence, one that can be utilized for diagnosis of diseases of all kinds, including inflammatory ones of the skin. Once a disorder of the skin and/or subcutaneous fat has…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

…sis, and in scale-crusts 6. Vesiculation common secondary to ballooning and/or spongiosis 6. Vesiculation uncommon, but secondary to ballooning mostly rather than spongiosis 7. Subepidermal vesiculation as common as intraepidermal vesiculation; s…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Dermal and Epidermal Types of Erythema Multiforme?

“Light and electron microscopical studies of erythema multiforme showed two types of tissue changes with bullae forming at a different location in each type. (a) Erythematous papular lesions revealed primarily dermal edema resulting in intra…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.47.1A: Perivascular dermatitis, interface, patchy lichenoid + 10.47.1B: Keratocytes with steel-gray nuclei, “margination” of chromatin, ballooned cytoplasm, and multinucleate and necrotic keratocytes = Infection by h…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

…time 2. No psoriasiform acanthosis 3. Spongiosis, but little ballooning, in the epidermis 3. Ballooning, but little spongiosis, in the epidermis 4. Very few, if any, individual necrotic keratocytes in the epidermis 4. Numerous individual necrotic…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Mucha-Habermann Disease a Lymphocytic Vasculitis?

“The basic and essential histopathologic change in pityriasis lichenoides et varioliformis acuta is a vasculitis, differing from pityriasis lichenoides chronica, which is primarily a disease of the epidermis…Very important and never des…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.42.1A: Perivascular dermatitis, interface, vacuolar + 10.42.1B: Lymphocytes along the dermoepidermal junction, slight spongiosis, and necrotic keratocytes in a thin epidermis = Graft-versus-host disease Sometimes it is difficult…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.36.1A: Diffuse dermatitis, mixed-cell, and pseudocarcinomatous proliferation of keratocytes + 10.36.1B: Amphophilic ovoid bodies in the cytoplasm of infundibular keratocytes = Milker’s nodule Changes identical with these a…