Histologic Diagnosis of Inflammatory Skin Diseases

Deep fungal infections

…d-cell infiltrates that extend throughout much of the dermis; scale-crusts represent collections of neutrophils and serum in zones of parakeratosis; warty appearance derives from papillated or verrucous surface epidermal and infundibular epidermal (p…

Histologic Diagnosis of Inflammatory Skin Diseases

Pellagra

…ar edema in spinous cells in the upper half of the epidermis. Scale consists of parakeratosis and scale-crust of parakeratosis, serum, and, sometimes, neutrophils. Differential diagnosis histopathologic Acrodermatitis enteropathica, necrolytic migra…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…ce, lichenoid + 10.25.4B: Predominance of lymphocytes and scale-crust atop an erosion = Lichenoid drug eruption Even at scanning magnification, a determination can be made that the diagnosis is not lichen planus, the evidence against it being the…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Figurate Erythemas?

…elevated and red, is typified further by tiny collarettes of scale positioned along its inner margin. Advancing lesions leave in their wake degrees variable of hyperpigmentation. Biopsy of the scaly portion of the rim of a lesion of erythema annular…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

…also in infundibular and surface epidermis, especially in the scale-crust. This condition, still thought by some authors to be related to Mucha-Habermann disease, is not an inflammatory process, but a CD 30 lymphoma. 11.13.6A: Perivascular and…

Histologic Diagnosis of Inflammatory Skin Diseases

Impetigo contagiosa

…show spongiform and subcorneal pustules, and in late lesions, scale-crusts laden with neutrophils. Clinically, bullous impetigo, which is nothing other than a blistering manifestation of impetigo contagiosa, may display both tense and flaccid blister…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Ichthyoses?

…proposed. Ichthyosis vulgaris patients have dry skin and fine scales on their trunk and extremities, but gross changes in the skin of their legs may be more severe. A granular layer is histologically absent. Lamellar ichthyosis patients have large, c…

Dermatology Practical & Conceptual

A keratoacanthoma with venous invasion

…peripherally. It was not tender to palpation and some surface scale was evident. Figure 1. (A) A new raised lesion is present on the left forehead. (B) Close-up imaging reveals central keratin surrounded by a white area, which merges into a pink a…

Histologic Diagnosis of Inflammatory Skin Diseases

Lichen striatus

…when linear, is red, and lesions are covered by a gray-white scale. An inflammatory linear verrucous epidermal nevus usually is present at birth or appears within the first few years of life, and lesions resemble those of linear psoriasis. Clinical…