Histologic Diagnosis of Inflammatory Skin Diseases

Pattern Analysis in Historical Perspective

In 1963, the year that one of us (A.B.A.) began a residency in dermatology, Walter Lever’s textbook, Histopathology of the Skin, was in its third edition and was deemed, universally, to be “the bible” of dermatopathology. To a firs…

Histologic Diagnosis of Inflammatory Skin Diseases

Identification of Basic Patterns: Skin: Vasculitis

See Fig. 5.218 A&B. Figure 5.218 Vasculitis. A. Small vessel. B. Large vessel. Before a reasoned and reasonable method for diagnosis histopathologic of vasculitis in skin and subcutaneous fat can be formulated, a definition of vasculitis must…

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

Behçet’s Disease

Behçet”s disease Synonyms Aphthosis Behçet Aphthosis Presentation stereotypical Age and sex Onset usually in the third decade of life with male predominance Distribution of lesions Face for acneiform lesions, lower extremities for panniculit…

Differential Diagnosis in Dermatopathology

Discussions

Erythema multiforme and the acute phase of graft-versus-host disease share numerous findings histopathologic. Both are characterized by superficial perivascular infiltrates of lymphocytes, prominent changes at the dermoepidermal junction, i.e., obsc…

Dermatology Practical & Conceptual

Balloon cell melanoma in primary care practice: a case report

Abstract A case of balloon cell melanoma encountered in a primary care skin cancer practice in Melbourne, Australia is presented. The presenting lesion was 6 mm in diameter, ulcerated, non-pigmented and without any algorithmic clues to melanoma. How…

Differential Diagnosis in Dermatopathology

Differential Diagnosis

…epidermal vesiculation 2. No intra-epidermal vesiculation 3. Ballooning of keratocytes 3. No ballooning of keratocytes 4. Reticular alteration of the epidermis 4. No reticular alteration 5. Confluent necrosis of epidermal keratocytes 5. No conf…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Subcorneal Blistering Diseases?

“The vesicles and bullae in acute vesicular dermatitis are usually intraepidermal in location, lying either within the rete malphigi or below the stratum corneum; subepidermal location is rare.” Lever WF. Noninfectious inflammatory dis…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.61.1A: Perivascular dermatitis, spongiotic lichenoid + 10.61.1B: Lymphocytes mostly, in conjunction with scale-crusts that contain neutrophils = Lichen striatus  The presence of a lichenoid infiltrate telegraphs that this is not…