Clinical Case Studies

Extensive Actinic Damage

INITIAL PRESENTATION A 67-year-old Caucasian male presented with severe photodamage of his face and scalp and a history of multiple nonmelanoma skin cancers. (Figure 1) The patient had been treated with radiation for adolescent acne vulgaris. One ye…

Histologic Diagnosis of Inflammatory Skin Diseases

Images

Images 10.37.1A: Pustular dermatitis, infundibular + 10.37.1B: Numerous Demodex folliculorum and squames in a zone of suppuration = Suppurative infundibulitis of unknown cause Demodex, Pityrosporum, bacteria, sebum, squames, and cornified…

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…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Erythema Dyschromicum Perstans?

“During the year 1959–1960 in the Department of Dermatology of the Vargas Hospital in Caracas, we studied five adult patients with a peculiar new pigmentary disorder. . . . The skin eruption is characterized by numerous macules with a…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Palpable Purpura?

“Because the small vessels—especially the capillaries—are involved, exudation and hemorrhage are the prominent clinical features of leukocytoclastic angiitis. Purpura is almost always present in the cutaneous lesions and is freque…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Keratosis Lichenoides Chronica?

“So we have to start once more [in regard to what is the authentic nature of lichen rubra moniliformia], returning to the old case of Kaposi by which the question began in 1886.” Pinkus H. Lichen ruber moniliformis Kaposi. Arch Dermato…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Parapsoriasis?

“Parapsoriasis. Under this provisional name, Brocq in 1902 grouped several rare and unclassifiable dermatological types, characterized by nonpruriginous erythmato-squamous spots, extremely persistent and rebellious to all treatment. It is ex…

Resolving Quandaries in Dermatology, Pathology & Dermatopathology

Urticarial Vasculitis?

“Although necrotizing angiitis (vasculitis) of the superficial venules and capillaries of the skin is usually appreciated visually as a purpuric papule, a group of patients has been defined in whom all of the skin lesions were urticarial. Mic…

Differential Diagnosis in Dermatopathology

Discussions

Lichen sclerosus et atrophicus, which is the superficial manifestation of morphea, and chronic radiation dermatitis are both fibrosing dermatitides that may resemble each other closely when viewed through the scanning objective of a conventional mic…