Dark skin focalities: Difference between revisions

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Mikael Häggström (talk | contribs)
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Mikael Häggström (talk | contribs)
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==Microscopic evaluation==
==Microscopic evaluation==
[[File:Pie chart of incidence and malignancy of pigmented skin lesions.png|thumb|370px|Various diagnoses of pigmented skin lesions, by relative incidence upon biopsy, and malignancy potential.]]
[[File:Pie chart of incidence and malignancy of pigmented skin lesions.png|thumb|370px|Various diagnoses of pigmented skin lesions, by relative incidence upon biopsy, and malignancy potential.]]
Evaluation is largely based on the relative incidence and malignancy of various differential diagnoses (see pie chart). Main approaches are:
*Direct pattern recognition
*Systematic


Either way can be done by scrolling through the epidermis at intermediate magnification and then through the dermis at a lower magnification.
===Melanocytic lesions===
Scrolling through the epidermis at intermediate magnification and then through the dermis at a lower magnification.


===Pattern recognition===
Melanocytic lesions (including nevus) are the most common, and can be classified as follows:
<gallery>
File:Histopathology of melanocytic nevus.jpg|link=Junctional nevus|[[Junctional nevus]]
File:Histopathology of melanoma, HE.jpg|link=Melanoma|[[Melanoma]]
File:Blue nevus (4 of 4) (2797064219).jpg|link=Blue nevus|[[Blue nevus]]
File:Histopathology of seborrheic keratosis.jpg|link=Seborrheic keratosis|[[Seborrheic keratosis]]
File:Basal Cell Carcinoma, Nodular Pattern (6032028849).jpg|link=Basal cell carcinoma|[[Basal cell carcinoma]]
</gallery>
 
===Systematic===
One approach for the most common conditions are:
{|class="wikitable"
{|class="wikitable"
!  !!colspan=2| Atypia and/or dysplasia
!  !!colspan=2| Atypia and/or dysplasia
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!  !! Low !! High
!  !! Low !! High
|-
|-
! Junction between epidermis and dermis
! Junction<br>between<br>epidermis<br>and dermis
| [[File:Histopathology of melanocytic nevus.jpg|link=Junctional nevus|200px|center]] [[Junctional nevus]] || [[File:Histopathology of lentigo maligna.jpg|200px|center|link=Melanoma in situ]] [[Melanoma in situ]]
| [[File:Histopathology of melanocytic nevus.jpg|link=Junctional nevus|200px|center]] '''[[Junctional nevus]]''' || [[File:Histopathology of lentigo maligna.jpg|200px|center|link=Melanoma in situ]] '''[[Melanoma in situ]]'''
|-
|-
! Dermis
! Dermis
| [[File:Histopathology of dermal nevus, high magnification.jpg|200px|center|link=Dermal nevus]] [[Dermal nevus]] || [[File:Histopathology of nodular melanoma, high magnification.jpg|200px|center|link=Invasive melanoma of the skin]] [[Invasive melanoma of the skin|Invasive melanoma]]
| [[File:Histopathology of dermal nevus, high magnification.jpg|160px|center|link=Dermal nevus]] '''[[Dermal nevus]]''' || [[File:Histopathology of nodular melanoma, high magnification.jpg|200px|center|link=Invasive melanoma of the skin]] '''[[Invasive melanoma of the skin|Invasive melanoma]]'''
|}
|}
A '''compound nevus''' consists of both junctional and dermal melanocytic nevus nests.
===Non-melanocytic===
<gallery mode=packed heights=180>
File:Histopathology of a pigmented basal-cell carcinoma.jpg|Pigmented '''[[basal-cell carcinoma]]''', with palisading cells around nests.
File:Histopathology of seborrheic keratosis.jpg|link=Seborrheic keratosis|[[Seborrheic keratosis]]
</gallery>
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