Dermatitis: Difference between revisions
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===Non vesicullobullous, non-pustular lesions with epidermal changes=== | ===Non vesicullobullous, non-pustular lesions with epidermal changes=== | ||
====Spongiotic dermatitis==== | |||
{|class="wikitable" | {|class="wikitable" | ||
! | !rowspan=2| !!colspan=3| Characteristics !!rowspan=2| Micrograph !!rowspan=2| Photograph | ||
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! Spongiotic dermatitis<br>- epithelial intercellular edema<ref name="Alsaad2005"/> | | | Acute || Subacute || Chronic | ||
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! Generally/Not otherwise specified<ref group="notes" name="not-otherwise-specified"/> | |||
| Typical findings:<ref name="Alsaad2005"/> | |||
*Variable degree of epidermal spongiosis and vesicle formation, filled with proteinaceous fluid containing lymphocytes and histiocytes. | |||
*Usually superficial dermal edema with perivascular lymphocytic infiltrate, with exocytosis. | |||
*No acanthosis or parakeratosis. | |||
| Typical findings:<ref name="Alsaad2005"/> | |||
*Mild to moderate spongiosis and exocytosis of inflammatory cells | |||
*Irregular acanthosis and parakeratosis. | |||
*Superficial dermal perivascular lymphohistiocytic infiltrate | |||
*Swelling of endothelial cells | |||
*Papillary dermal edema are present | |||
| Typical findings:<ref name="Alsaad2005"/> | |||
*The spongiosis is mild to absent | |||
*Pronounced irregular acanthosis, hyperkeratosis, and parakeratosis | |||
*Minimal dermal inflammation and exocytosis of inflammatory cells are present. | |||
*Possibly fibrosis of papillary dermis | |||
PAS stain is essential to exclude fungal infection.<ref name="Alsaad2005"/> | |||
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! Allergic/contact dermatitis or atopic dermatitis | |||
| Eosinophils may be present in the dermis and epidermis (eosinophilic spongiosis).<ref name="Alsaad2005"/> | |||
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! Seborrheic dermatitis | |||
| Typical findings:<ref name=pathologyoutlines>{{cite web|url=https://www.pathologyoutlines.com/topic/skinnontumorseborrheicdermatitis.html|title=Skin inflammatory (nontumor) > Spongiotic, psoriasiform and pustular reaction patterns > Seborrheic dermatitis|author=Mowafak Hamodat|website=PathologyOutlines.com}} Topic Completed: 1 August 2011. Revised: 26 March 2019 </ref> | |||
*Focal, usually mild, spongiosis with overlying scale crust, with a few neutrophils | |||
*The crust is often centered on a follicle | |||
*The papillary dermis is generally mildly edematous | |||
*Dilated blood vessels in the superficial vascular plexus | |||
*Mild superficial perivascular infiltrate of lymphocytes, histiocytes and occasional neutrophils. There is some exocytosis of inflammatory cells but not as prominent as in nummular dermatitis | |||
| Typical findings:<ref name=pathologyoutlines/> | |||
*Psoriasiform hyperplasia, initially slight, with mild spongiosis | |||
*Usually numerous yeast-like organisms in the surface keratin | |||
*Same changes as seen in acute stage. | |||
| Typical findings:<ref name=pathologyoutlines/> | |||
*More pronounced psoriasiform hyperplasia | |||
*Only minimal spongiosis | |||
*Presence of scaling crusts in a folliculocentric distribution, distinguishes from psoriasis. | |||
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| [[File:Seborrhoeic dermatitis example.jpg|190px]] | |||
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====Interface and psoriaform==== | |||
{|class="wikitable" | |||
! Main conditions<ref name="Alsaad2005"/> !! Characteristics !! Micrograph !! Photograph | |||
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! Spongiotic dermatitis<br>- epithelial intercellular edema<ref name="Alsaad2005"/> | |||
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| Interface dermatitis || || | | Interface dermatitis || || | ||