Dermatitis: Difference between revisions

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! Urticaria, lymphocyte predominant
! Urticaria, lymphocyte predominant
| Perivascular location. Mast cells are relatively sparse, potentially demonstrated with special stains, preferably tryptase stain. Extravasated erythrocytes are present in about 50% of the cases. No vasculitis.<ref name="BarzilaiSagi2017">{{cite journal|last1=Barzilai|first1=Aviv|last2=Sagi|first2=Lior|last3=Baum|first3=Sharon|last4=Trau|first4=Henri|last5=Schvimer|first5=Michael|last6=Barshack|first6=Iris|last7=Solomon|first7=Michal|title=The Histopathology of Urticaria Revisited—Clinical Pathological Study|journal=The American Journal of Dermatopathology|volume=39|issue=10|year=2017|pages=753–759|issn=0193-1091|doi=10.1097/DAD.0000000000000786}}</ref>
| Perivascular location. Mast cells are relatively sparse, potentially demonstrated with special stains, preferably tryptase stain. Extravasated erythrocytes are present in about 50% of the cases. No vasculitis.<ref name="BarzilaiSagi2017">{{cite journal|last1=Barzilai|first1=Aviv|last2=Sagi|first2=Lior|last3=Baum|first3=Sharon|last4=Trau|first4=Henri|last5=Schvimer|first5=Michael|last6=Barshack|first6=Iris|last7=Solomon|first7=Michal|title=The Histopathology of Urticaria Revisited—Clinical Pathological Study|journal=The American Journal of Dermatopathology|volume=39|issue=10|year=2017|pages=753–759|issn=0193-1091|doi=10.1097/DAD.0000000000000786}}</ref>
| [[File:Micrograph of urticaria.jpg|190px]] Dermal edema [solid arrows in (A,B)] and a sparse superficial predominantly perivascular and interstitial infiltrate of lymphocytes and eosinophils without signs of vasculitis (dashed arrow).<ref>{{cite journal|last1=Giang|first1=Jenny|last2=Seelen|first2=Marc A. J.|last3=van Doorn|first3=Martijn B. A.|last4=Rissmann|first4=Robert|last5=Prens|first5=Errol P.|last6=Damman|first6=Jeffrey|title=Complement Activation in Inflammatory Skin Diseases|journal=Frontiers in Immunology|volume=9|year=2018|issn=1664-3224|doi=10.3389/fimmu.2018.00639}}</ref>
| [[File:Urticaria near navel.jpg|190px]]
|-
|-
! [[Fungal skin infection]]
! [[Fungal skin infection]]
| Visible fungus. Other signs depend on fungus species.<ref name="GuarnerBrandt2011">{{cite journal|last1=Guarner|first1=J.|last2=Brandt|first2=M. E.|title=Histopathologic Diagnosis of Fungal Infections in the 21st Century|journal=Clinical Microbiology Reviews|volume=24|issue=2|year=2011|pages=247–280|issn=0893-8512|doi=10.1128/CMR.00053-10}}</ref>
| Often visible fungus. Other signs depend on fungus species.<ref name="GuarnerBrandt2011">{{cite journal|last1=Guarner|first1=J.|last2=Brandt|first2=M. E.|title=Histopathologic Diagnosis of Fungal Infections in the 21st Century|journal=Clinical Microbiology Reviews|volume=24|issue=2|year=2011|pages=247–280|issn=0893-8512|doi=10.1128/CMR.00053-10}}</ref>
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|  
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|-
! Pigmented purpuric dermatosis
! Pigmented purpuric dermatosis
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*The epidermis may be normal or may exhibit spongiosis, focal parakeratosis, exocytosis and/or vacuolar change.<ref name=dermpedia/>
*The epidermis may be normal or may exhibit spongiosis, focal parakeratosis, exocytosis and/or vacuolar change.<ref name=dermpedia/>
| [[File:Histopathology of Schamberg disease.jpg|190px]]
| [[File:Histopathology of Schamberg disease.jpg|190px]]
| [[File:Schambergdisease-26male.png|190px]]
|-
|-
! Erythema annulare centrifugum
! Erythema annulare centrifugum
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Deep lesions: Sharply demarcated perivascular mononuclear cell infiltrate in middle to deep dermis<ref name=dermnetz/>
Deep lesions: Sharply demarcated perivascular mononuclear cell infiltrate in middle to deep dermis<ref name=dermnetz/>
| [[File:Micrograph of erythema annulare centrifugum.jpg|190px]]
| [[File:Micrograph of erythema annulare centrifugum.jpg|190px]]
| [[File:Erythema annulare centrifugum on arms and legs.jpg|190px]]
|-
|-
! Not otherwise specified
! Not otherwise specified
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|-
|-
! Not otherwise specified
! Not otherwise specified
| A lesion with superficial lymphocytic infiltrate without additional histopathologic characteristics can be due to for example drug reactions and insect bites.<ref name="Alsaad2005"/>
| A lesion with superficial lymphoeosinophilic infiltrate without additional histopathologic characteristics can be due to for example drug reactions and insect bites.<ref name="Alsaad2005"/>
|}
 
====Lymphoplasmacytic infiltrate====
{|class="wikitable"
! Main conditions<ref name="Alsaad2005"/> !! Characteristics !! Micrograph !! Photograph
|-
! Rosacea
| Typically enlarged, dilated capillaries and venules located in the upper dermis, angulated telangiectasias, perivascular and perifollicular lymphocytic infiltration, and superficial dermal edema.<ref name=Celiker2017>{{cite journal|last1=Celiker|first1=Hande|last2=Toker|first2=Ebru|last3=Ergun|first3=Tulin|last4=Cinel|first4=Leyla|title=An unusual presentation of ocular rosacea|journal=Arquivos Brasileiros de Oftalmologia|volume=80|issue=6|year=2017|issn=0004-2749|doi=10.5935/0004-2749.20170097}}</ref>
| [[File:Micrograph of rosacea.jpg|190px]]
| [[File:Rosacea.jpg|190px]]
|-
! Secondary syphilis
| Various, but often one or a combination of:<ref>{{cite web|url=https://www.dermnetnz.org/topics/syphilis-pathology/|title=Syphilis pathology|Assoc Prof Patrick Emanuel|year=2013|website=Dermnet NZ}}</ref>
*Psoriasiform hyperplasia with superficial neutrophils
*Lichenoid tissue reaction, epidermal apoptosis and exocytosis of neutrophils
*Superficial and deep chronic infiltrate in the dermis
*Often numerous plasma cells in about 1/3 of cases
*Often endothelial swelling.
| [[File:Micrograph of secondary syphilis, HE.jpg|190px]]
| [[File:Secondary stage syphilis sores (lesions) on the soles of the feet. Plantar lesions-CDC.jpg|190px]]
|-
! Erythema migrans
| Typically a superficial and deep perivascular lymphocytic infiltrate.<ref name="WilsonLegler2012">{{cite journal|last1=Wilson|first1=Thomas C.|last2=Legler|first2=Allison|last3=Madison|first3=Kathi C.|last4=Fairley|first4=Janet A.|last5=Swick|first5=Brian L.|title=Erythema Migrans|journal=The American Journal of Dermatopathology|volume=34|issue=8|year=2012|pages=834–837|issn=0193-1091|doi=10.1097/DAD.0b013e31825879be}}</ref> Plasma cells are typically located at the periphery of the lesion, whereas eosinophils are in the center.<ref name="WilsonLegler2012"/>
|
| [[File:Erythema migrans - erythematous rash in Lyme disease - PHIL 9875.jpg|190px]]
|-
! Not otherwise specified
| A lesion with superficial lymphoplasmacytic infiltrate without additional histopathologic characteristics can be due to for example trauma, ulceration, or scar.<ref name="Alsaad2005"/>
|}
|}
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