Difference between revisions of "Benign non-inflammatory skin conditions"

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These are aberrations that do not display signs of [[Suspected malignant skin excisions|suspected malignant excisions]] or [[dermatitis]]:
 
These are aberrations that do not display signs of [[Suspected malignant skin excisions|suspected malignant excisions]] or [[dermatitis]]:
  
==Fixation==
 
 
{{Fixation - standard}}
 
{{Fixation - standard}}
 
{{Fixation - general notes}}
 
{{Fixation - general notes}}
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==Microscopic evaluation==
 
==Microscopic evaluation==
 
The primary objective is to determine the location, and then the most likely cell type of the aberration:
 
The primary objective is to determine the location, and then the most likely cell type of the aberration:
 +
 +
===Epidermis===
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<gallery mode=packed heights=190>
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File:Histopathology of chondrodermatitis nodularis chronica helicis.jpg|'''Ulceration''': On the outer ear, consider chondrodermatitis nodularis chronica helicis (pictured): With the ulceration surrounded by acanthosis and parakeratosis.
 +
File:Micrograph of perinuclear vacuolization, annotated.jpg|'''Perinuclear vacuolization''', most likely insignificant as an isolated finding. In case of dermatitis, consider '''[[Vacuolar interface dermatitis]]'''
 +
File:Prominent hyperkeratosis.jpg|'''[[Hyperkeratosis]]''', a thickening of stratum corneum
 +
</gallery>
  
 
===Dermis===
 
===Dermis===
====Sebaceous glands====
+
<gallery mode=packed heights=190>
<gallery>
+
File:Micrograph of solar elastosis.jpg|'''[[Elastosis]]''' is the buildup of elastin in tissues (actinic or "solar" elastosis pictured).
File:Histopathology of sebaceous hyperplasia.jpg|Sebaceous hyperplasia: Multiple, mature sebaceous lobules attached to the central dilated duct in the upper dermis.<ref>{{cite journal|last1=Sato|first1=Toshitsugu|last2=Tanaka|first2=Masaru|title=Linear sebaceous hyperplasia on the chest|journal=Dermatology Practical & Conceptual|year=2014|issn=21609381|doi=10.5826/dpc.0401a16}}</ref>
+
File:Histopathology of sebaceous hyperplasia.jpg|'''Sebaceous hyperplasia''': Increased volume of multiple, mature sebaceous lobules attached central dilated ducts in the upper dermis.<ref>{{cite journal|last1=Sato|first1=Toshitsugu|last2=Tanaka|first2=Masaru|title=Linear sebaceous hyperplasia on the chest|journal=Dermatology Practical & Conceptual|year=2014|issn=21609381|doi=10.5826/dpc.0401a16}}</ref>
 +
File:Histopathology of edematous granulation tissue, low magnification.jpg|Edematous '''granulation tissue''', low magnification
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File:Histopathology of edematous granulation tissue, high magnification.jpg|Edematous '''granulation tissue''', high magnification, with connective tissue, inflammatory cells and blood vessels.
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File:Histopathology of desmoplasia.jpg|'''[[Desmoplasia of the skin]]''', an increase of fibrous or connective tissue
 +
File:Histopathology of a keloid.jpg|'''[[Keloid]]''': Wide bands of collagen with large, brightly eosinophilic, glassy fibers, parallel to fibroblasts and myofibroblasts.
 +
File:Histopathology of a hypertrophic scar, medium magnification.jpg|'''[[Hypertrophic scar]]''': Replacement of the papillary and reticular dermis by scar tissue with prominent vertically oriented blood vessels.<ref name="RabelloSouza2014">{{cite journal|last1=Rabello|first1=FB|last2=Souza|first2=CD|last3=Farina Jr|first3=JA|title=Update on hypertrophic scar treatment|journal=Clinics|volume=69|issue=8|year=2014|pages=565–573|issn=18075932|doi=10.6061/clinics/2014(08)11}}</ref>
 
</gallery>
 
</gallery>
  
 
====Fatty tissue====
 
====Fatty tissue====
<gallery>
+
<gallery mode=packed heights=190>
File:Histopathology of lipoma.jpg|[[Lipoma]]: The mass is composed of lobules of mature white adipose tissue divided by delicate and inconspicuous fibrous septa containing thin-walled capillary-sized vessels.<ref name="Kim2016">{{cite journal|last1=Kim|first1=Hei Sung |title=Lipoma on the antitragus of the ear|journal=Journal of Clinical Research in Dermatology|volume=3|issue=2|year=2016|pages=01–02|issn=23781726|doi=10.15226/2378-1726/3/2/00121}}</ref>
+
File:Histopathology of lipoma.jpg|'''[[Lipomatous tumor]]s''' cause expansion of fatty tissue.
 
</gallery>
 
</gallery>
 
{{Bottom}}
 
{{Bottom}}

Revision as of 19:01, 26 July 2021

Author: Mikael Häggström [note 1]
These are aberrations that do not display signs of suspected malignant excisions or dermatitis:

Fixation

Generally 10% neutral buffered formalin.

  See also: General notes on fixation


Gross processing

Gross pathology processing of skin lesions with benign appearance, by lesion size:[1]
<4 mm 4 - 8 mm 9 - 15 mm

Tissue selection from skin excision with lesion less than 4 mm with benign appearance.png

Tissue selection from skin excision with lesion 4-8 mm with benign appearance.png

Tissue selection from skin excision with lesion 9-15 mm with benign appearance.png

In table above, each top image shows recommended lines for cutting out slices to be submitted for further processing. Bottom image shows which side of the slice that should be put to microtomy. Dashed lines here mean that either side could be used. Further information: Gross processing of skin excisions

Microscopic evaluation

The primary objective is to determine the location, and then the most likely cell type of the aberration:

Epidermis

Dermis

Fatty tissue

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ". Ochsner J 5 (2): 22–33. 2003. PMID 22826680. PMC: 3399331. Archived from the original. . 
    - With a "standard histologic examination" that, in addition to the lesion, only includes one section from each side along the longest diameter of the specimen.
    - It also shows an example of circular coverage, with equal coverage distance in all four directions.
    - The entire specimen may be submitted if the risk of malignancy is high.
  2. Sato, Toshitsugu; Tanaka, Masaru (2014). "Linear sebaceous hyperplasia on the chest ". Dermatology Practical & Conceptual. doi:10.5826/dpc.0401a16. ISSN 21609381. 
  3. Rabello, FB; Souza, CD; Farina Jr, JA (2014). "Update on hypertrophic scar treatment ". Clinics 69 (8): 565–573. doi:10.6061/clinics/2014(08)11. ISSN 18075932. 

Image sources