Benign non-inflammatory skin conditions
Author:
Mikael Häggström [note 1]
These are aberrations that do not display signs of suspected malignant excisions or dermatitis. These may present as skin cysts.
Contents
Fixation
Generally 10% neutral buffered formalin.
See also: General notes on fixation
Gross processing
| <4 mm | 4 - 8 mm | 9 - 15 mm |
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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
Ulceration: On the outer ear, consider chondrodermatitis nodularis chronica helicis (pictured): With the ulceration surrounded by acanthosis and parakeratosis.
Perinuclear vacuolization, most likely insignificant as an isolated finding. In case of dermatitis, consider Vacuolar interface dermatitis
Hyperkeratosis, a thickening of stratum corneum
Dermis
Elastosis is the buildup of elastin in tissues (actinic or "solar" elastosis pictured).
Sebaceous hyperplasia: Increased volume of multiple, mature sebaceous lobules attached central dilated ducts in the upper dermis.[2]
Edematous granulation tissue, low magnification
- Histopathology of edematous granulation tissue, high magnification.jpg
Edematous granulation tissue, high magnification, with connective tissue, inflammatory cells and blood vessels.
Desmoplasia of the skin, an increase of fibrous or connective tissue
Keloid: Wide bands of collagen with large, brightly eosinophilic, glassy fibers, parallel to fibroblasts and myofibroblasts.
Hypertrophic scar: Replacement of the papillary and reticular dermis by scar tissue with prominent vertically oriented blood vessels.[3]
Fatty tissue
Lipomatous tumors cause expansion of fatty tissue.
Notes
- ↑ 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
- ↑
- . Handläggning av hudprover – provtagningsanvisningar, utskärningsprinciper och snittning (Handling of skin samples - sampling instructions, cutting principles and incision. Swedish Society of Pathology.
- For number of slices and coverage of lesions, as well as including sections from each edge in case of diffuse border. - . Dermatopathology Grossing Guidelines. University of California, Los Angeles. Retrieved on 2019-10-23.
- For microtomy of the most central side at the lesion - "The principles of mohs micrographic surgery for cutaneous neoplasia
- 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. - . Handläggning av hudprover – provtagningsanvisningar, utskärningsprinciper och snittning (Handling of skin samples - sampling instructions, cutting principles and incision. Swedish Society of Pathology.
- ↑ Sato, Toshitsugu; Tanaka, Masaru (2014). "Linear sebaceous hyperplasia on the chest ". Dermatology Practical & Conceptual. doi:. ISSN 21609381.
- ↑ Rabello, FB; Souza, CD; Farina Jr, JA (2014). "Update on hypertrophic scar treatment ". Clinics 69 (8): 565–573. doi:. ISSN 18075932.
Image sources
