Download Atlas of Skin Pathology by Ronald Marks, Arthur Knight, P. Laidler (auth.) PDF

By Ronald Marks, Arthur Knight, P. Laidler (auth.)

Dermatopathology is either intriguing and exasperating. tum corneum cells. this happens in issues of keratiniza­ epidermis has a sublime simplicity in its features but a tion as the technique of desquamation is disturbed (Figure 1. 1). ferocious complexity in its constitution. this is often one of many paradoxes that underly the pathology of epidermis disorder Parakeratosis. The presence of nucleated horn cells in and should move a way in explaining the multitudinous the stratum corneum. more often than not the horn cells (corneocy­ problems to which the outside is topic. The prepared visibility tes) are skinny lamellae of below 1 f. lm thickness. They of the surface can assist clarify why trouble-free include no detectable cytoplasmic contents as those are histological exam can't continuously offer an misplaced within the granular phone layer. Parakeratosis happens whilst solution to a clinicians's query. really dramatic seem­ the method of keratinization is disturbed akin to whilst ances can be as a result of adjustments of the relative premiums of the speed of epidermal mobilephone creation is elevated (as in blood circulate, without or with oedema, within the diversified psoriasis) in order that nuclei are usually not damaged down prior to the vascular plexuses or round diverse buildings within the stratum corneum is reached and while harm happens horizontal size, neither of which could lead to to the higher skin (Figure 1. 2). 'much to work out' histologically. The inherent sampling blunders Porokeratosis.

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Pemphigus Foliaceus A[though other features, including the results of immunof[uorescence staining, are the same as in pemphigus vulgaris, the clefting in pemphigus fo[iaceus is subcorneal or between granular cells. This plane of cleavage is immediately beneath the granular layer and so dyskeratosis is characteristically superficial. Shrunken, basophi[ic epidermal cells are seen in the granular zone. Erythema Multiforme This is a relapsing condition, idiopathic but sometimes precipitated by viral infections or drugs and characterized by erythematous plaques, macu[es or papules.

Clinically the lesion is a warty growth on a finger of a pathologist handling cadavers or on the buttocks of a child from a country with a high incidence of pulmonary tuberculosis. Histopathology. The epidermis is thickened. papillomatous and may show pseudoepitheliomatous hyperplasia. There is an acute inflammatory infiltrate in the upper dermis with abscess formation. In the mid and deep dermis a tuberculoid granuloma develops with significant central necrosis. Acid-fast bacilli may be demonstrable.

Pityriasis rubra pilaris. This is an uncommon inflammatory skin disorder of unknown cause. In the early erythrodermic phase it resembles psoriasis with widespread erythema and scaling, though at some sites a characteristic plugging of follicles with horny spines may be seen. As in psoriasis there is a high rate of epidermal 53 ECZEMA. PSORIASIS. 1 Differential diagnosis of chronic psoriasis Psoriasis Pityriasis lichenoides chronica Pityriasis rubra pilaris Lichenification + + + + + + Parakeratosis Munro abscess Prominent granular cell layer Neutrophils in epidermis Follicular plugging + + Differential Diagnosis of Psoriasis Conditions to be differentiated histologically are: pityriasis rubra pilaris, subcorneal pustular dermatosis, impetigo, Bowen's disease, lichenification, pityriasis lichenoides chronica, hypertrophic lichen planus and a psoriasiform naevus.

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