DERMATOSES

Acute Spongiotic
Dermatitis. The
stratum corneum is
largely
normal, and there is
intraepidermal
edema (spongiosis)
and a superficial
perivascular
inflammatory
infiltrate.
Chronic Spongiotic
Dermatitis. There is
compact
hyperkeratosis,
a thickened granular
layer, minimal
spongiosis, and a
sparse
perivascular
infiltrate.
Subacute
Spongiotic
Dermatitis.
The epidermis
is acanthotic
and
spongiotic
with overlying
parakeratosis
Langerhans Cell
Microabscess.
Intraepidermal
collections
of Langerhans
cells are often
found in allergic
contact
dermatitis.
Stasis Dermatitis.
Within the
superficial dermis
there is a
lobular proliferation
of relatively thick-
walled vessels with
hemorrhage
and overlying
spongiosis in the
epidermis.
Typical Appearance of
Psoriasis. Note the
engorgement
of papillae and Munro
microabscesses.
Guttate Psoriasis.
Note the discrete
mound of
parakeratosis
with overlying
collections of
neutrophils.
Lichen Simplex
Chronicus. There is
compact
hyperkeratosis
overlying an
acanthotic
epidermis with a
thickened granular
layer. Vertically
oriented, thickened
collagen bundles
are present in the
superficial dermis.
Erythema
Multiforme. There is
interface change with
basal
vacuolization,
numerous
dyskeratotic
keratinocytes, and a
sparse perivascular
infiltrate.
Microscopic
changes of
acute graft-
versus-host
reaction.
Extensive facial
lesions of chronic
discoid lupus
erythematosus.
Lesion of
chronic discoid
lupus
erythematosus
showing
hyperkeratosis
and interface
change with
hydropic
degeneration
along
basal layer.
Clinical
Appearance of
Lichen Planus
Affecting the
Dorsum of the
Hand. One of
the lesions has
been biopsied.
Lichenoid Tissue
Reaction. Lichenoid
drug reactions
resemble lichen
planus, but typically
have parakeratosis,
which is usually
absent in lichen
planus. (Courtesy of
Dr Fabio Facchetti,
Brescia, Italy.)
Microscopic
Appearance of
Lichen Planus.
There is
orthotopic
hyperkeratosis,
hypergranulosis,
basal vacuolization,
and a
band-like
inflammatory
infiltrate with
melanophages.
Fixed Drug
Eruption. The
infiltrate is rich
in eosinophils
and is
accompanied
by necrotic
keratinocytes.
Pityriasis
Lichenoides Et
Varioliformis Acuta.
There is
interface change with
basal vacuolization
and a superficial and
deep
lymphocytic infiltrate
with papillary dermal
hemorrhage.
Morbilliform Drug
Eruption. The
epidermis is
relatively
normal. Within the
dermis there is a
mild perivascular
infiltrate of
lymphocytes
and eosinophils.
Arthropod Bite. A, Heavy inflammatory dermal infiltrate
around necrotic focus. B, Section of the arthropod.
Acute Necrotizing
Changes in
Leukocytoclastic
Vasculitis.
Perniosis is
characterized by
a superficial and
deep
perivascular
lymphocytic
vasculitis.
Non-
Necrotizing
Vasculitis in
Pigmented
Purpuric
Dermatosis.