Atlas of Dermatopathology

Practical Differential Diagnosis by Clinicopathologic Pattern

Günter Burg, Werner Kempf, Heinz Kutzner, Josef Feit, Laszlo Karai, Gunter Burg, Werner Kempf, Heinz Kutzner, Josef Feit, Laszlo Karai

• Publisher: Wiley-Blackwell
• Year: 2015
• ISBN:
  9781118658291
• Edition: 1
• Topic: Medicine
• Subtopic: Dermatology

Improve your dermatological diagnostic accuracy.

The most efficient method in the diagnosis of skin diseases is the combined validation of clinical and histopathological features. The results of biopsy investigation in isolation don't always yield answers. But when considered together, the clinical pattern and the histopathology, then diagnosis can become clearer. In this process the diagnostic impact of histopathology may be decisive or just confirmative to the clinical differential diagnosis. The structure of the book follows a basic approach to morphology, which is overall orientation at scanning magnification first, then identifying a prototypic pattern, and finally finding the essential diagnostic clue(s) under high power magnification.

Dermatopathology: Practical Differential Diagnosis by Clinicopathologic Pattern provides top quality images to correlate clinical presentations with histopathologic features. Annotated images highlight subtle indications that can clinch the diagnosis. Concise, bullet-pointed text provides further context.

Written by internationally renowned authors, the book is ideal for anyone involved in the diagnosis of skin disease.

Chapter 1
Horny Layer

CHAPTER MENU

Reduced granular layer

Prominent granular layer

Reduced granular layer

PROTOTYPE: Ichthyosis vulgaris

Cl: Starts in first year of life, dry rough scaly skin, gray-white scales are shed, symmetrical sparing of flexural areas, hyperlinear palms and soles, often atopic dermatitis (50%).

Ichthyosis vulgaris

Hi: Compact orthohyperkeratosis, granular layer reduced or absent, lack of parakeratosis, follicular dilatation and hyperkeratosis. Epidermis usually normal, sometimes acanthotic or atrophic. No or sparse perivascular infiltrate in the papillary dermis.

VARIANTS: Acquired ichthyosis vulgaris

Histology is identical to ichthyosis vulgaris.

DIFFERENTIAL DIAGNOSIS: Ichthyosis hystrix

Cl: Massive, dark, sometimes spiny hyperkeratosis. Various genetic forms exist. Flexures, palms and soles are involved.

Hi: Mild hyperorthokeratosis, acanthosis, papillomatosis, elongation of rete ridges. Perinuclear vacuolization of granular and spinous layer keratinocytes, presenting epidermolytic features.

Other Diagnosis

Refsum syndrome (heredopathia atactica polyneuritiformis): Vacuolization of basal and suprabasal keratinocytes (accumulation of phytanic acid; Sudan red stain)X-linked dominant ichthyosis (Harlequin ichthyosis): Clinical features similar to ichthyosis vulgaris, but flexures are involved, undescended testes in 30%. Vacuolization of basal and suprabasal keratinocytes (accumulation of phytanic acid; Sudan red stain)

Lamellar ichthyosis: Genetically heterogeneous disorder, usually present at birth presenting as collodion baby in case of generalized involvement. Erythrodermic and non-erythrodermic forms. Transglutaminase-deficiency in most forms. Histology shows mild to moderate hyperorthokeratosis, stratum granulosum normal or broadened, acanthosis, papillomatosis

Bullous, epidermolytic ichthyosis (bullous form of erythrodermia ichthyosiformis congenitalis): Erythroderma at birth with diffuse blistering and erosions, like burned. Histologically the most striking feature is acanthokeratolysis with epidermal thickening leading to superficial blister formation. Tonofilaments can be seen as dark clumps in a shell-like arrangement around the nucleus

Syndromes of ichthyosis and trichothiodystrophy (Tay syndrome): Additional clinical symptoms and biochemical findings.

References

1. de Berker, D., W. A. Branford, S. Soucek, and L. Michaels (1993). “Fatal keratitis ichthyosis and deafness syndrome (KIDS). Aural, ocular, and cutaneous histopathology.” Am J Dermatopathol 15(1): 64–9.
2. de Wolf, K., J. M. Gourdain, G. D. Dobbeleer, and M. Song (1995). “A pa...

Table of contents

• Cover
• Title Page
• Copyright
• Table of Contents
• Dedication
• Preface
• Abbreviations
• Introduction
• Chapter 1: Horny Layer
• Chapter 2: Epidermis
• Chapter 3: Dermal–epidermal Junction (Interface)
• Chapter 4: Dermis
• Chapter 5: Vessels
• Chapter 6: Subcutis
• Chapter 7: Deposition and Storage
• Chapter 8: Adnexae
• Index
• End User License Agreement