CM: Inflammatory Dermatoses

Question 1

normal epidermis
infiltrate around blood vessels in superficial plexus
blood vessels dilated

Answer 1

superficial perivascular dermatitis w/o epidermal change

Question 2

What is the clinical presentation of superficial perivascular dermatitis w/o epidermal change?

Answer 2

erythematous macules and patches, papules and plaques

normal epidermis –> smooth skin surface

Question 3

What kinds of skin diseases commonly show a superficial perivascular dermatitis w/o epidermal change pattern?

Answer 3

viral exanthems

drug eruptions of morbilliform type (7-14 days after)

Question 4

thickened stratum corneum = parakeratosis

alteration of dermoepidermal jxn by infiltrate

Answer 4

superficial perivascular dermatitis w interface change

Question 5

What are the two types of superficial perivascular dermatitis w interface change?

Answer 5

vacuolar subtype - interface altered by vacuolated basal cells as result of inflammation
lichenoid subtype - lichen planus like, band of lymphocytes obscures interface

Question 6

What is the clinical presentation of superficial perivascular dermatitis w interface change?

Answer 6

erythema, violaceous

papules and plaques, scale

Question 7

What skin diseases commonly show superficial perivascular inflammation w interface change?

Answer 7

EM, dermatomyositis, lichen planus, mycosis fungoides, cutaneous t cell lymphoma

Question 8

spongiosis
serum and inflammatory cells in stratum corneum
acanthosis and parakeratosis
superficial perivascular infiltrate

Answer 8

superficial perivascular dermatitis w spongiosis

Question 9

What is the clinical presentation of superficial perivascular dermatitis w spongiosis?

Answer 9

erythema, papules and plaques, crust

Question 10

Which skin diseases present w superficial perivascular dermatitis w spongiosis?

Answer 10

allergic contact dermatitis
nummular dermatitis
tinea inf

Question 11

superficial perivascular infiltrate
epidermal hyperplasia due to elongation of thinned rete ridges
diminished granular layer and parakeratosis
thin epidermis above widened capillaries
neutrophils in stratum corneum or spinous layer

Answer 11

superficial perivascular dermatitis w psoriasiform hyperplasia

Question 12

What is the clinical presentation of superficial perivascular dermatitis w psoriasiform hyperplasia?

Answer 12

erythema, papules and plaques, sharp circumscription of lesions, (silver) scale

Question 13

What are skin diseases that show superficial perivascular dermatitis w psoriasiform hyperplasia?

Answer 13

psoriasis

lichen simplex chronicus

Question 14

inflammatory cells in superficial and deep vascular plexuses in dermis
variable changes in epidermis

Answer 14

superficial and deep perivascular dermatitis

Question 15

What is the clinical presentation of superficial and deep perivascular dermatitis?

Answer 15

erythema, papules and plaques, indurated due to deeper inflammation

Question 16

What are skin diseases that present w superficial and deep perivascular dermatitis?

Answer 16

lupus and dermatomyositis (interface change)
secondary syph (psoriasiform + lichenoid changes)
arthropod bite rxn (maybe spongiosis)

Question 17

perivascular aggregates of inflammatory cells around superficial and deep vascular plexi
extensive coalescence of nodular aggregates to form sheets
possible granulomas

Answer 17

nodular and diffuse dermatitis

Question 18

What is the clinical correlation of nodular and diffuse dermatitis?

Answer 18

reddish-brown granulomatous infiltrates by exam
yellow-brown infiltrates on diascopy
erythematous non-granulomatous infiltrates
papules, nodules, plaques

Question 19

What are skin diseases that show a nodular and diffuse dermatitis pattern?

Answer 19

Hansen’s dz, tb, sarcoidosis, sweet syndrome, b-cell lymphoma

Question 20

*blood vessel injury or destruction

Answer 20

vasculitis

Question 21

What are the different kinds of vasculitis?

Answer 21

small vessel: leukocytoclasis = perivascular neutrophilic infiltrate, extravasated erythrocytes, fibrinoid degeneration, endothelial cell necrosis
medium and large vessel

Question 22

What is the clinical correlation of vasculitis?

Answer 22

purpura
small vessel: purpuric macules, patches, papules, plaques
medium vessel: papulonodules

Question 23

What are the skin diseases that present w vasculitis?

Answer 23

leukocytoclastic vasculitis, PN, Wegener’s

Question 24

vesicles w/i epidermis
acantholysis
ballooning degeneration
spongiosis

Answer 24

intraepidermal vesicular dermatitis

Question 25

What is the clinical correlation of intraepidermal vesicular dermatitis?

Answer 25

translucent vesicle or bulla | erythema

Question 26

What are skin diseases that present w intraepidermal vesicular dermatitis?

Answer 26

pemphigus vulgarus herpes impetigo allergic contact dermatitis

Question 27

vesicles beneath epidermis | sometimes superficial perivascular inflammation in dermis

Answer 27

subepidermal vesicular dermatitis

Question 28

What is the clinical correlation of subepidermal vesicular dermatitis?

Answer 28

translucent vesicle or bullae, erythema at base of blister thicker roof = tense bullae loss of roof = erosions

Question 29

What are skin dzs that show subepidermal vesicular dermatitis?

Answer 29

bullous pemphigoid dermatitis herpatiformis porphyria cutanea tarda

Question 30

alteration in quality and quantity of collagen | fibrosis w increase in fibrocytes, sclerosis w decrease in fibrocytes

Answer 30

fibrosing and/or sclerosing dermatitis

Question 31

What is the clinical correlation of fibrosing and/or sclerosing dermatitis?

Answer 31

erythema and violaceous border of active inflammation papules and plaques from increased collagen depressed plaques from decreased collagen

Question 32

What are skin dzs that show a fibrosing or sclerosing dermatitis?

Answer 32

scar, keloid, morphea, scleroderma

Question 33

inflammatory cells w/i follicle | follicular pustule

Answer 33

folliculitis

Question 34

inflammatory cells around follicle granulomatous lymphocytic

Answer 34

perifolliculitis

Question 35

What is the clinical correlate of folliculitis/perifolliculitis?

Answer 35

erythema, yellow or creamy pustules follicular papules papules or nodules

Question 36

What are skin diseases that show folliculitis/perifolliculitis?

Answer 36

acne vulgaris and hidradenitis suppurativa rosacea alopecia areata (just perifolliculitis)

Question 37

inflammatory cells in fibrous septa of subcutaneous fat

Answer 37

septal panniculitis (erythema nodosum)

Question 38

inflammatory cells present through lobules as well as septa of subcutaneous fat foamy macrophages

Answer 38

lobular panniculitis (lupus profundus)

Question 39

What is the clinical correlate of panniculitis?

Answer 39

nodules and plaques w ill defined boundaries fixed to underlying fascia

Question 40

What does erythema correlate with?

Answer 40

inflammation (non-granulomatous) and vascular dilation

Question 41

What does scale correlate with?

Answer 41

hyperkeratosis/parakeratosis

Question 42

What does serous crust correlate with?

Answer 42

spongiosis, serum and inflammatory cells in stratum corneum, loss of epidermal barrier fxn

Question 43

What does deep inflammation correlate with?

Answer 43

induration

Question 44

What does flaccid blister correlate with?

Answer 44

intraepidermal vesicle

Question 45

What does tense blister correlate with?

Answer 45

subepidermal vesicle

Question 46

What does sclerotic abundant collagen extending throughout dermis correlate with?

Answer 46

hide bound skin

Question 47

What does ill-defined borders correlate with?

Answer 47

subcutaneous inflammation