FIBROSING & SCLEROSING DERMATITIS, COLLAGEN, ELASTIC, METABOLIC & PIGMENTARY DISORDERS Flashcards
1
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Lichen Sclerosus et Atrophicus: Early lesion
- Marked basal cell hydropic degeneration
2
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Lichen Sclerosus et Atrophicus
3
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Radiation Dermatitis
- Hyperkeratosis and epidermal atrophy
- Papillary dermal pallor without vacuolar change or lymphoid band
- Large stellate radiation fibroblasts
- Radiation elastosis
- Loss of adnexa
- Dilated ectatic vessels superficially
4
Q
Differentiate lichen sclerosus and chronic radiation dermatitis
A
5
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Morphea and Scleroderma
- Early inflammatory stage: Superficial and deep lymphoplasmacytic infiltrate
- Square/rectangular punch
- Thick closely packed hyalinized collagen bundles in the lower dermis.
- Loss of adventitial fat resulting in “trapped” eccrine glands
6
Q
Conditions with Square Punch Biopsy
A
- Morphea/Scleroderma
- Scleredema
- Chronic Graft vs Host Disease
- Chronic Radiodermatitis
- Connective Tissue Nevi
- Scar
- Normal skin of the back
7
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8
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9
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Pseudoxanthoma Elasticum
- Curled and frayed, calcified elastic fibers in the reticular dermis
- Elastic tissue (Verhoeff–Van Gieson) and calcium (Von Kossa) stains highlight the distorted elastic fibers
10
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Macular Amyloidosis
- Sparse pink deposits in the papillary dermis
- Amyloid is outlined by a fine network of melanophages
11
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Lichen Amyloidosis
- Hyperkeratosis and acanthosis
- Pink amorphous deposits in the papillary dermis outlined by a network of melanophages
12
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13
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14
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Calciphylaxis
- Calcified and thrombosed vessels in the subcutaneous fat
- Necrosis
15
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Calciphylaxis
- Calcified and thrombosed vessels in the subcutaneous fat
- Necrosis
16
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Ochronosis
- Early lesion: markedly swollen collagen fibers
- Developed lesion: Yellowbrown bodies in between collagen bundles in the dermis (Banana bodies)
17
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Scleredema
- Thickened dermis
- Widened spaces with mucin between normal collagen bundles
- Mucin is most prominent in the deep dermis
- No inflammatory infiltrate or increased fibroblasts
- Features can be subtle with increased space between collagen fibers in the deep dermis
18
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Scleromyxedema
Increase in:
- dermal fibroblasts
- fine collagen fibers
- interstitial mucin
19
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Vitiligo
- Active stage: Lymphocytic infiltrates
- Absent melanocytes
- Complete loss of melanin pigment from epidermis
20
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Café au lait macules
- Basal hyperpigmentation
- No increase in melanocytes
- Giant melanin granules
- Disease associations:
- Neurofibromatosis
- McCune–Albright syndrome tuberous sclerosis
- Fanconi anemia
- Bloom syndrome
- Russell–Silver syndrome
- etc
