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DERMATOPATHOLOGY > PSORIASIFORM, SPONGIOTIC, AND INTERFACE DERMATITIS > Flashcards

PSORIASIFORM, SPONGIOTIC, AND INTERFACE DERMATITIS Flashcards

1
Q

IDENTIFY THE PATTERN

A

Superficial Perivascular Dermatitis (with minimal epidermal change)

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2
Q

IDENTIFY THE PATTERN

A

Superficial Perivascular Dermatitis (with minimal epidermal change)

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3
Q
A

Pityriasis Rosea

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4
Q

What are the 9 basic inflammatory patterns

A
  1. Superficial perivascular dermatitis
  2. Superficial and deep perivascular dermatitis
  3. Nodular and diffuse dermatitis
  4. Intraepidermal vesicular and pustular dermatitis
  5. Subepidermal vesicular dermatitis
  6. Fibrosing dermatitis
  7. Folliculitis and perifolliculitis
  8. Vasculitis
  9. Panniculitis
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5
Q

2 MOST IMPORTANT HISTOLOGIC FEATURES OF PSORIASIS

A

Munro Microabscesses
Spongiform Pustule of Kogoj

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6
Q

give differentials for psoriasiform dermatitis

A

*Psoriasis

*Lichen Simplex Chronicus/ Prurigo Nodularis

*Pityriasis Rosea

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7
Q
A

LICHEN SIMPLEX CHRONICUS/PRURIGO NODULARIS

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8
Q
A

PITYRIASIS ROSEA

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9
Q

give differentials for spongiotic dermatitis

A

DIFFERENTIALS: “D’ CAIN”

1)Dyshidrotic eczema

2)Contact Dermatitis

3)A- llergic contact dermatitis/ Atopic Dermatitis

4)I-rritant contact dermatitis

5)N-ummular eczema

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10
Q

give differentials for spongiotic dermatitis

A

DIFFERENTIALS: “D’ CAIN”

1)Dyshidrotic eczema

2)Contact Dermatitis

3)A- llergic contact dermatitis/ Atopic Dermatitis

4)I-rritant contact dermatitis/ Id reaction

5)N-ummular eczema

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11
Q

Acute/ subacute or chronic?

A

Acute Spongiosis

✓ Intraepidermal vesicles
✓ Prominent epidermal edema

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12
Q

Acute/ subacute or chronic?

A

Subacute spongiotic dermatitis

✓ Intraepidermal edema less prominent
✓ Acanthosis
✓ Beginning papillary dermal fibrosis

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13
Q

Acute/ subacute or chronic?

A

Chronic Spongiotic Dermatitis

  • “psoriasiform-like”
  • Acanthosis
  • Papllary dermal fibrosis
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14
Q
A

EOSINOPHILIC SPONGIOSIS

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15
Q

give differentials for EOSINOPHILIC SPONGIOSIS

A

S- CABIES
H -ERPES GESTATIONIS
A - RTHROPOD BITE/ ALLERGIC CONTACT DERMATITIS
P- EMPHIGUS
P- EMPHIGOID
I - NCONTINENTIA PIGMENTI
E - RYTHEMA TOXICUM NEONATORUM

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16
Q

what are the features of vacuolar interface dermatitis

A

1.BASAL LAYER VACUOLIZATION (Black arrows) *other term: vacuolar interface change

  1. PIGMENT INCONTINENCE
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17
Q

give differentials for vacuolar interface dermatitis

A

1.Ashy Dermatosis

2.Post-inflammatory hyperpigmentation

3.LATE STAGE fixed drug eruption

18
Q
A

VACUOLAR INTERFACE: ERYTHEMA MULTIFORME

FEATURES:
1.BASAL LAYER VACUOLIZATION (Black arrows) other term: vacuolar interface change

  1. APOPTOTIC KERATINOCYTES (Green arrows)
  2. Orthokeratosis (acute process)
19
Q

give differentials for VACUOLAR INTERFACE: ERYTHEMA MULTIFORME

A

DIFFERENTIALS:

1.Stevens-Johnson Syndrome (beginning)

2.Graft-versus-host disease (GVHD)

20
Q
A

VACUOLAR INTERFACE: STEVENS JOHNSON SYNDROME /TOXIC EPIDERMAL NECROLYSIS

FEATURES:

1.SUBEPIDERMAL SPLIT

  1. FULL THICKNESS EPIDERMAL NECROSIS
  2. Orthokeratosis (acute process)
21
Q
A

VACUOLAR INTERFACE: CUTANEOUS LUPUS ERYTHEMATOSUS

  • Basal layer vacuolization (black arrows) with thickening of basement membrane (Green arrows)

FEATURES:

✓ PATTERN: INTERFACE
✓ Basal layer vacuolization
✓ Superficial AND deep perivascular, perieccrine, and periadnexal infiltrates of lymphocytes and plasma cells

22
Q

What’s the DIF and stain pattern of Cutaneous Lupus Erythematosus

A

BANDLINKE deposits of immunoglobulin G (IgG) in the basement membrane zone

23
Q

Ddx of Lupus

A

Dermatomyositis

24
Q
A

LICHENOID INTERFACE: LICHEN PLANUS

FEATURES:

✓ PATTERN: LICHENOID – band-like pattern of infiltrates in the papillary dermis
✓ Wedge-shaped hypergranulosis
✓ Saw-tooth appearance of the rete ridges

25
Q

Identify. What disease is this seen?

A

Max Joseph Space
- seen in Lichen planus
- The eponym “Max Joseph space” stands for “the appearance of the liquefaction degeneration of the basal cells and extracellular fluid accumulation about the individual basal cells (that) is strongly suggestive of mild irritation. (from google)

26
Q

Identify. What disease is this seen?

A

Basal layer vacuolization with “CIVATTE BODIES” (black arrows)

  • seen in lichen planus
27
Q
A

LICHENOID INTERFACE: LICHEN NITIDUS

FEATURES:

✓ PATTERN: lichenoid
✓ Dense infiltrate of lymphocytes and histiocytes in an expanded dermal papilla

✓ CLAWLIKE epidermal lateral borders

28
Q

DDx for Neutrophils in the Stratum corneum

A

PTICSS! (Neuts in the SC)

Psoriasis
Tinea
Impetigo
Candida
Seborrheic dermatitis
Syphilis

28
Q

DDx for Eosinophilic spongiosis

A

“SHAPPIE”
Scabies
Herpes gestationis
Arthropod bite/ACD
Pemphigus
Pemphigoid
Incontinentia pigmenti
Erythema toxicum neonatorum

29
Q

What type of psoriasis

A

Guttate Psoriasis

  • pronounced inflammatory infiltrate
  • less acanthosis
  • basket-weave orthokeratotic stratum corneum
  • overlying mounds of parakeratosis with neutrophils -“seagull”
30
Q

What type of psoriasis

A

Pustular Psoriasis

  • presents as macropustule
  • spongiform pustule formation:
    ⚬ aggregates of neutrophils
    ⚬ cytolysis of epidermal cells
    ⚬ cornified layer: pyknotic
  • upper dermis contains lymphocytes
  • migrating neutrophils in the papillae to epidermis
31
Q

Differentials for Subcorneal Pustules

A

CAT SIPS

Candida
Acropustulosis of infancy
Transient neonatal pustular melanosis
Sneddon-Wilkinson
Impetigo
Pustular psor
SSSS

32
Q
A

Pityriasis Rubra Pilaris

  • acanthosis with broad and short rete ridges
  • thick suprapapillary plates
  • hypergranulosis
  • mild superficial perivascular lymphocytic infiltrate
33
Q
A

Pityriasis Rubra Pilaris
- alternating ortho and parakeratosis in both vertical and horizontal directions

34
Q
A

Pityriasis Rosea
- acanthosis, epidermal spongiosis (bracket)
- exocytosis of lymphocytes
- superficial perivascular infiltrate

35
Q
A

Pityriasis Rosea

  • extravasated erythrocytes in the papillary dermis
  • MOUNDS of parakeratosis
36
Q
A

Seborrheic Dermatitis

  • “shoulder parakeratosis”
  • regular acanthosis and elongation of the rete ridges
  • mild spongiosis sparse
  • mononuclear cell infoltrate
37
Q
A

Inflammatory linear verrucous epidermal nevus (ILVEN)

  • papillated epidermal hyperplasia
  • thick, elongated rete
  • spongiosis
  • alternating ortho and parakeratosis
38
Q
A

Lichen Simplex Chronicus

  • compact orthokeratosis
  • irregular psoriasiform acanthosis
  • elongation of the rete ridges
  • wedge-shaped hypergranulosis
  • vertically-oriented collagen bundles
39
Q
A

Nutritional deficiency dermatitis

40
Q
A

DERMATOPATHOLOGY (16 decks)

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