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Histopathology of the Skin
Ashok Aggarwal
CHAPTER 1:
Histology of Normal Skin
DERMIS
Extracellular Matrix
Collagen
Elastic Fibers
Ground Substance
Subcutaneous Fat
Nerves
Blood Vessels
Lymphatic Vessels
Mucosal Epithelium
DERMAL MUSCLE CELLS
Smooth Muscle(Involuntary Muscle)
Striated Muscle(Voluntary Muscle)
CHAPTER 2:
Techniques of Skin Biopsy
CHAPTER 3:
Dermoepidermal Junction
CHAPTER 4:
The Cells of the Skin and their Identification
CHAPTER 5:
Common Terminologies Used in Dermatopathology
CHAPTER 6:
Staining Techniques in Dermatopathology
PROCEDURE FOR STAINING PARAFFIN SECTIONS
Hematoxylin and Eosin
METHODOLOGY
Solutions Required
Staining Technique
SPECIAL STAINING PROCEDURES
Reticulin Stain
METHODOLOGY
Solutions Required
Staining Technique
Result
van Gieson's Stain
METHODOLOGY
Solutions Required
Staining Technique
Note
Verhoeff's Stain
METHODOLOGY
Solutions Required
Staining Technique
PERL'S STAIN
Solutions Required
Staining Technique
PAS (Periodic acid-schiff's)
METHODOLOGY
Solutions Required
Staining Technique
MASSON'S TRICHROME STAIN
METHODOLOGY
Solutions Required
Staining Technique
ZIEHL-NEELSEN (ZN) STAIN
METHODOLOGY
Solutions Required
Staining Technique
FITE-FARACCO STAIN
METHODOLOGY
Solutions Required
Staining Technique
CONGO RED STAIN
METHODOLOGY
Staining Technique
VON KOSSA STAIN
METHODOLOGY
Staining Technique
GIEMSA STAIN
METHODOLOGY
Staining Technique
GRAM'S STAIN FOR BACTERIA
METHODOLOGY
Staining Technique
DOPA OXIDASE
METHODOLOGY
Staining Technique
MASSON-FONTANA STAIN
METHODOLOGY
Solutions Required
Staining Technique
CHAPTER 7:
Dermatitis and Eczema (Spongiotic Dermatitis)
SPECIFIC TYPES OF SPONGIOTIC DERMATITIS
Allergic Contact Dermatitis (ACD)
Histopathology
Nummular Dermatitis
Irritant Contact Dermatitis
Dyshidrotic Dermatitis
Photo-allergic Dermatitis
Seborrheic Dermatitis
Erythroderma and Generalized Exfoliative Dermatitis
Histopathology (Fig. 7.6C)
Stasis Dermatitis
Histopathology
Chronic Superficial Dermatitis (Digitate Dermatosis)
Histopathology
Id Eruption (Autosensitization)
Histopathology
Atopic Dermatitis
CHAPTER 8:
Lichen Planus
HISTOPATHOLOGY (Fig. 8.2)
Atrophic Lichen Planus
Histopathology (Fig. 8.3)
Bullous Lichen Planus
Histopathology (Fig. 8.4)
Lichen Planus Pemphigoides (LPP)
Histopathology
Lichen Planus Pigmentosus
Histopathology
Erythema Dyschromicum Perstans (EDP) (Ashy dermatosis)
Histopathology (Fig. 8.5)
Drug-induced Lichen Planus
Histopathology (Fig. 8.6)
Ulcerative (Erosive) Lichen Planus
Histopathology
Lichen Planus Actinicus
Histopathology (Fig. 8.7)
Oral Lichen Planus
Histopathology (Fig. 8.8)
Lichen Planus-like Keratosis (LPLK)
Histopathology
Lichen Nitidus
Histopathology (Fig. 8.9)
Lichen Striatus
Histopathology (Fig. 8.10)
CHAPTER 9:
Vesiculobullous Disorders
PEMPHIGUS GROUP
Pemphigus Vulgaris
Histopathology (Fig. 9.1A)
IMMUNOFLUORESCENCE TESTING
DIF (Direct Immunofluorescence Testing)
Indirect Immunofluorescence Testing (IIF)
Pemphigus Vegetans
Transient Acantholytic Dermatosis (Grover's Disease)
Histopathology
Acropustulosis of Infancy
Histopathology
DIFFERENTIAL DIAGNOSIS
Linear IgA Dermatosis
ADULT TYPE
HISTOPATHOLOGY
PARANEOPLASTIC PEMPHIGUS
Histopathology
Immunofluorescence Testing
PEMPHIGUS FOLIACEOUS
Histopathology (Fig. 9.3)
Immunofluorescence Testing
Differential Diagnosis
Bullous Pemphigoid
Histopathology
Immunofluorescence Testing
SALT-SPLIT SKIN IMMUNOFLUORESCENCE STUDIES
DIFFERENTIAL DIAGNOSIS
Pemphigus Erythematosus (Senear-Usher syndrome)
Histopathology
Direct Immunofluorescence Test
Lupus Band Test
Endemic Pemphigus Foliaceous (Fogo Selvagem - Wild Fire, Brazilian Pemphigus Foliaceous)
Histopathology
IgA Pemphigus
Histopathology
CHAPTER 10:
Dermatophytosis (Superficial Fungal Infections)
SPOROTRICHOSIS
Lymphocutaneous Form
Fixed Cutaneous
Disseminated Form
Histopathology
Chronic Lesions may Show
CHAPTER 11:
Yeast Infections
CHAPTER 12:
Viral Infections of Skin
CHAPTER 13:
Tuberculosis of the Skin
LICHEN SCROFULOSORUM (LS)
CHAPTER 14:
Hansen's Disease (Leprosy)
BT (BORDERLINE TUBERCULOID) (FIG. 14.2)
BB (Borderline) (Fig. 14.3)
Histopathology shows
BL (Borderline Lepromatous) (Fig. 14.4A)
Histopathology shows
LL (Lepromatous)
Histopathology shows (Fig. 14.5)
LLS (Subpolar Lepromatous)
Histopathology shows
LLp (Polar Lepromatous)
Histopathology shows
Idt (Indeterminate lesions - Unclassified lesions)
False-positive Demonstration of Acid Fast Bacilli
LEPRA REACTION
Histology of Delayed Hypersensitivity Reaction
Histology of Erythema Nodosum Leprosum
HISTOID LEPROSY
Histopathology (Fig. 14.6)
Lucio Phenomenon
Histopathlogy
Bacterial Index of the Granuloma (BIG)
CHAPTER 15:
Leishmaniasis
CHAPTER 16:
Disorders of Hypopigmentation
VITILIGO
Histopathology (Fig. 16.1)
NEVUS DEPIGMENTOSUS: (ACHROMIC NEVUS)
Histopathology (Fig. 16.2)
NEVUS ANEMICUS
Histopathology
Idiopathic Guttate Hypomelanosis
Histopathology (Figs 16.3A and B)
Hypomelanosis of Ito: (Incontinentia Pigmenti Achromians)
Histopathology
Pityriasis Alba
Histopathology
Ash-leaf Spot
Histopathology
Piebaldism
CHAPTER 17:
Erythema Multiforme
CHAPTER 18:
Lichen Sclerosus et Atrophicus (LSA)
CHAPTER 19:
Scleroderma
LOCALIZED SCLERODERMA (MORPHEA)
Histopathology
SYSTEMIC SCLEROSIS (FIG. 19.3)
Histopathology
Histopathology of Morphea Profundus (Fig. 19.4)
Eosinophilic Fasciitis (Shulman's Syndrome)
Differential Diagnosis: Scleroderma
MIXED CONNECTIVE TISSUE DISEASE
Histopathology
CHAPTER 20:
Lichen Simplex Chronicus (Circumscribed Neurodermatitis)
CHAPTER 21:
Pigmented Purpuric Dermatosis (Schamberg's Disease)
CHAPTER 22:
Dermatitis Herpetiformis
CHAPTER 23:
Sarcoidosis
CHAPTER 24:
Lupus Erythematosus (LE)
SUBACUTE CUTANEOUS LUPUS ERYTHEMATOSUS
Histopathology (Fig. 24.4)
SYSTEMIC LUPUS ERYTHEMATOSUS
Histopathology (Cell-poor interface dermatitis, “invisible dermatosis”)
Differential Diagnosis: Lichen Planus
Dermatomyositis
Histopathology (Fig. 24.5)
CHAPTER 25:
Pyoderma Gangrenosum
SUPERFICIAL GRANULOMATOUS (VEGETATIVE) PYODERMA GANGRENOSUM
Histopathology
CHAPTER 26:
Urticaria Pigmentosa (UP)
CHAPTER 27:
Gyrate and Annular Erythemas
ERYTHEMA ANNULARE CENTRIFUGUM
Histopathology
Erythema Gyratum Repens
Histopathology
Erythema Marginatum
Histopathology
Erythema Chronicum Migrans
Histopathology
CHAPTER 28:
Seborrheic Keratosis (Senile Warts)
CHAPTER 29:
Basal Cell Carcinoma (BCC)
CHAPTER 30:
Verrucous Epidermal Nevus
CHAPTER 31:
Epidermal or Infundibular Cyst
TRICHILEMMAL OR PILAR CYST
Histopathology (Fig. 31.2)
MILIA
Histopathology (Fig. 31.3)
STEATOCSYTOMA MUL TIPLEX
Histopathology (Fig. 31.4)
Dermoid Cyst
Histopathology
Nevus Sebaceous: (Nevus sebaceous of Jadassohn, organoid nevus) (Fig. 31.5)
Histopathology
Lesions in Childhood Show
Lesions at Puberty Show Diagnostic Histopathological Changes
Lesions in Adulthood
CHAPTER 32:
Keratoacanthoma
CHAPTER 33:
Squamous Cell Carcinoma (SCC)
VERRUCOUS CARCINOMA
CHAPTER 34:
Actinic Keratosis (Solar Keratosis)
CHAPTER 35:
Bowen's Disease
CHAPTER 36:
Oral Leukoplakia
CHAPTER 37:
Paget's Disease
CHAPTER 38:
Alopecias
SCALP BIOPSY
ALOPECIA AREATA
Histopathology
TRICHOTILLOMANIA
(Trichotill – Greek-“hair pulling madness”)
Histopathology (Fig. 38.2)
Traction Alopecia
ANDROGENETIC ALOPECIA (AGA)
Histopathology
Anagen Effluvium (AE)
Classic Telogen Effluvium
Histopathology
Chronic Telogen Effluvium (CTE)
Histopathology
Pseudopelade of Brocq (PPB)
Histopathology (Fig. 38.4)
Active Lesions Show
Progressive Lesions Show
End Stage Lesion Show
Alopecia Mucinosa and Follicular Mucinosis
Histopathology (Fig. 38.5)
CHAPTER 39:
Psoriasis
PARAPSORIASIS
Pityriasis Rosea
Histopathology (Fig. 39.7)
Pityriasis Rubra Pilaris
Histopathology Shows (Fig. 39.8)
CHAPTER 40:
Lymphocytoma Cutis (Cutaneous Lymphoid Hyperplasia)
CHAPTER 41:
Disorders of Hyperpigmentation
SKIN BIOPSY AND SPECIAL STAINS
Freckles (Ephelides)
Histopathology
Melanotic Macules of Albright's Syndrome
Histopathology
Mucosal Melanotic Macules (Mucosal Lentigines)
Histopathology (Fig. 41.2)
Becker's Melanosis (Becker's Pigmented Hairy Nevus)
Histopathology (Fig. 41.3)
Lentigines
Solar Lentigo (Actinic Lentigo)
Histopathology (Solar Lentigo)
LENTIGO SIMPLEX
Histopatholgy
Lentiginosis Profusa/Multiple Lentiginosis Syndrome
Speckled Lentiginous Nevus (Nevus Spilus)
Peutz-Jegher's Syndrome
MELANOCYTIC NEVI (COMMON MELANOCYTIC NEVUS)
Histopathology
Junctional Nevus
Lentiginous Junctional Nevi
Compound Nevus
Intradermal Nevus
Nevus of ota
Histopathology Shows
Notalgia Paraesthetica
Histopathology Shows
Café au lait Spots
Histopathology Shows
CHAPTER 42:
Syringoma/Trichoepithelioma/Cylindroma
DIFFERENTIAL DIAGNOSIS
Histopathology
Trichoepithelioma
Histopathology
Cylindroma
Histopathology
CHAPTER 43:
Acne Vulgaris
STEROID ACNE
Histopathology
ROSACEA
Histopathology
PERIORAL DERMATITIS
Histopathology
DEMODICIDOSIS
Histopathology
LUPUS MILIARIS DISSEMINATUS FACIEI (LMDF)
Histopathology
CHAPTER 44:
Polymorphous Light Eruption
ACTINIC PRURIGO (HUTCHINSON’S SUMMER PRURIGO, HEREDITARY POLYMORPHOUS LIGHT ERUPTION)
Histopathology
CHRONIC ACTINIC DERMATITIS (CAD)
Persistent Light Reaction
Histopathology (Fig. 44.3)
Photosensitive Eczema
Histopathology
Actinic Reticuloid
Histopathology (Fig. 44.4)
CHAPTER 45:
Dermatofibroma: (Benign Fibrous Histiocytoma, Sclerosing Hemangioma)
TUBEROUS SCLEROSIS
Histopathology
Soft Fibromas
Histopathology (Fig. 45.2)
Keloid and Hypertrophic Scar
STRIAE DISTENSAE
Histopathology (Fig. 45.5)
Knuckle Pads
Histopathology
CHAPTER 46:
Mycosis Fungoides (MF)
CHAPTER 47:
Ichthyosis Vulgaris
CHAPTER 48:
Porokeratosis
CHAPTER 49:
Xeroderma Pigmentosum
CHAPTER 50:
Erythema Nodosum (EN)
ERYTHEMA INDURATUM - NODULAR VASCULITIS
Histopathology (Fig. 50.2)
CHAPTER 51:
Urticaria
LEUKOCYTOCLASTIC (HYPERSENSITIVITY) VASCULITIS
Histopathology (Fig. 51.4)
Resolving Lesions Show
CHAPTER 52:
Erythema Elevatum Diutinum
CHAPTER 53:
Pityriasis Lichenoides
CHAPTER 54:
Acanthosis Nigricans
CHAPTER 55:
Fixed Drug Eruption
CHAPTER 56:
Granuloma Annulare
CHAPTER 57:
Hemangiomas Lymphangiomas
CHERRY HEMANGIOMA
Histopathology
CAVERNOUS HEMANGIOMA
Histopathology
VERRUCOUS HEMANGIOMA
Histopathology
ANGIOKERATOMAS
Histopathology
LYMPHANGIOMA
Superficial Lymphangioma
Histopathology
Deep Lymphangioma
Histopathology
NEVUS FLAMMEUS
GLOMUS TUMOR
Histopathology
PYOGENIC GRANULOMA
Histopathology
CHAPTER 58:
Syringocystadenoma Papilliferum
TUBULAR APOCRINE ADENOMA
Histopathology Shows
CHAPTER 59:
Leiomyoma
CHAPTER 60:
Sweet's Syndrome
ACUTE FEBRILE NEUTROPHILIC DERMATOSIS
Histopathology Shows (Fig. 60.1)
CHAPTER 61:
Secondary Syphilis
CHAPTER 62:
Arthropod Bite Reactions (Papular Urticaria)
CHAPTER 63:
Keratosis Pilaris
CHAPTER 64:
Lichen Amyloidosis and Macular Amyloidosis
CHAPTER 65:
Malignant Melanoma
CHAPTER 66:
Cutaneous Neurofibroma
INDEX
TOC
Index
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