Histology of eczematous processes Apologize for 1 mistake-called nickel an irritant, although it causes more of an allergic reaction. For irritant, other metals can sometimes cause it. Link to slides pathpresenter.net/#/public/pr...
0:50 Case 1 --> Spongiotic Dermatitis reaction pattern -- 4:25 slide of acute phase with vesiculation. 5:36 slide of sub-acute phase. 6:58 slide of chronic phase. 9:00 ICD 10:00 Dyshidrotic eczema 10:41 Seborrhic Dermatitis 11:58 Stasis Dermatitis 13:40 Pityriasis Rosea 15:17 Polymorphic Eruption of Pregnancy 16:34 Mycosis Fungoides 17:47 Summary with Clues 18:19 slides of fungal infection (TV) as ddx 19:19 Dermatophytosis with PAS stain For Additional in-depth information you can visit publication.pathpresenter.net for free
@ Case 1 -> Spongiotic Dermatitis reaction pattern - @ slide of acute phase with vesiculation. @ slide of sub-acute phase. @ slide of chronic phase. intraepidermal edema with clear spaces separating keratinocytes Acute: also perivascular lymphocytic infiltrates in upper dermis, lymphocyte exocytosis Subacute: focal parakeratosis, acanthosis, papillomatosis, eosinophils Chronic: prominent parakeratosis, acanthosis, papillomatosis; may have minimal spongiosis; fibroplasia of papillary and upper reticular dermis; variable inflammatory infiltrate Different types of eczema 1. Allergic contact dermatitis 2. Irritant contact dermatitis 3, Numular eczema 4, Dyshidrotic eczema (hands and feet only) 5. Atopic dermatitis (children) 6. Id reaction ( in response to a separate rash) 7 Seborrhic Dermatitis @ ICD - irritant contact dermatitis --- A little necorsis, spongiosis more in superficial epidemris, numerous admixed neuts @ Dyshidrotic eczema - acral site bx, vesiculation , spongiotic changes @ Seborrhic Dermatitis ---Parafollicular Parakeratosis in association with hair follicle Other things to consider: 1.Stasis Dermatitis 2.Pityriasis Rosea 3. Polymorphic Eruption of Pregnancy 4.Mycosis Fungoides 6. Always do a PAS tor rule out fungal infection @ Stasis Dermatitis Lower leg, mild spongiosis , dilated vessels with thickend walls, haemosiderin deposiyion , a lobular proliferation of vessels Characterstic lobular pattern of superficial and deep dermal neovascularization with dermal fibrosis, perivascular lymphocytic infiltrates, histiocytes and variable number of plasma cells, extravasated erythrocytes and hemosiderin laden macrophages Hyperplasia of endothelial cells Variable acanthosis and hyperkeratosis @ Pityriasis Rosea Non-specific subacute or chronic dermatitis with focal hyperkeratosis and angulated mounds of parakeratosis with slight acanthosis Granular cell layer is absent beneath the foci of parakeratosis Intraepidermal cytoid body may be present Focal acantholytic dyskeratosis occasionally documented Also lymphohistiocytic infiltrate around vessels of superficial plexus and slight spongiosis Occasionally scattered eosinophils and erythrocytes within epidermis @ Polymorphic Eruption of Pregnancy @ Mycosis Fungoides @ Summary with Clues @ slides of fungal infection (TV) as ddx @ Dermatophytosis with PAS stain
