Dermatopathology Cases

Case 70   A 35 yr old immunosuppressed patient with a polypoid mass in the perianal region.       Image1 Image2    Image3             Special stain: PAS     Answer      

Dermatophyte Infection (Dermatophytoses) - Superficial filamentous Infection (Tinea - ringworm) Visit: Dermatopathology site Visit: Pathology of Dermatophytoses Abstract: Current knowledge of host response in human tinea.Mycoses.2009 Jan 21. Summary Skin infection caused by dermatophytes is called tinea. In this short review, the known mechanisms and factors involved in human tinea and important for the host response are briefly delineated. To establish tinea, fungal propagules must attach to the skin, germinate and overcome the epidermal barrier. Keratinases and other enzymes are released in this process and host keratinocytes are activated. This is followed by an inflammatory response mediated by a plentitude of cytokines and receptors, comprising innate as well as acquired immunity, including neutrophilic granulocytes, macrophages, antibodies and T cells. Cellular defence mechanisms appear to be decisive for clearing of infection. Nails and hair follicles are the particular sites of

Image 1 Image2 Image3 (Special stain-PAS) Image4 (Special stain - Grocott) Case 69 Spot Diagnosis Answer

Scabies Visit: Dermatopathology site Abstract: Langerhans cell hyperplasia of the skin mimicking Langerhans cell histiocytosis: a report of two cases in children not associated with scabies. Fetal Pediatr Pathol.2010;29(4):231-8. Langerhans cells histiocytosis (LCH) affecting the skin most commonly has clinical and histopathologic diagnostic features. We are reporting two examples of Langerhans cell (LC) hyperplasia recognized in the skin biopsies of two children initially interpreted as LCH. The first was an 8-year-old boy finally interpreted as having an atypical type of contact dermatitis, while the second, an 8-year-old girl, was assumed to have Pytiriasis lichenoides et varioliformis acuta. None showed evidences of scabies. Both presented spongiotic dermatitis with numerous CD1a+ cells. As more cases of LC hyperplasia are recognized, new details emerge helping in the differential diagnosis. Strict clinical-pathologic correlation is suggested in order to avoid misdiagnosis. Scabie

Image1 Image2 Image3 Image4 Section of the superficial dermis Case 68 Intensely pruritic papules in the inframammary region of a 35 year old woman. Spot diagnosis! Answer