Professional Documents
Culture Documents
Epidermis
Dermis
o Papillary dermis
o Reticular dermis
*subcutis: altered to appear tissue-like
tendon/fascia
Other structures seen:
o Sweat glands
o Hair follicle
o Sebaceous gland
EPIDERMIS
o
o
Basal
o
o
o
MACROSCOPIC TERMS
Excoriation
o Traumatic lesion that results in a
liner skin lesion
o Most of the time induced
o Looks like a deep scratch
Lichenification
o Thickened and rough skin
characterized by prominent skin
markings (as lichen on a tree
trunk)
o Usually the result of repeated
rubbing
o Prominent skin markings
Macule
MICROSCOPIC TERMS
Acantholysis
o Loss of intercellular cohesion
between keratinocytes
Acanthosis
o Epidermal hyperplasia
Interdigitating papillary
dermis
Thickening of the epidermis
Widening and elongation of
the rete ridges
Dyskeratosis
o Prematurely keratinized cells
beneath stratum granulosum
o Not dysplastic because there is
still polarity of the cells
o Abnormal, premature
keratinization within cells below
the stratum granulosum
Erosion
o Discontinuity of the skin resulting
to incomplete loss/separation of
the epidermis
Exocytosis
o Infiltration of the epidermis by
inflammatory cells such as
lymphocytes
Hydropic swelling (ballooning)
o Intracellular edema of
keratinocytes
o Often seen in viral infections
o Swollen because of accumulation
of cellular fluids
Hypergranulosis
o Hyperplasia of the stratum
granulosum
o Due to intense/repeated rubbing
Hyperkeratosis
o Secondary to qualitative
abnormality of the keratin or
keratinization resulting to
hyperplastic/thickened stratum
corneum
Lentiginous
o A linear pattern of melanocyte
proliferation within the epidermal
basal cell layer
o Results into a hyperpigmented
stratum basale
Papillomatosis
o Surface elevation caused by
hyperplasia and enlargement of
contiguous dermal papillae
o Resut:
Whitening of dermal
papillae
Thickening of rete ridges
Parakeratosis
o Keratinization with retained nuclei
in the stratum corneum
Nevus/nevi/melanocytic nevi
Freckles
Lentigo/Lentigins
Dysplastic nevus
Melanoma
ABCs of melanoma:
o A: asymmetry
A part is flat and others are
elevated
o B: border
Irregular
o C: color
Variation in color
Mole melanoma
o Enlargement
o Pain
o Itching
Under the microscope:
o Melanoma cells are monotonous
o Infiltrating (on LPO) the epidermis
Equivalent to Clarks
method
5 levels
1- epidermis
2 papillary dermis
3 papillary-reticular
dermal interface
4 reticular dermis
5 subcutaneous
tissue
Central to the understanding of
melanoma:
o Radial growth
Confined in the epidermis
Superficial spreading type of
melanoma
Period is non-predictable
Lentigo melanoma
Manifestation of
melanoma in its
radial growth phase
Lentiginous
proliferation of
melanocytes on the
melanoma
Medium to large cells, large
nuclei, prominent nucleoli,
found arranged in nests
o Vertical growth
Herald down into a tumor
Once melanoma is in its
vertical growth phase, it
already has the potential to
metastasize
Lymphocytic infiltration
alongside any tumor is a
good sign good
immunosurveillance
Acanthosis Nigricans
Microscope:
o Epidermis and the underlying
enlarged dermal papillae forming
peaks and valleys
o Hyperpigmented stratum basale
o Hyperplasia of stratum corneum
hyperkeratosis
Fibroepithelial polyp
Adnexal tumors
.
o
o
o
o
Dermatofibroma
Dermatofibrosarcoma protuberans
Mycosis fungoides
ICHTHYOSIS
Mastocytosis
Pruritic
Contact dermatitis
Plaque like appearance
Erythema multiforme
Seborrheic dermatitis
Dandruff
Not a disease of the sebaceous glands
Papulopustular lesions
External ear is also susceptible
o Sometimes fissures develop in the
retroauricular region
Histologic features:
o Like eczematous dermatitis and
o Acanthotic lesions seen during the
later part of the disease
o Hyperkeratosis falling into the hair
follicles together with neutrophils
follicular limping
o Perivascular inflammatory
infiltrates mixture of
lymphocytes, histiocytes and
neutrophils
Lichen planus
6P
o
o
o
o
Pruritic
Purple
Polygonal
Papules
o Planar plaques
Distinguished from psoriasis through:
o Wickham striae hypergranulosis
Oral lesions fish net or reticulated
patterned
T cell mediated skin disorder
Microscopic
o Hypergranulosis
Hyperplasia of the granular
layer of the epidermis
o Interphase dermatitis
Along the dermo-epithelial
junction
o Retention of nuclei in the stratum
corneum parakeratosis
o Necrotic keratinocytes at the
epidermis
o Stratum basale cuboidal
spindle
o Change in contour of the dermoepidermal contour unangulated
appearance saw-toothing
o Dead keratinocytes at the stratum
basale they are called Civatte
bodies
BULLOUS DISEASES
Pemphigus vulgaris
o With oral ulcers
Pemphigus vegetans
o Verrucous wart-like lesions
Pemphigus folliaceous
o Erythematous
o Not as raw as vulgaris
o Occur in mallar area
Paraneoplastic pemphigus
o Autoantibodies against
desmolgelins
Prominent feature in pemphigus
Microscopic
o Acantholytic keratinocytes are
prominently seen between stratum
corneum and basale
Suprabasal acantholytic blister
Under immunofluorescence
o Immunoglobulins
o Entire epidermis
o Distinguished from pemphigous
Pemphigus vegetans microabsecces,
verrucous hyperplasia of the epidermis,
severe acanthosis
Dermatitis herpetiforms