macroscopic term microscopic term

References
1. Robbins, Pathologic basis of Diseases, any edition 2. Anderson, Textbook of Pathology, any edition 3. Lever, Histopathology of skin, any edition 4. Any textbook about skin or dermatopathology, any edition 5. Websites

CONTENT

1. Introduction 2. Macroscopic terminology 3. Microscopic terminology

- Heaviest organ
- 16% of total body weight

- Surface area 1.22.3 sq.m.

NORMAL SKIN
FUNCTION
1. Mechanical barrier 2. Immunologic organ 3. Participation in electrolyte regulation 4. Organ of sensuality and psychological well-being 5. Manifestation of diseases 6. Synthesis of vitamin D

NORMAL SKIN
1. Epidermis 2. Dermis 3. Subcutaneous tissue (hypodermis)

HISTOLOGY OF NORMAL SKIN

EPIDERMIS

Keratinocytes
- Stratum basale (germinativum) - basal cell layer - Stratum spinosum - prickle cell or squamous layer - Stratum granulosum - granular cell layer - Stratum corneum - hornified or cornified cell layer

Rete ridges and dermal papillae

DIAGRAM SHOWING EPIDERMAL LAYER

DEFINITION OF TERMS
(Dermatopathological Terminology)

Lesion: describes an area of disease, usually small

Eruption (rash) : describes more widespread skin involvement, normally composed of several lesions which may be the primary pathology or due to secondary factors (scratching, infection, etc.)

Lesions
1. Primary lesion : the first to appear, due to the disease
or abnormal state, must be distinguished from secondary or induced lesions

2. Secondary lesion : result from the natural evolution of

primary lesions (eroded area left by bursting vesicle) or from the patient's manipulation of the primary lesion (scratching)

MACROSCOPIC TERMS

 Macule
Circumscribed area of any size characterized by its flatness and usually distinguished from surrounding skin by its coloration

Primary lesion

 Papule
Elevated solid areas 5 mm.or less across

Primary lesion

 Nodule
Elevated solid area greater than 5 mm. across

Primary lesion

 Plaque
Elevated flat-topped area, usually greater than 5 mm. across

Primary lesion

 Vesicle
Fluid-filled raised area 5 mm. or less across

Primary lesion

 Bulla
Fluid-filled raised area greater than 5 mm. across, a large blister
Primary lesion

 Pustule
Discrete, pus-filled, raised area

Primary lesion

 Wheal
Itchy, transient, elevated area with variable blanching and erythema formed as the result of dermal edema
Primary lesion

 Scale
Dry, horny, plate-like excrescence, usually the result of imperfect cornification
Primary lesion

 Cyst
An epithelial lined cavity containing liquid or semisolid material (fluid, cells, and cell products)
Primary lesion

 Lichenification
Thickened and rough skin characterized by prominent skin markings, usually the result of repeated rubbing in susceptible persons

Secondary lesion

 Crust
Dried serum, blood, or pus on the surface of skin

Secondary lesion

 Scar
Replacement of normal tissue by fibrous connective tissue at the site of injury to the dermis

Secondary lesion

 Excoriation
A traumatic lesion characterized by the breakage of the epidermis causing a raw linear area, i.e. a deep scratch. Such lesions are often self induced .

Secondary lesion

 Atrophy
1.Epidermal atrophy
2.Dermal atrophy
paper-thin, wrinkled skin with easily visible vessels. Results from loss of epidermis, dermis or both. Seen in aged, some burns, and long-term use of highly potent topical
corticosteroids. Secondary lesion

 Ulcer
Circumscribed area of skin loss extending through the epidermis and at least part of the dermis (papillary)
Secondary lesion

 Onycholysis
Separation of nail plate from nail bed

MICROSCOPIC TERMS

 Hyperkeratosis
Hyperplasia of the stratum corneum often associated with qualificative abnormality of the keratin

 Parakeratosis
Mode(s) of keratiniz-

ation characterized by the retention of nuclei in the stratum corneum. On mucosal membranes, parakeratosis is normal.

 Acanthosis
Epidermal hyperplasia

 Dyskeratosis
Abnormal keratinization occurring prematurely within individual cells or groups of cells below stratum granulosum

 Acantholysis
Loss of intercellular connections resulting in loss of cohesion between keratinocytes

 Papillomatosis
Hyperplasia of the papillary dermis with elongation and/ or widening of dermal papillae

Lentiginous
Referring to a linear pattern of melanocyte proliferation within the epidermal basal layer, lentiginous melanocytic hyperplasia can occur as a reactive change or as a part of neoplasm of melanocytes

 Spongiosis
Intercellular edema of the epidermis

 Exocytosis
Infiltration of the epidermis by inflammatory or circulating blood

 Erosion
Discontinuity of the skin, exhibiting incomplete loss of the epidermis

 Ulceration
Discontinuity, often excavative, of skin exhibiting complete loss of the epidermis and portions of the dermis and even subcutaneous fat

 Vacuolization
Formation of vacuoles within or adjacent to cells, often refers to the basal cell basement membrane zone area

 Vasculitis
Heterogeneous groups of disorders that are characterized by inflammatory destruction of blood vessels (artery and vein) (plural- vasculitides)

 Panniculitis
Group of diseases whose hallmark is inflammation of subcutaneous adipose tissue (panniculus)

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