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Example text
Diffuse parakeratosis with loss of the underlying epidermal granular cell layer is observed 37 Fig. 3 Psoriasis. Neutrophils are observed in the epidermis and as microabscesses in the stratum corneum Fig. 4 Monro microabscesses. These collections of neutrophils in the stratum corneum are characteristic of psoriasis 17 Perforating Dermatoses Reactive Perforating Collagenosis • Transepidermal elimination of deeply basophilic degenerate collagen fibers • Dermal chronic inflammatory infiltrate • Trichrome positive Elastosis Perforans Serpiginosa • Epidermal intoeing with intraepidermal channel and microabscesses • “Claw and ball”-like transepidermal elimination of elastotic material, keratin, and basophilic inflammatory debris • Elastic stain reveals thickened dermal elastic fibers abutting and exiting the epidermis • Variable granulomatous infiltrate Perforating Folliculitis • Hair follicle rupture with granulomatous dermal reaction • Channel containing basophilic debris in follicle epithelium 38 Kyrle’s Disease* (Hyperkeratosis Follicularis et Parafollicularis in Cutem Penetrans) • Associated with chronic renal insufficiency and uremia • Hyperkeratosis, acanthosis • Epidermal invaginations with keratin and neutrophil-rich debris-laden plug • Transepidermal elimination of keratotic material • Absence of hair follicle or shaft fragments • Variable dermal lymphohistiocytic inflammatory infiltrate *Historically, Kyrle’s disease occurred in renal disease and displayed one or more of these patterns, because of significant overlap – there are no longer considered to be distinct entities.
5 Reactive lymphoid follicle, BCL6 stain highlights the follicle center B cells Part V Epithelial Proliferations 23 Immunohistochemistry of Epithelial Proliferations Epithelial tumors that derive from the epidermis and adnexal structures may share keratinocytic cytology and epithelial growth patterns. Immunohistochemical stains using antibodies to detect specific proteins that are associated with the tumor cell origin are helpful in diagnosis. S. 1007/978-1-4471-4471-7_23, © Springer-Verlag London 2013 Sebaceous carcinoma Eccrine carcinoma + + + + + Microcystic adnexal carcinoma + (Focal) – – + – (+ in normal glands) + 40–50 % – + (Central) – + – – + + + + (Inner cuticle) + ± 5% – + + 23 Immunohistochemistry of Epithelial Proliferations 55 Fig.
There is diffuse staining of the epidermal keratinocytes Fig. 2 in epidermis and spindled squamous cell carcinoma. 2 stains the epidermis less uniformly than CK5/6. S.