Sunday, December 06, 2009

Necrobiosis lipoidica is an idiopathic granulomatous disorder belonging to the palisading granulomatous group. In at leaset 55% of the cases it is associated with diabetes.   Histologically it is characterized by involvement of the entire skin.

Friday, April 06, 2007

Epithelioid melanocytes in a Spitz or Reed nevus from a patient over 20 years old is a worrisome feature.

Wednesday, April 04, 2007

Features that favor a benign proliferative nodule in congenital nevus 1. mature into adjacent nevus 2. uniformly present pigmentation 3. uniform cytology 4. rare mitosis 5. absence of significant necrosis (can see apoptosis) 6. no inflammation

Tuesday, April 03, 2007

Features that favor a malignant proliferative nodule 1. sharply demarcated nodule 2. pleomorphic, discohesive 3. mitosis frequent, often atypical 4. zonal necrosis 5. clonal pigmentation 6. inflammation common

Monday, April 02, 2007

Features that favor Spitz nevus in children 1.size less than 1 cm 2.thickness less than 2 MM 3.no ulceration 4.epidermal hyperplasia present 5.no regression 6.no radial growth phase 7.maturation present 8.mitoses less than 5-6/mm2

Sunday, April 01, 2007

Features that favor melanoma in children 1.size larger than 1 cm 2.thickness larger than 2 cm 3.ulceration is a worrisome feature especially in late      childhood 4.epidermal hyperplasia not present; epidermis is often atrophic 5.regression often present with changes of fibroplasia, epidermal atrophy and melanophages in papillary dermis 6.maturation not well demonstrated; sometimes inverse maturation with superficial cells more benign than more atypical deep cells 7.mitoses more than 5-6/mm2

Tuesday, February 06, 2007

Prominent dilated vessels at the bottom of melanoma often are associated with lymph node metastasis.

Monday, February 05, 2007

Three lesions that have epidermis invading into vessels in dermis are angiokeratoma, lymphangioma scriptum and radiation dermatitis.

Sunday, February 04, 2007

Biopsies of polymorphous light eruption usually do not have eosinophils. Biopsies of light reaction such as photoallergic dermatitis can demonstrate eosinophils.

Saturday, February 03, 2007

Square shape biopsy can be seen in morphea, scar, scleromyxedema, connective tissue nevus, chronic GVHD and radiation dermatitis.

Tuesday, January 08, 2002

The presence of fibrin thrombi in reactive angioendotheliomatosis should always lead to investigation of the patient for a hypercoagulable state

Tuesday, December 04, 2001

Lymphoid follicles can be observed in lymphocytoma cutis, insect bite reaction, some examples of Jessner's lymphocytic infiltrate, angiolymphoid hyperplasia with eosinophilia, and importantly In MALT lymphomas as they affect the skin.

Tuesday, November 06, 2001

Often the only clue to a connective tissue nevus is a rather nodular array of thick connective tissue fibers in a whorled pattern distinct from the normal interlacing pattern of reticular dermal fibers.

Tuesday, October 23, 2001

The infiltrate in erythema annulare centrifigum is classically described as exhibiting a tight cuffing of lymphocytes about superficial venules; often, however, it is a deep process with a quite prominent, loosely arrayed pattern of cells around vessels often admixed with eosinophils.

Saturday, September 22, 2001

Several entities may be misdiagnosed as normal skin without very careful observation. These include anetoderma, connective tissue nevus, icthyosis, graft versus host and urticaria, among others.

Monday, May 22, 2000

Observation of mitoses in the dermal component of a nevus should lead the pathologist to cut several sections and observe for maturation to rule out a nevoid melanoma.

Saturday, May 20, 2000

The presence of more than three mitoses in a single section of the dermal component of the nevus should raise the possibility of a possible malignant lesion. Multiple sections should be performed and complete excision of the lesion be considered.

Monday, May 08, 2000

Numerous dyskeratotic cells in the epidermis are seen in:     a. PLEVA     b. Some drug reactions     c. Severe erythema multiforme     d. 2° stage of incontinentia pigmenti, among others.

Monday, May 01, 2000

Abrupt margins separating and intraepidermal proliferative lesion from the normal epidermis are features of:     a. Eccrine poroma     b. clear cell acanthoma     c. often in squamous cell carcinoma in situ of non sun-exposed skin, trunk, palms and soles and the mucosae.

Monday, April 03, 2000

Marginal mitoses in Spitz of children combined with atypia and failure of maturation of the cells are features of malignancy.

Monday, March 27, 2000

Atrophy of the epidermis singly dispersed atypical melanocytes along the basilar region of the epidermis of the external root sheath of the hair follicle is in the presence of solar elastosis are features of lentigo maligna.

Monday, March 13, 2000

Spongiotic psoriasiform dermatitis associated with eosinophils tagging along the dermoepidermal junction is highly suggestive of the eczematous fibers of bullous pemphigoid.

Monday, March 06, 2000

Penicillamine induced skin lesions exhibit lateral budding on dermal elastic fibers best visualized by elastic tissue stains.

Monday, February 28, 2000

Gouty panniculitis exhibits aggregates of crystalline uric acid within subcutaneous collections of neutrophils, usually in skin of the trunk.

Monday, February 21, 2000

In primary amyloidosis, deposits may be observed in erector pili muscles and in the basal lamina of sweat glands.

Monday, February 14, 2000

The clue to the possible recurrence of a pyogenic granuloma is the finding of a deep vascular component in the lower reticular dermis and fat.

Sunday, February 14, 1999

CUTANEOUS LYMPHOID HYPERPLASIA, MALT (ORSALT) LYMPHOMA Lymphoid follicles are commonly observed in cutaneous lymphoid infiltrates in:    + Cutaneous lymphoi hyperplasia + Chronic insect bite reaction + Angiolymphoid hyperplasia + MALT (or SALT) lymphoma

Saturday, February 13, 1999

SPITZ NEVUS, CHILDREN Marginal mitoses in Spitz nevi of children combined with atypia and failure of maturation of the cells are features of malignancy.

Saturday, February 06, 1999

LENTIGO MALIGNA Features of lentigo maligna: + Atrophy of the epidermis + Singly dispersed atypical melanocytes along the basilar region of the epidermis of the external root sheath of the hair follicle + The presence of solar elastosis

Friday, February 05, 1999

NEVOID MELANOMA Observation of mitoses in the dermal component of a nevus should lead the pathologist to cut several sections and observe for maturation to rule out a nevoid melanoma.