HISTOPATHOLOGY
OF VARIOUS DERMATOSES

1. Lichen Planus
Section show laminated hyperkeratosis with irregular
acanthosis of the epidermis. The retepegs are elongated
and pointed giving a saw toothed appearance to the section.Wedge
shaped hypergranulosis is present and there is marked
degeneration of the basal layer with presence of several
civatte bodies at the dermo-epidermal junction.A band
like infiltrate of lymphocytes and histiocytes is presene
in the superficial dermis aborting to the epidermis.
2. Lichen Planus Hypertrophicus.
Section shows laminated hyperkeratosis with
patchy parakeratosis and marked keratotic plugging.The
epidermis is irregularly acanthotic with elongated thickened,
bulbous retepegs. There is wedge shaped hypergranulosis
seen and patchy degeneration of the basal cell layer is
present. A band like infiltrate of lymphocytes and histiocytes
is seen in the superficial dermis aborting on to the epidermis
at places.
3. Becker Nevus
Section shows mild basket weave ,hyperkeratosis,
the epidermis is acanthotic with downward extension and
branching of the rete pegs. The granular layer is present
throughout and basal cell layer is intact with focal hyperpigmentation
specially at the lower most end of the rete pegs. The
dermis shows no pathology.
4. Intradermal Nevus
Section shows mild laminated hyperkeratosis with atrophy
of the epidermis. The rete peg pattern is well maintained.
Basal cell layer is intact with normal pigmentation. No
functional activity seen. Dermis shows presence of tumor
tissue composed of nests and cords of proliferating melanocytes.
Nests of cells in the superficial dermis are round with
central nuclei and abundant melanin pigment. The tumor
cells in the deeper dermis are spindle shaped arranged
in bundles simulating nerve fibres. No atypical changes
seen.
5. Sweet Syndrome
Section shows mild basket weave hyperkeratosis with
irregular acanthosis of the epidermis. The basal cell
layer is intact with normal pigmentation. A sub-epidermal
bulla is present which shows fibrin strands with few neutrophils.
The base of the bulla is formed by the dermis that shows
a band like infiltrate of neutrophils with few lymphocytes
and histiocytes. There is marked superficial edema with
dialatation and congestion of blood vessels.
6. Schamberg’s disease
Section shows laminated hyperkeratosis with karatotic
plugging. The epidermis is atrophic and shows a complete
flattening of the rete pegs. The granular layer is present
throughout and the basal cell layer is intact with normal
pigmentation. A band like infiltrate of lymphocytes and
histiocytes is present in the superficial dermis. Perl’s
stain is positive for iron deposition.
7. Milia
Section shows laminated hyperkeratosis overlying an
epidermis that shows patchy atrophy. There are several
cystic structures present that are arising from the lower
portion of the infundibulum of the vellus hairs. The cysts
are lined by stratified epithelium and contain concentric
ring of keratin. A sparse perivascular lymphocytes is
present in the surrounding blood vessels.
8. Basal Cell Carcinoma
Section shows mild basket weave pattern of stratum corneum
with follicular plugging . the epidermis is atrophic with
flattening of rete pegs. The dermis shows presence of
tumor tissues present in lobules that are surrounded by
proliferating fibroblasts. Tumor cells have a monomorphic
appearance and shows large hyperchromatic nuclei surrounded
by thin rim of cytoplasm. Palisading mass present in the
groups of tumor cells among which some shows central keratinisation.
9. Epidermoid cyst
10. BL
11. LD Bodies
12. BT
13. Morphea
Section shows mild basket weave hyperkeratosis. The
epidermis is normal in appearance and has a well defined
rete peg pattern. Basal cell layer is intact and shows
normal pigmentation. There is thickening and hyalinization
of the dermal collagen, together with a perivascular lympho-hystiocytic
infiltrate seen in the superficial dermis. The sweat glands
are atrophic and seem to be “pulled up: into the
dermis.

VVG stain shows normal elastic fibers.

14. FF
15. Spongiotide
16. Pigmented Seborrhoeic
Keratosis
17. Pitryiasis Lichenoides
18. lichen planus
19. Histoid leprosy
Section shows laminated hyperkeratosis overlying a mildly
atrophic epidermis. There is flattening of rete pegs but
the basal layer is intact with normal pigmentation. A
free grenz zone is present beneath which the dermis shows
infilteration by foamy histiocytes and few lymphocytes.
The histiocytes at places show spindled out appearance
and there is evidence of nerve infilteration. FF stain
is positive for AFB.
20. Sarcoidosis
21. L set at
22. Syringoma
Section shows basket weave pattern of stratum corneum
overlying a normal epidermis with well defined rete peg
pattern. Basal layer is intact and shows normal pigmentation.
The dermis shows the presence of tumor tissue that is
made up of several tubular structures embedded in a fibrous
stroma. These ducts are lined by two rows of epithelial
cells with the inner layer showing marked vacuolization.
Amorphous material is present in some of these ducts that
also posses a small comma like.
23. lupus vulgaris
24. Tricholemmal cyst
25. Squamous cell carcinoma
Section shows hyperkeratotic acanthotic stratified squamous
epithelium. The underlying subepithelial tissue shows
the presence of groups and nests of malignant squamous
cells infilterating up to and into the muscle layers.
The cells are large with central hyperchromatic nuclei
and there are areas of keratinization seen with formation
of squamous perls. Few mitotic figures are present and
the surrounding connective tissue is heavily infilterated
by lymphocytes, histiocytes, eosinophils and few neutrophils.
26. Postular psoriasis
27. Lymphangioma
28. Spongiotic Postule
of Kojog
29. Psoriasis
Section shows hyperparakeratosis with general aggregates
of neutrophils forming numerous abscesses. The epidermis
is acanthotic and has narrow elongated rete pegs. Marked
hypogranulosis is seen but basal cell layer is intact
and shows normal pigmentation. There is papillary edema
and thinning of the suprapapillary epidermal plates. Thin
walled congested blood vessels are present in dermal papillae
and an perivascular lymphohistiocyic infilteration is
present in superficial dermis.
30. Bullous pemphigoid
31. Pityriasis lichenoides
Chronicus
32. Discoid lupus erythematosus
33. Keloid
34. SCLE
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