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Difference between revisions of "Dermal scar"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = ScarHistology.JPG | |||
| Width = | |||
| Caption = Dermal scar. [[H&E stain]]. | |||
| Micro = dense collagen - fibers run parallel to the DE junction, loss of dermal papilla, loss of adnexal structures, thin-wall blood vessels | |||
| Subtypes = | |||
| LMDDx = [[malignant melanoma]] desmoplastic-neurotropic type, [[dermatofibroma]], desmoplastic [[Spitz nevus]], sclerosing [[blue nevus]] | |||
| Stains = S-100 -ve (mostly) | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[skin]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = trauma, previous excision or biopsy | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
}} | |||
{{ Infobox external links | |||
| Name = {{PAGENAME}} | |||
| EHVSC = | |||
| EHVSC_mult = {{EHVSC3|10187|Dermal scar adjacent to a basal cell carcinoma}} | |||
| pathprotocols = | |||
| wikipedia = Scar | |||
| pathoutlines = | |||
}} | |||
'''Dermal scar''', also simply '''scar''', is commonly seen in [[dermatopathology]]. It is also known a '''cicatrix'''. | |||
==General== | |||
*Previous surgery, biopsy, trauma. | |||
==Gross== | |||
*Raised irregularity - may be linear. | |||
*Typically pale.<ref>{{Cite journal | last1 = Velangi | first1 = SS. | last2 = Rees | first2 = JL. | title = Why are scars pale? An immunohistochemical study indicating preservation of melanocyte number and function in surgical scars. | journal = Acta Derm Venereol | volume = 81 | issue = 5 | pages = 326-8 | month = | year = | doi = | PMID = 11800137 }}</ref> | |||
**May be hyperpigmented.<ref name=pmid23162241>{{Cite journal | last1 = Chadwick | first1 = S. | last2 = Heath | first2 = R. | last3 = Shah | first3 = M. | title = Abnormal pigmentation within cutaneous scars: A complication of wound healing. | journal = Indian J Plast Surg | volume = 45 | issue = 2 | pages = 403-11 | month = May | year = 2012 | doi = 10.4103/0970-0358.101328 | PMID = 23162241 }}</ref> | |||
===Images=== | |||
<gallery> | |||
Image:Scars 2yrs.png | Scars. (WC) | |||
</gallery> | |||
==Microscopic== | |||
Features: | |||
*Loss of dermal papilla. | |||
*Dense collagen - fibers run parallel to the dermal-epidermal (DE) junction<ref name=Ref_Derm499>{{Ref Derm|499}}</ref> - '''key feature'''. | |||
*Loss of adnexal structures. | |||
Other feature: | |||
*Thin-walled blood vessels. | |||
**Described as running perpendicular to the surface<ref name=Ref_Derm499>{{Ref Derm|499}}</ref> - this may not be apparent. | |||
Note: | |||
*There should not be any nuclear hyperchromasia or pleomorphism.<ref name=Ref_Derm479>{{Ref Derm|479}}</ref> | |||
DDx: | |||
*[[Malignant melanoma]], desmoplastic-neurotropic type - nuclear pleomorphism and/or hyperchromasia; may be focal.<ref name=Ref_Derm479>{{Ref Derm|479}}</ref> | |||
**Epidermal hyperplasia and the preservation of adnexal structures is very suspicious. | |||
*[[Dermatofibroma]]. | |||
*Desmoplastic [[Spitz nevus]]. | |||
*Sclerosing [[blue nevus]]. | |||
===Image=== | |||
<gallery> | |||
Image:ScarHistology.JPG | Scar. (WC) | |||
</gallery> | |||
==IHC== | |||
*S100 focal/scattered +ve. | |||
**Desmoplastic melanoma strong +ve. | |||
*HMB-45 -ve. | |||
**Sclerosing blue nevus +ve. | |||
==Sign out== | |||
<pre> | |||
SKIN, LOWER MID BACK, RE-EXCISION: | |||
- DERMAL SCAR. | |||
- SOLAR ELASTOSIS. | |||
</pre> | |||
<pre> | |||
SKIN LESION, LEFT UPPER ABDOMINAL WALL, RE-EXCISION: | |||
- DERMAL SCAR, COMPLETELY EXCISED. | |||
- BENIGN PIGMENT. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Micro=== | |||
The sections show skin with a dermis with dense collagen fibres that run parallel to the skin surface without adnexal structures. The overlying dermal-epidermis interface lacks the typical undulation. | |||
==See also== | |||
*[[Non-malignant skin disease]]. | |||
*[[Dermatopathology]]. | |||
*[[Cesarean scar defect]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | |||
[[Category:Dermatopathology]] | |||