Difference between revisions of "Dermal scar"
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==Gross== | ==Gross== | ||
*Raised irregularity - may be linear. | *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=== | ===Images=== | ||
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DDx: | DDx: | ||
*[[Malignant melanoma]], desmoplastic-neurotropic type - nuclear pleomorphism and/or hyperchromasia; may be focal.<ref name=Ref_Derm479>{{Ref Derm|479}}</ref> | *[[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]]. | *[[Dermatofibroma]]. | ||
*Desmoplastic [[Spitz nevus]]. | *Desmoplastic [[Spitz nevus]]. | ||
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- DERMAL SCAR. | - DERMAL SCAR. | ||
- SOLAR ELASTOSIS. | - 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> | </pre> | ||
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*[[Non-malignant skin disease]]. | *[[Non-malignant skin disease]]. | ||
*[[Dermatopathology]]. | *[[Dermatopathology]]. | ||
*[[Cesarean scar defect]]. | |||
==References== | ==References== | ||
Latest revision as of 15:56, 9 October 2018
| Dermal scar | |
|---|---|
| Diagnosis in short | |
 Dermal scar. H&E stain. | |
|
| |
| LM | dense collagen - fibers run parallel to the DE junction, loss of dermal papilla, loss of adnexal structures, thin-wall blood vessels |
| LM DDx | malignant melanoma desmoplastic-neurotropic type, dermatofibroma, desmoplastic Spitz nevus, sclerosing blue nevus |
| Stains | S-100 -ve (mostly) |
| Site | skin |
|
| |
| Clinical history | trauma, previous excision or biopsy |
| Prevalence | common |
| Prognosis | benign |
| Dermal scar | |
|---|---|
| External resources | |
| EHVSC | 10187 (Dermal scar adjacent to a basal cell carcinoma) |
| Wikipedia | Scar |
Dermal scar, also simply scar, is commonly seen in dermatopathology. It is also known a cicatrix.
General
- Previous surgery, biopsy, trauma.
Gross
Images
Scars. (WC)
Microscopic
Features:
- Loss of dermal papilla.
- Dense collagen - fibers run parallel to the dermal-epidermal (DE) junction[3] - key feature.
- Loss of adnexal structures.
Other feature:
- Thin-walled blood vessels.
- Described as running perpendicular to the surface[3] - this may not be apparent.
Note:
- There should not be any nuclear hyperchromasia or pleomorphism.[4]
DDx:
- Malignant melanoma, desmoplastic-neurotropic type - nuclear pleomorphism and/or hyperchromasia; may be focal.[4]
- Epidermal hyperplasia and the preservation of adnexal structures is very suspicious.
- Dermatofibroma.
- Desmoplastic Spitz nevus.
- Sclerosing blue nevus.
Image
Scar. (WC)
IHC
- S100 focal/scattered +ve.
- Desmoplastic melanoma strong +ve.
- HMB-45 -ve.
- Sclerosing blue nevus +ve.
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SKIN, LOWER MID BACK, RE-EXCISION: - DERMAL SCAR. - SOLAR ELASTOSIS.
SKIN LESION, LEFT UPPER ABDOMINAL WALL, RE-EXCISION: - DERMAL SCAR, COMPLETELY EXCISED. - BENIGN PIGMENT. - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
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
References
- ↑ Velangi, SS.; Rees, JL.. "Why are scars pale? An immunohistochemical study indicating preservation of melanocyte number and function in surgical scars.". Acta Derm Venereol 81 (5): 326-8. PMID 11800137.
- ↑ Chadwick, S.; Heath, R.; Shah, M. (May 2012). "Abnormal pigmentation within cutaneous scars: A complication of wound healing.". Indian J Plast Surg 45 (2): 403-11. doi:10.4103/0970-0358.101328. PMID 23162241.
- ↑ 3.0 3.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 499. ISBN 978-0443066542.
- ↑ 4.0 4.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 479. ISBN 978-0443066542.