Dermal scar

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Dermal scar, also simply scar, is commonly seen in dermatopathology. It is also known a cicatrix.

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

General

  • Previous surgery, biopsy, trauma.

Gross

  • Raised irregularity - may be linear.

Images

Microscopic

Features:

  • Loss of dermal papilla.
  • Dense collagen - fibers run parallel to the dermal-epidermal (DE) junction[1] - key feature.
  • Loss of adnexal structures.

Other feature:

  • Thin-walled blood vessels.
    • Described as running perpendicular to the surface[1] - this may not be apparent.

Note:

  • There should not be any nuclear hyperchromasia or pleomorphism.[2]

DDx:

Image

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.

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

  1. 1.0 1.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 499. ISBN 978-0443066542.
  2. 2.0 2.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 479. ISBN 978-0443066542.