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Difference between revisions of "Dermatopathology"
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Pathology is a significant part of dermatology and dermatologists spend five years in residency. So, it is a huge area. | Pathology is a significant part of dermatology and dermatologists spend five years in residency. So, it is a huge area. | ||
=Layers of the skin= | |||
*Epidermis - outer most layer, avascular, separated from dermis by a basement membrane, epithelial tissue. | *Epidermis - outer most layer, avascular, separated from dermis by a basement membrane, epithelial tissue. | ||
*Dermis - below the epidermis, vascular, separated from the epidermis by a basement membrane, connective tissue. | *Dermis - below the epidermis, vascular, separated from the epidermis by a basement membrane, connective tissue. | ||
*Subdermis - below the dermis, connective tissue. | *Subdermis - below the dermis, connective tissue. | ||
==Layers of epidermis== | |||
Epidermis layers - from the surface to epidermal-dermal junction: | Epidermis layers - from the surface to epidermal-dermal junction: | ||
*Stratum corneum. | *Stratum corneum. | ||
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Mnemonic: ''Corn Lovers Grow Several Bales''. | Mnemonic: ''Corn Lovers Grow Several Bales''. | ||
=Adnexal structures= | |||
The top five structures of the skin:<ref>{{Ref Derm|4-8}}</ref> | The top five structures of the skin:<ref>{{Ref Derm|4-8}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
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*Eccrine ducts - cuboidal type subepithelial cells. | *Eccrine ducts - cuboidal type subepithelial cells. | ||
=Common terms= | |||
*Acanthosis = thickening of the prickle layer (stratum spinosum) of epidermis.<ref>[http://dictionary.reference.com/browse/acanthosis http://dictionary.reference.com/browse/acanthosis]</ref> | *Acanthosis = thickening of the prickle layer (stratum spinosum) of epidermis.<ref>[http://dictionary.reference.com/browse/acanthosis http://dictionary.reference.com/browse/acanthosis]</ref> | ||
*Parakeratosis = retention of nuclei in the stratum corneum, normal in mucous membranes | *Parakeratosis = retention of nuclei in the stratum corneum, normal in mucous membranes | ||
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*[http://commons.wikimedia.org/wiki/File:Spongiotic_dermatitis_%282%29_Dyshidrotic_.JPG Spongiosis (WC)]. | *[http://commons.wikimedia.org/wiki/File:Spongiotic_dermatitis_%282%29_Dyshidrotic_.JPG Spongiosis (WC)]. | ||
=Skin diseases= | |||
==[[Cancer]]== | |||
{{main|Dermatologic cancer}} | {{main|Dermatologic cancer}} | ||
Skin cancer is very common. The basic DDx of a malignant skin lesion is: | Skin cancer is very common. The basic DDx of a malignant skin lesion is: | ||
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*Metstases. | *Metstases. | ||
==Non-malignant disease== | |||
{{main|Non-malignant skin disease}} | {{main|Non-malignant skin disease}} | ||
Non-malignant skin disease is common. It is the domain of dermatologists. It can be scary for general anatomical pathologist because the differential diagnosis is often broad, and, it's generally not something the general anatomical pathologist sees a lot of. | Non-malignant skin disease is common. It is the domain of dermatologists. It can be scary for general anatomical pathologist because the differential diagnosis is often broad, and, it's generally not something the general anatomical pathologist sees a lot of. | ||
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Bullous diseases, e.g. pemphigus vulgaris, is dealt with in the ''[[bullous disease]]'' article. | Bullous diseases, e.g. pemphigus vulgaris, is dealt with in the ''[[bullous disease]]'' article. | ||
=Common entities in tables= | |||
==Non-malignant non-cystic== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | {| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | ||
! Entity | ! Entity | ||
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|} | |} | ||
==Non-malignant cystic== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | {| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | ||
! Entity | ! Entity | ||
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|} | |} | ||
==Pre-malignant== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | {| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | ||
! Entity | ! Entity | ||
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| [http://commons.wikimedia.org/wiki/File:Actinic_Keratosis,_H%26E.jpg (WC)] | | [http://commons.wikimedia.org/wiki/File:Actinic_Keratosis,_H%26E.jpg (WC)] | ||
|} | |} | ||
==Common malignant== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | {| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | ||
! Entity | ! Entity | ||
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|} | |} | ||
==Less common malignant== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | {| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | ||
! Entity | ! Entity | ||
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|} | |} | ||
=Presentations= | |||
==Leukoplakia== | |||
DDx:<ref>{{Ref PBoD|1065}}</ref> | DDx:<ref>{{Ref PBoD|1065}}</ref> | ||
*Vitiligo (loss of pigment). | *Vitiligo (loss of pigment). | ||
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**[[Non-malignant_skin_disease#Lichen_simplex_chronicus|Lichen simplex chronicus]]. | **[[Non-malignant_skin_disease#Lichen_simplex_chronicus|Lichen simplex chronicus]]. | ||
=Skin disease and systemic conditions= | |||
==Acanthosis nigricans== | |||
Associated with: [[diabetes mellitus]],<ref>URL: [http://www.emedicine.com/derm/topic1.htm http://www.emedicine.com/derm/topic1.htm], URL: [http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=1943559504].</ref> malignancy.<ref name=Ref_PCPBoD8|596>{{Ref PCPBoD8|596}}</ref> | Associated with: [[diabetes mellitus]],<ref>URL: [http://www.emedicine.com/derm/topic1.htm http://www.emedicine.com/derm/topic1.htm], URL: [http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=1943559504].</ref> malignancy.<ref name=Ref_PCPBoD8|596>{{Ref PCPBoD8|596}}</ref> | ||
===Microscopic=== | |||
Features ''BPH'':<ref name=Ref_PCPBoD8|596>{{Ref PCPBoD8|596}}</ref> | Features ''BPH'':<ref name=Ref_PCPBoD8|596>{{Ref PCPBoD8|596}}</ref> | ||
*Basal cell hyperpigmentation. | *Basal cell hyperpigmentation. | ||
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*[http://dermatology.cdlib.org/149/reviews/acanthosisnigricans/higgins.html AN (cdlib.org)]. | *[http://dermatology.cdlib.org/149/reviews/acanthosisnigricans/higgins.html AN (cdlib.org)]. | ||
==Others== | |||
*[[Dermatitis herpetiformis]]: gluten enteropathy ([[celiac disease]]), [[thyroid]] disease, intestinal [[lymphoma]].<ref>TN07 D23.</ref> | *[[Dermatitis herpetiformis]]: gluten enteropathy ([[celiac disease]]), [[thyroid]] disease, intestinal [[lymphoma]].<ref>TN07 D23.</ref> | ||
*[[Pemphigus vulgaris]]: [[thymoma]], myasthenia gravis, malignancy.<ref>TN07 D23.</ref> | *[[Pemphigus vulgaris]]: [[thymoma]], myasthenia gravis, malignancy.<ref>TN07 D23.</ref> | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Dermatopathology]] | [[Category:Dermatopathology]] | ||