Difference between revisions of "Non-malignant skin disease"

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Non-malignant skin disease (view source)

Revision as of 12:03, 11 October 2013

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→‎Verruca vulgaris: split-out
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=Very common - viral=
=Very common - viral=
==Verruca vulgaris==
==Verruca vulgaris==
*[[AKA]] common wart.
{{Main|Verruca vulgaris}}
===General===
*Etiology - [[HPV]].
*Very common.
 
Notes:
*Related to [[condyloma acuminatum]].
 
===Gross===
Features:
*[[Papule]] or [[plaque]] with granular surface.
*Classic location: hand.
 
Images:
*[http://commons.wikimedia.org/wiki/File:Porea_doet_djin_wi.jpg Wart (WC)].
*[http://commons.wikimedia.org/wiki/File:Wart_ASA_animated.gif Wart - animated (WC)].
 
===Microscopic===
Features:<ref>URL: [http://missinglink.ucsf.edu/lm/DermatologyGlossary/verruca_vulgaris.html http://missinglink.ucsf.edu/lm/DermatologyGlossary/verruca_vulgaris.html]. Accessed on: 14 July 2010.</ref>
*Hyperkeratosis (more keratin - thick stratum corneum) - in "columns"; keratin in separate towers - ''not'' a flat thick sheet.
*Hypergranulosis (thicker stratum granulosum).
*''Papillomatous hyperplasia'':
**Rete ridge lengthening (~7-10x normal) and thickening.
**Rete ridge curvature toward the centre of the lesion (like the roads to the ''Palace of Versailles'') - '''important'''.
*Large blood vessels at the dermal-epidermal junction - between the rete ridges.
*+/-Viral changes - perinuclear halo, nucleus small and hyperchromatic<ref name=Ref_Derm106-7>{{Ref Derm|106-7}}</ref> - virtually '''diagnostic''' when present.
**+/-Binucleation.
 
Memory device: there is more of everything - more s. corneum, s. granulosum, s. spinosum, longer rete ridges, more (larger) blood vessels.
 
DDx:
*[[Squamous cell carcinoma of the skin|Squamous cell carcinoma]] - nuclear atypia full thickness and often more pronounced.
*Hypertrophic [[actinic keratosis]] - often accompanied by solar elastosis.
**Actinic keratosis with superimposed [[lichen simplex chronicus]].<ref name=Ref_Derm353>{{Ref Derm|353}}</ref>
*[[Seborrheic keratosis]] - may have focal clear cell changes.
*[[Condyloma accuminatum]] - genital region.
 
====Images====
<gallery>
Image:Verruca_vulgaris_-_very_low_mag.jpg | Verruca vulgaris - very low mag. (WC)
Image:Verruca_vulgaris_-_intermed_mag.jpg | Verruca vulgaris - intermed mag. (WC)
</gallery>
www:
*[http://alf3.urz.unibas.ch/pathopic/getpic-fra.cfm?id=4528 Verruca vulgaris (unibas.ch)].
 
===Sign out===
<pre>
SKIN LESION, RIGHT LOWER LEG, SHAVE BIOPSY:
- VERRUCA VULGARIS.
</pre>
 
====Micro====
The sections show skin with elongated rete ridges, acanthosis, hypergranulosis, hyperkeratosis in  vertical columns, focal parakeratosis, dilated blood vessels at the dermal-epidermal junction and koilocytic change. Mild basilar nuclear atypia is present.
 
=====Without koilocytes=====
The sections show skin with elongated rete ridges that curve toward the centre of the lesion, acanthosis, hypergranulosis, hyperkeratosis in vertical columns, and dilated blood vessels at the dermal-epidermal
junction. Minimal basilar nuclear enlargement is present.  No definite koilocytic change is
apparent.
 
No parakeratosis is identified. Mild solar elastosis is identified.  No melanocytic nests
are apparent. Mitotic activity is not apparent.


==Verruca plana==
==Verruca plana==
Michael
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