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| '''Non-malignant skin disease''' is relatively common. The pathology may or may not be specific. Some diseases require clinical information to diagnose. | | '''Non-malignant skin disease''' is relatively common. The pathology may or may not be specific. Some diseases require clinical information to diagnose. |
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| An introduction to dermatopathology is in the ''[[dermatopathology]]'' article. [[Nevi]] (moles) and other melanocytic lesions are dealt with in the article ''[[melanocytic lesions]]''. Inflammatory skin conditions are dealt with in ''[[inflammatory skin disorders]]''. | | An introduction to dermatopathology is in the ''[[dermatopathology]]'' article. [[Nevi]] (moles) and other melanocytic lesions are dealt with in the article ''[[melanocytic lesions]]''. Inflammatory skin conditions are dealt with in ''[[inflammatory skin disorders]]''. |
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| *[[Exocytosis]] - blood cell infiltrate the epidermis. | | *[[Exocytosis]] - blood cell infiltrate the epidermis. |
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| Images: | | ====Images==== |
| *[[WC]]:
| | <gallery> |
| **[http://commons.wikimedia.org/wiki/File:Dermatomycosis_-_intermed_mag.jpg Dermatomycosis - intermed. mag. (WC)].
| | Image:Dermatomycosis_-_intermed_mag.jpg | Dermatomycosis - intermed. mag. (WC) |
| **[http://commons.wikimedia.org/wiki/File:Dermatomycosis_-_high_mag.jpg Dermatomycosis - high mag. (WC)].
| | Image:Dermatomycosis_-_high_mag.jpg | Dermatomycosis - high mag. (WC) |
| **[http://commons.wikimedia.org/wiki/File:Dermatomycosis_-_gms_-_low_mag.jpg Dermatomycosis - GMS stain - low mag. (WC)].
| | Image:Dermatomycosis_-_gms_-_low_mag.jpg | Dermatomycosis - GMS stain - low mag. (WC) |
| **[http://commons.wikimedia.org/wiki/File:Dermatomycosis_-_gms_-_high_mag.jpg Dermatomycosis - GMS stain - high mag. (WC)].
| | Image:Dermatomycosis_-_gms_-_high_mag.jpg | Dermatomycosis - GMS stain - high mag. (WC) |
| *www:
| | </gallery> |
| **[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/tinea_pas.jpg Dermatophytosis (ucsf.edu)].<ref>URL: [http://missinglink.ucsf.edu/lm/DermatologyGlossary/tinea.html http://missinglink.ucsf.edu/lm/DermatologyGlossary/tinea.html]. Accessed on: 25 February 2013.</ref>
| | www: |
| | *[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/tinea_pas.jpg Dermatophytosis (ucsf.edu)].<ref>URL: [http://missinglink.ucsf.edu/lm/DermatologyGlossary/tinea.html http://missinglink.ucsf.edu/lm/DermatologyGlossary/tinea.html]. Accessed on: 25 February 2013.</ref> |
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| ===Stains=== | | ===Stains=== |
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| Notes: | | Notes: |
| *It differs from verruca vulgaris... (1) orthokeratosis, (2) flat surface and base. | | *It differs from [[verruca vulgaris]]... (1) orthokeratosis, (2) flat surface and base. |
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| Images: | | ====Images==== |
| | www: |
| *[http://www.fujita-hu.ac.jp/~tsutsumi/case/case180.htm Verruca plana - several images (fujita-hu.ac.jp)]. | | *[http://www.fujita-hu.ac.jp/~tsutsumi/case/case180.htm Verruca plana - several images (fujita-hu.ac.jp)]. |
| *[http://bg.convdocs.org/pars_docs/refs/55/54881/54881_html_m70d4f7e5.jpg Verruca plana (convdocs.org)].<ref>URL: [http://bg.convdocs.org/docs/index-54881.html?page=10 http://bg.convdocs.org/docs/index-54881.html?page=10]. Accessed on: 9 October 2013.</ref>
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| *[http://www.dermatopathonline.com/verruca%20plana2.html Verruca plana - several good images (dermatopathonline.com)]. | | *[http://www.dermatopathonline.com/verruca%20plana2.html Verruca plana - several good images (dermatopathonline.com)]. |
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| ==Clear cell acanthoma== | | ==Clear cell acanthoma== |
| ===General===
| | {{Main|Clear cell acanthoma}} |
| *Benign.
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| *Elderly.
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| *Classically on the leg.<ref name=pmid18583817>{{Cite journal | last1 = Akin | first1 = FY. | last2 = Ertam | first2 = I. | last3 = Ceylan | first3 = C. | last4 = Kazandi | first4 = A. | last5 = Ozdemir | first5 = F. | title = Clear cell acanthoma: new observations on dermatoscopy. | journal = Indian J Dermatol Venereol Leprol | volume = 74 | issue = 3 | pages = 285-7 | month = | year = | doi = | PMID = 18583817 | URL = http://www.ijdvl.com/text.asp?2008/74/3/285/41396 }}</ref>
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| *Rare.
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| *Clinically not distinct.
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| **Suspected clinically in only ~3% of cases.<ref name=pmid20931670>{{Cite journal | last1 = Morrison | first1 = LK. | last2 = Duffey | first2 = M. | last3 = Janik | first3 = M. | last4 = Shamma | first4 = HN. | title = Clear cell acanthoma: a rare clinical diagnosis prior to biopsy. | journal = Int J Dermatol | volume = 49 | issue = 9 | pages = 1008-11 | month = Sep | year = 2010 | doi = | PMID = 20931670 }}</ref>
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| ===Microscopic===
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| Features:<ref>URL: [http://www.drmihm.com/cases/case.cfm?CaseID=45 http://www.drmihm.com/cases/case.cfm?CaseID=45]. Accessed on: 7 February 2012.</ref>
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| *Psoriasiform pattern - epidermal thickening ([[acanthosis]]).
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| *Keratinocytes:
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| **Pale or light pink cytoplasm (when compared to surrounding non-lesional keratinocytes).
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| **Separated from one another (spongiosis).
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| *+/-Stratum corneum [[neutrophil]]s.
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| DDx:
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| *[[Psoriasis vulgaris]].
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| Images:
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| *[http://www.drmihm.com/cases/casefigure.cfm?figID=906&CaseID=45 CCA (drmihm.com)].
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| *[http://www.dermatlas.com/derm/IndexDisplay.cfm?ImageID=-327718365 CCA - low mag. (dermatlas.com)].
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| *[http://www.dermatlas.com/derm/IndexDisplay.cfm?ImageID=546460717 CCA - high mag. (dermatlas.com)].
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| ==Chondrodermatitis nodularis chronica helicis== | | ==Chondrodermatitis nodularis chronica helicis== |
| *[[AKA]] ''chondrodermatitis nodularis helicis''. | | *[[AKA]] ''chondrodermatitis nodularis helicis''. |
| *Abbreviated ''CNCH''. | | *Abbreviated ''CNCH''. |
| ===General===
| | *[[AKA]] ''Winkler disease''.<ref>URL: [http://www.head-face-med.com/content/4/1/2 http://www.head-face-med.com/content/4/1/2]. Accessed on: 16 January 2014.</ref> |
| *Tender/painful - '''key clinical feature'''. | | {{Main|Chondrodermatitis nodularis chronica helicis}} |
| *Typically right [[ear]] - people more often sleep on this one.<ref name=pmid17879469>{{Cite journal | last1 = Devani | first1 = A. | last2 = Barankin | first2 = B. | title = Dermacase. Chondrodermatitis nodularis chronica helicis. | journal = Can Fam Physician | volume = 53 | issue = 5 | pages = 821, 837 | month = May | year = 2007 | doi = | PMID = 17879469 }}</ref>
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| *Usually >40 years old.
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| Etiology:
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| *Trauma/mechanical.
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| ===Gross===
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| *[[Papule]] on ear.
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| *+/-Erythematous.
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| *+/-Crust.
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| Clinical DDx:<ref name=pmid17879469/>
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| *[[BCC]].
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| *[[SCC]].
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| Images:
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| *[http://commons.wikimedia.org/wiki/File:Chondrodermatitis.jpg CNCH (WC)].
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| *[http://www.dermnetnz.org/lesions/chondrodermatitis.html CNCH (dermnetnz.org)].
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| ===Microscopic===
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| Features:<ref name=pmid17879469/>
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| *Dermal inflammation.
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| *Epithelial hyperlasia.
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| *Fibrosis.
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| *Cartilaginous pathology:
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| **Perichondrial inflammation - '''key feature'''.
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| **Perichondrial disruption.
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| **+/-Necrosis.
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| **+/-Hemorrhage.
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| Images:
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| *[http://www.dermpedia.org/case/chondrodermatitis-nodularis-chronica-helicis CNCH (dermpedia.org)].
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| *[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?s=20080802171837514 CNCH (surgicalpathologyatlas.com)].
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| *[http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=2140701395 CNCH (dermatlas.med.jhmi.edu)].
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| ===Sign out===
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| ====Superficial biopsy====
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| <pre>
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| SKIN LESION, LEFT ANTIHELIX OF EAR, BIOPSY:
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| - SUPERFICIAL SKIN WITH ACANTHOSIS, HYPERKERATOSIS, MODERATE SOLAR ELASTOSIS,
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| HYPERGRANULOSIS AND A MILD LYMPHOCYTIC PERIVASCULAR INFILTRATE.
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| - NO CARTILAGE IS IDENTIFIED.
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| - NEGATIVE FOR DYSPLASIA AND MALIGNANCY.
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| COMMENT:
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| The findings are non-specific. Chondrodermatitis cannot be excluded.
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| </pre>
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| ==Cutaneous calcinosis== | | ==Cutaneous calcinosis== |
| *[[AKA]] ''calcinosis cutis''. | | *[[AKA]] ''calcinosis cutis''. |
| ===General===
| | {{Main|Cutaneous calcinosis}} |
| *Benign in itself; underlying cause may not be benign.
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| *May be a [[scrotum|scrotal]] lesion - known as ''scrotal calcinosis''.<ref name=pmid20178701>{{Cite journal | last1 = Dubey | first1 = S. | last2 = Sharma | first2 = R. | last3 = Maheshwari | first3 = V. | title = Scrotal calcinosis: idiopathic or dystrophic? | journal = Dermatol Online J | volume = 16 | issue = 2 | pages = 5 | month = | year = 2010 | doi = | PMID = 20178701 }}</ref>
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| Subtypes:<ref name=emed>URL: [http://emedicine.medscape.com/article/1103137-overview http://emedicine.medscape.com/article/1103137-overview]. Accessed on: 21 September 2011.</ref>
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| #Dystrophic - due to death of cells; may be related to a tumour.
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| #Metastatic - due to chronic renal failure; hyperkalemia; paraneoplastic phenomenon.
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| #Iatrogenic - post surgical.
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| #Idiopathic.
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| ===Microscopic===
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| Features:
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| *Dermal calcification:
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| **Acellular purple blobs on [[H&E]].
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| ***+/-Artefactual tearing of surrounding tissue due to processing (cutting).
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| ***+/-Small artefactual lines ~1-2 micrometers due to processing (cutting).
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| ***+/-Greyish rim of paucicellular material.
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| **Usu. well-circumscribed.
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| ***May be surrounded by a palisading granuloma & [[giant cell]]s.
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| Images:
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| *[http://www.dermatopathonline.com/calcinosis%20cutis2.html Calcinosis cutis (dermatopathonline.com)].
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| ===Sign out===
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| <pre>
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| SKIN AND SUBCUTANEOUS LESION, LEFT HIP, EXCISION:
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| - SUBCUTANEOUS CALCIFICATION SURROUNDED BY BENIGN FIBROUS TISSUE.
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| - DERMAL SCAR.
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| - NEGATIVE FOR MALIGNANCY.
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| </pre>
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| <pre>
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| SUBCUTANEOUS MASS, OVER BURSA OF ELBOW, EXCISION:
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| - CALCINOSIS CUTIS.
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| </pre>
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| ====Micro====
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| The sections show subcutaneous calcifications surrounded by macrophages and giant cells. No nuclear atypia is apparent. The overlying skin is unremarkable.
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| ==Dilated pore of Winer== | | ==Dilated pore of Winer== |
| ===General=== | | ===General=== |
| *Benign. | | *Benign. |
| *Looks like zit. | | *Looks like a zit. |
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| ===Microscopic=== | | ===Microscopic=== |
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| ==Lichenoid keratosis== | | ==Lichenoid keratosis== |
| *[[AKA]] ''lichen planus-like keratosis''. | | *[[AKA]] ''lichen planus-like keratosis''. |
| *[[AKA]] ''lichenoid keratosis''.
| | {{Main|Lichenoid keratosis}} |
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| ===General===
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| *Caucasians - middle age or older.
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| *May be a variant of [[seborrheic keratosis]] (with marked inflammation).<ref name=Ref_Derm346>{{Ref Derm|346}}</ref>
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| Clinical DDx:<ref name=Ref_Derm346>{{Ref Derm|346}}</ref>
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| *[[Basal cell carcinoma]], [[squamous cell carcinoma of the skin]], melanocytic neoplasm.
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| ===Microscopic===
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| Features:<ref name=Ref_Derm347>{{Ref Derm|347}}</ref>
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| *Hyperkeratosis.
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| *Parakeratosis.
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| *Band of inflammatory cells at DE junction (lichenoid inflammation).
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| *Dead keratinocytes (Civatte bodies).
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| *Dermal melanophages.
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| DDx:
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| *[[Lichen planus]] - need clinical correlation (mucosal lesions).
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| *[[Drug reaction]].
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| *[[Cutaneous T-cell lymphoma]].
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| *Regressed melanocytic lesion, esp. [[malignant melanoma]].
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| *Lichenoid [[actinic keratosis]] - has atypical hyperchromatic basal cells - esp. at edge of lesion, usu. in the context of [[solar elastosis]].
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| Images:
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| *[http://www.dermpathexpert.com/id57.html Lichenoid keratosis (dermpathexpert.com)].
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| ===Sign out===
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| <pre>
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| SKIN LESION, MID-MIDDLE BACK, PUNCH BIOPSY:
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| - LICHENOID KERATOSIS.
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| </pre>
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| ====Incompletely excised====
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| <pre>
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| SKIN LESION, LEFT CHEST, PUNCH BIOPSY:
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| - LICHENOID KERATOSIS VERSUS ACTINIC KERATOSIS.
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| - NEGATIVE FOR BASAL CELL CARCINOMA.
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| - SEE COMMENT.
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| COMMENT:
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| No eosinophils are apparent. No melanocytic lesion is identified; however, excision of the
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| whole lesion to exclude a partially regressed melanocytic lesion is suggested.
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| </pre>
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| ==Granuloma annulare== | | ==Granuloma annulare== |
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| :See also: ''[[nasopharyngeal angiofibroma]]''. | | :See also: ''[[nasopharyngeal angiofibroma]]''. |
| :Should '''not''' be confused with ''[[angiokeratoma]]''. | | :Should '''not''' be confused with ''[[angiokeratoma]]''. |
| ===General===
| | {{Main|Angiofibroma}} |
| *May be seen in the context of [[tuberous sclerosis]] - especially "butterfly area of the face".<ref name=Ref_WMSP492>{{Ref WMSP|492}}</ref>
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| *Solitary lesions in adults are known as ''[[fibrous papules]]'' and classically arise on the nose.<ref name=Ref_Derm505>{{Ref Derm|505}}</ref>
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| Clinical:
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| *Firm, dome-shaped, flesh coloured.
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| ===Microscopic===
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| Features:<ref name=Ref_WMSP492>{{Ref WMSP|492}}</ref>
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| *Dome-shaped.
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| *Fibrotic dermis.
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| **Enlarged fibroblasts.
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| *Dilated small vessels.
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| DDx:
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| *[[Benign fibrous papule]] - solitary, nose lesion.
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| Image:
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| *[http://www.drdittmar.lu/images/sce/angiofibroma-s.jpg Angiofibroma (drdittmar.lu)].<ref>URL: [http://www.drdittmar.lu/Services.aspx http://www.drdittmar.lu/Services.aspx]. Accessed on: 1 September 2011.</ref>
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| ==Benign fibrous papule== | | ==Benign fibrous papule== |
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| Note: | | Note: |
| *Several variants exist.<ref name=pmid18032900>{{Cite journal | last1 = Jacyk | first1 = WK. | last2 = Rütten | first2 = A. | last3 = Requena | first3 = L. | title = Fibrous papule of the face with granular cells. | journal = Dermatology | volume = 216 | issue = 1 | pages = 56-9 | month = | year = 2008 | doi = 10.1159/000109359 | PMID = 18032900 }}</ref> | | *Several variants exist.<ref name=pmid18032900>{{Cite journal | last1 = Jacyk | first1 = WK. | last2 = Rütten | first2 = A. | last3 = Requena | first3 = L. | title = Fibrous papule of the face with granular cells. | journal = Dermatology | volume = 216 | issue = 1 | pages = 56-9 | month = | year = 2008 | doi = 10.1159/000109359 | PMID = 18032900 }}</ref> |
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| | ===Images=== |
| | *[http://www.dermaamin.com/site/histopathology-of-the-skin/58-f/1739-fibrous-papule-angiofibroma-.html Fibrous papule (dermaamin.com)]. |
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| ===Sign out=== | | ===Sign out=== |
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| ==Mastocytosis== | | ==Mastocytosis== |
| ===General===
| | {{Main|Mastocytosis}} |
| *Abundance of [[mast cell]]s.
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| Classification:<ref name=pmid21083038>{{Cite journal | last1 = Arock | first1 = M. | last2 = Valent | first2 = P. | title = Pathogenesis, classification and treatment of mastocytosis: state of the art in 2010 and future perspectives. | journal = Expert Rev Hematol | volume = 3 | issue = 4 | pages = 497-516 | month = Aug | year = 2010 | doi = 10.1586/ehm.10.42 | PMID = 21083038 }}</ref>
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| #Cutaneous (only) - usually children.
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| #*Urticaria pigmentosa.
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| #*Others.
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| #Systemic - usually adults.
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| #*Indolent subvariant.
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| #*Aggressive subvariant.
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| #*Leukemic subvariant.
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| ===Microscopic===
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| Features:<ref name=Ref_PBoD8|1185>{{Ref PBoD8|1185}}</ref>
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| *Cells in the superficial/mid dermis that are:
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| **Lymphocyte-like with more cytoplasm that is granular.
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| ***Cells may have spindled or stellate morphology.
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| ***Tend to be more abundant around vessels.
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| *+/-Eosinophils (common).
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| *+/-Edema - often prominent; gives cells a white halo.
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| Notes:
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| *Lymphocyte vs. mast cell:
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| **Lymphocytes = round; mast cells = ovoid.
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| Images:
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| *www:
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| **[http://www.jameswpattersonmd.com/case_studies/index.cfm?CFID=387434 Mastocytosis - low res. (jameswpattersonmd.com)].
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| **[http://path.upmc.edu/cases/case366.html Mastocytosis - bone marrow - several images (upmc.edu)].
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| *[[WC]]:
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| **[http://commons.wikimedia.org/wiki/File:Mastocytosis_-_high_mag.jpg Mastocytosis - high mag. (WC)].
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| **[http://commons.wikimedia.org/wiki/File:Mastocytosis_-_cropped_-_very_high_mag.jpg Mastocytosis - very high mag. (WC)].
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| **[http://path.upmc.edu/cases/case409.html Systemic mastocytosis - several images (upmc.edu)].
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| ===Stains===
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| *[[Toluidine blue stain|Toluidine blue]] -- highlights the granules.
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| ===IHC===
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| *CD117 +ve.
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| *Tryptase +ve.<ref name=pmid21866466>{{Cite journal | last1 = Rudzki | first1 = Z. | last2 = Sotlar | first2 = K. | last3 = Kudela | first3 = A. | last4 = Starzak-Gwóźdź | first4 = J. | last5 = Horny | first5 = HP. | title = Systemic mastocytosis (SM) and associated malignant bone marrow histiocytosis - a hitherto undescribed form of SM-AHNMD. | journal = Pol J Pathol | volume = 62 | issue = 2 | pages = 101-4 | month = | year = 2011 | doi = | PMID = 21866466 }}
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| </ref>
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| ==Ichthyosis== | | ==Ichthyosis== |
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| ==Angiokeratoma== | | ==Angiokeratoma== |
| ===General===
| | {{Main|Angiokeratoma}} |
| *Rare.
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| *May be seen in the context of [[Fabry disease]].<ref name=pmid16403380/>
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| Notes:
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| *Shouldn't be confused with ''[[angiofibroma]]'' which is associated [[tuberous sclerosis]].
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| ===Gross===
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| *Dark lesions.
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| Clinical DDx:
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| *[[Melanocytic lesions]].
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| ====Images====
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| <gallery>
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| Image:Angiokeratoma_of_the_Scrotum_7.jpg | Angiokeratoma. (WC)
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| </gallery>
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| ===Microscopic===
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| Features:<ref name=pmid16403380>{{Cite journal | last1 = Karen | first1 = JK. | last2 = Hale | first2 = EK. | last3 = Ma | first3 = L. | title = Angiokeratoma corporis diffusum (Fabry disease). | journal = Dermatol Online J | volume = 11 | issue = 4 | pages = 8 | month = | year = 2005 | doi = | PMID = 16403380 }}</ref>
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| #Ectatic superficial dermal vessels.
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| #Overlying hyperkeratosis (thick stratum corneum).
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| *Should have "epidermal collarette".<ref name=Ref_Derm548>{{Ref Derm|548}}</ref>
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| **Vascular space surrounded by epidermis on three sides.
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| Others features:{{fact}}
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| *Irregular [[acanthosis]].
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| *Longer rete ridges.
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| DDx:
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| *[[Venous lake]].
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| ====Images====
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| <gallery>
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| Image:Angiokeratoma_-_low_mag.jpg | Angiokeratoma - low mag. (WC/Nephron)
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| Image:Angiokeratoma_-_intermed_mag.jpg | Angiokeratoma - intermed. mag. (WC/Nephron)
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| </gallery>
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| www:
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| *[http://www.pathologyoutlines.com/images/skintumorangiokerat1.jpg Angiokeratoma (pathologyoutlines.com)].
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| ===Sign out===
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| <pre>
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| SKIN LESION, LEFT POPITEAL FOSSA, PUNCH BIOPSY:
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| - ANGIOKERATOMA.
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| </pre>
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| ==Inverted follicular keratosis== | | ==Inverted follicular keratosis== |
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| ==Porokeratosis== | | ==Porokeratosis== |
| ===General===
| | {{Main|Porokeratosis}} |
| *Genetic.
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| *Several subtypes.
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| Notes:
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| *Not the same as ''punctate porokeratotic keratoderma''.<ref name=pmid20137755>{{Cite journal | last1 = Alikhan | first1 = A. | last2 = Burns | first2 = T. | last3 = Zargari | first3 = O. | title = Punctate porokeratotic keratoderma. | journal = Dermatol Online J | volume = 16 | issue = 1 | pages = 13 | month = | year = 2010 | doi = | PMID = 20137755 | URL = http://dermatology.cdlib.org/1601/case_presentations/ppk/alikhan.html }}</ref>
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| | |
| ===Microscopic===
| |
| Features:
| |
| *Cornoid lamella (pathognomonic) - '''key feature''':
| |
| **Compact keratosis over a hair follicle.
| |
| *+/-Rete ridge loss.
| |
| | |
| ====Images====
| |
| <gallery>
| |
| Image:Porokeratosis_-_intermed_mag.jpg | Porokeratosis - intermed. mag. (WC)
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| Image:Porokeratosis_-_very_high_mag.jpg | Porokeratosis - very high mag. (WC)
| |
| </gallery>
| |
|
| |
|
| ==Nevus sebaceous== | | ==Nevus sebaceous== |
| *[[AKA]] ''nevus sebaceous of Jadassohn''. | | *[[AKA]] ''nevus sebaceous of Jadassohn''. |
| ===General===
| | {{Main|Nevus sebaceous}} |
| *Congenital - considered a [[hamartoma]].<ref name=pmid23217958/>
| |
| *Usually sporadic - may be transmitted autosomal dominant.<ref name=pmid23217958/>
| |
| *Malignant tumours may arise within a ''nevus sebaceous''.
| |
|
| |
| ===Gross===
| |
| Features:<ref name=pmid23217958>{{Cite journal | last1 = West | first1 = C. | last2 = Narahari | first2 = S. | last3 = Kwatra | first3 = S. | last4 = Feldman | first4 = S. | title = Autosomal dominant transmission of nevus sebaceous of Jadassohn. | journal = Dermatol Online J | volume = 18 | issue = 11 | pages = 17 | month = Nov | year = 2012 | doi = | PMID = 23217958 }}</ref><ref name=pmid19171988>{{Cite journal | last1 = Simi | first1 = CM. | last2 = Rajalakshmi | first2 = T. | last3 = Correa | first3 = M. | title = Clinicopathologic analysis of 21 cases of nevus sebaceus: a retrospective study. | journal = Indian J Dermatol Venereol Leprol | volume = 74 | issue = 6 | pages = 625-7 | month = | year = | doi = | PMID = 19171988 }}</ref>
| |
| *Head and neck [[plaque]] or [[papule]] with:
| |
| **Well-circumscribed borders.
| |
| **Waxy, yellow appearance.
| |
| *Area usu. devoid of hair.<ref name=pmid22148058>{{Cite journal | last1 = Kim | first1 = JH. | last2 = Park | first2 = HY. | last3 = Ahn | first3 = SK. | title = Nevus sebaceous accompanying secondary neoplasms and unique histopathologic findings. | journal = Ann Dermatol | volume = 23 | issue = Suppl 2 | pages = S231-4 | month = Oct | year = 2011 | doi = 10.5021/ad.2011.23.S2.S231 | PMID = 22148058 }}</ref>
| |
| | |
| DDx - gross:
| |
| *[[Seborrheic keratosis]].
| |
| | |
| Image:
| |
| *[http://www.dermnet.com/images/Nevus-Sebaceous/picture/17082?imgNumber=14 NS (dermnet.com)].
| |
| | |
| ===Microscopic===
| |
| Features:<ref name=pmid19171988/>
| |
| *Abundant sebaceous glands.
| |
| *Immature/abortive hair follicles.
| |
| **No normal terminal hair follicles.
| |
| *Papillomatous epidermal hyperplasia.
| |
| | |
| Images:
| |
| *[http://commons.wikimedia.org/wiki/File:SkinTumors-P6260391.JPG NS (WC)].
| |
| *[http://www.dermnet.com/images/Nevus-Sebaceous/picture/17087 NS (dermnet.com)].
| |
|
| |
|
| ==Nevus lipomatosus superficialis== | | ==Nevus lipomatosus superficialis== |
Line 811: |
Line 521: |
| *[[AKA]] ''nevus lipomatosus cutaneous superficialis'', abbreviated ''NLCS''. | | *[[AKA]] ''nevus lipomatosus cutaneous superficialis'', abbreviated ''NLCS''. |
| *[[AKA]] ''nevus lipomatosus''.<ref name=pmid15677959>{{Cite journal | last1 = Kaw | first1 = P. | last2 = Carlson | first2 = A. | last3 = Meyer | first3 = DR. | title = Nevus lipomatosus (pedunculated lipofibroma) of the eyelid. | journal = Ophthal Plast Reconstr Surg | volume = 21 | issue = 1 | pages = 74-6 | month = Jan | year = 2005 | doi = | PMID = 15677959 }}</ref> | | *[[AKA]] ''nevus lipomatosus''.<ref name=pmid15677959>{{Cite journal | last1 = Kaw | first1 = P. | last2 = Carlson | first2 = A. | last3 = Meyer | first3 = DR. | title = Nevus lipomatosus (pedunculated lipofibroma) of the eyelid. | journal = Ophthal Plast Reconstr Surg | volume = 21 | issue = 1 | pages = 74-6 | month = Jan | year = 2005 | doi = | PMID = 15677959 }}</ref> |
| ===General===
| | {{Main|Nevus lipomatosus superficialis}} |
| *Rare.
| |
| *Congenital - considered a [[hamartoma]].<ref name=pmid22984661/>
| |
| *Usually young adults.<ref>URL: [http://www.dermpedia.org/dermpedia-textbook/nevus-lipomatosus http://www.dermpedia.org/dermpedia-textbook/nevus-lipomatosus]. Accessed on: 8 January 2013.</ref>
| |
| | |
| Clinically separated into:<ref name=pmid17288284>{{Cite journal | last1 = Triki | first1 = S. | last2 = Mekni | first2 = A. | last3 = Haouet | first3 = S. | last4 = Mokni | first4 = M. | last5 = Kchir | first5 = N. | last6 = Ben Osman Dhahri | first6 = A. | last7 = Zitouna | first7 = M. | title = [Nevus lipomatosus cutaneous superficialis: a clinico-pathological study of 13 cases]. | journal = Tunis Med | volume = 84 | issue = 12 | pages = 800-2 | month = Dec | year = 2006 | doi = | PMID = 17288284 }}</ref>
| |
| *''Solitary'' - one lesion.
| |
| *''Multiple'' - more than one lesion.
| |
| | |
| ===Gross===
| |
| Features:<ref name=pmid22984661>{{Cite journal | last1 = Goucha | first1 = S. | last2 = Khaled | first2 = A. | last3 = Zéglaoui | first3 = F. | last4 = Rammeh | first4 = S. | last5 = Zermani | first5 = R. | last6 = Fazaa | first6 = B. | title = Nevus lipomatosus cutaneous superficialis: Report of eight cases. | journal = Dermatol Ther (Heidelb) | volume = 1 | issue = 2 | pages = 25-30 | month = Dec | year = 2011 | doi = 10.1007/s13555-011-0006-y | PMID = 22984661 | PMC = 3437641 }}</ref>
| |
| *Pedunculated lesion.
| |
| *Soft.
| |
| *Usually lower trunk or gluteal region.<ref name=pmid1235780>{{Cite journal | last1 = Jones | first1 = EW. | last2 = Marks | first2 = R. | last3 = Pongsehirun | first3 = D. | title = Naevus superficialis lipomatosus. A clinicopathological report of twenty cases. | journal = Br J Dermatol | volume = 93 | issue = 2 | pages = 121-33 | month = Aug | year = 1975 | doi = | PMID = 1235780 }}</ref>
| |
| | |
| Image:
| |
| *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437641/figure/Fig1/ NLS (nih.gov)].<ref name=pmid22984661/>
| |
| | |
| ===Microscopic===
| |
| Features:<ref name=pmid19495497>{{Cite journal | last1 = Yap | first1 = FB. | title = Nevus lipomatosus superficialis. | journal = Singapore Med J | volume = 50 | issue = 5 | pages = e161-2 | month = May | year = 2009 | doi = | PMID = 19495497 | URL = http://smj.sma.org.sg/5005/5005cr3.pdf }}</ref>
| |
| *Benign adipose tissue in the dermis.
| |
| **Adipocytes in [[reticular dermis]] +/- [[papillary dermis]].<ref name=pmid20673540>{{Cite journal | last1 = Ghosh | first1 = SK. | last2 = Bandyopadhyay | first2 = D. | last3 = Jamadar | first3 = NS. | title = Nevus lipomatosus cutaneous superficialis: An unusual presentation. | journal = Dermatol Online J | volume = 16 | issue = 7 | pages = 12 | month = | year = 2010 | doi = | PMID = 20673540 }}</ref>
| |
| | |
| DDx:
| |
| *[[Lipoma]].
| |
| *[[Fibroepithelial polyp]] (skin tag).
| |
| *[[Intradermal nevus]] with adipocytes.<ref name=pmid9810886>{{Cite journal | last1 = Eng | first1 = W. | last2 = Cohen | first2 = PR. | title = Nevus with fat: clinical characteristics of 100 nevi containing mature adipose cells. | journal = J Am Acad Dermatol | volume = 39 | issue = 5 Pt 1 | pages = 704-11 | month = Nov | year = 1998 | doi = | PMID = 9810886 }}</ref>
| |
| | |
| Images:
| |
| *[http://www.dermaamin.com/site/images/histo-pic/n/nevus-lipomatosus-superficialis/nevus-lipomatosus-superficialis1.jpg NLS (dermamin.com)].<ref>URL: [http://www.dermaamin.com/site/histopathology-of-the-skin/66-n/1971-nevus-lipomatosus-superficialis----.html http://www.dermaamin.com/site/histopathology-of-the-skin/66-n/1971-nevus-lipomatosus-superficialis----.html]. Accessed on: 7 March 2012.</ref>
| |
| *[http://www.humpath.com/IMG/jpg/nevus_superficialis_lipomatosus_01_1.jpg NLS (humpath.com)].<ref>URL: [http://www.humpath.com/spip.php?article8134 http://www.humpath.com/spip.php?article8134]. Accessed on: 17 December 2012.</ref>
| |
| *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437641/figure/Fig3/ NLS (nih.gov)].<ref name=pmid22984661/>
| |
| *[http://www.dermpedia.org/dermpedia-textbook/nevus-lipomatosus Nevus lipomatosus (dermpedia.org)].
| |
| | |
| ===Sign out===
| |
| <pre>
| |
| SKIN LESION ("SKIN TAG"), LEFT HIP, EXCISION:
| |
| - NEVUS LIPOMATOSUS SUPERFICIALIS.
| |
| </pre>
| |
|
| |
|
| =Bullous disease= | | =Bullous disease= |