Pityriasis rubra pilaris - Revision history

Michael: +IF

2014-09-30T05:02:08Z

+IF

← Older revision		Revision as of 05:02, 30 September 2014
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	\| EM =		\| EM =
	\| Molecular =		\| Molecular =
	\| IF =		\| IF = negative (changes in ''Desmoglein 1'' & ''Desmoglein 3'' in [[pemphigus vulgaris]])
	\| Gross = salmon-coloured plaques, well-demarcated		\| Gross = salmon-coloured plaques, well-demarcated
	\| Grossing =		\| Grossing =

Michael: tweak, wikify

2014-09-30T04:51:20Z

tweak, wikify

← Older revision		Revision as of 04:51, 30 September 2014
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	*Occasional mild spongiosis.		*Occasional mild spongiosis.

	~~==Histologic DDx==~~		Notes:
	*PRP is easy to miss - clinical history (r/o PRP) usually needed to prompt correct diagnosis.		*PRP is easy to miss - clinical history (r/o PRP) usually needed to prompt correct diagnosis.
	*Psoriasis vulgaris <ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref> - thinned suprapapillary plates, hypogranulosis, neutrophils in the stratum corneum, dilated papillary dermal blood vessels, acantholysis absent
	*Lichen simplex chronicus - usually a localized process, not a widespread process.		===Microscopic DDx===

			*[[Psoriasis vulgaris]]<ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref> - thinned suprapapillary plates, hypogranulosis, neutrophils in the stratum corneum, dilated papillary dermal blood vessels, acantholysis absent.
			*[[Lichen simplex chronicus]] - usually a localized process, not a widespread process.
	*Darier disease - acantholysis is prominent with corps ronds and grains, follicular plugging absent.		*Darier disease - acantholysis is prominent with corps ronds and grains, follicular plugging absent.
	*Pemphigus vulgaris - PRP with extensive acantholysis ~~could~~ mimic - IF will be negative in PRP		*[[Pemphigus vulgaris]] - PRP with extensive acantholysis can mimic; [[immunofluorescence\|IF]] will be negative in PRP.
	*Hailey-Hailey - ~~Falling~~ brick wall pattern of acantholysis.		*[[Hailey-Hailey disease]] - falling brick wall pattern of acantholysis.
	*Seborrhoeic dermatitis - more spongiotic, often with neutrophils.		*Seborrhoeic dermatitis - more spongiotic, often with neutrophils.
	*[[~~Dermatophtosis~~\|Fungal infection]].		*[[Dermatophytosis\|Fungal infection]].

	==Associated Diagnoses==		==Associated Diagnoses==

Michael at 04:40, 30 September 2014

2014-09-30T04:40:41Z

← Older revision		Revision as of 04:40, 30 September 2014
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	\| Micro = alterating [[orthokeratosis]] and [[parakeratosis]] (known as "checkerboard pattern"), marked uniform [[acanthosis]] with broad dermal papillae and broad epidermal ridges, , +/-eosinophils (common), follicular plugging, scattered foci of [[acantholysis]] (common), occasional mild spongiosis		\| Micro = alterating [[orthokeratosis]] and [[parakeratosis]] (known as "checkerboard pattern"), marked uniform [[acanthosis]] with broad dermal papillae and broad epidermal ridges, , +/-eosinophils (common), follicular plugging, scattered foci of [[acantholysis]] (common), occasional mild spongiosis
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[Dermatomycosis\|fungal infection]], ~~Psoriasis~~, Darier disease, seborrhoeic dermatitis		\| LMDDx = [[Dermatomycosis\|fungal infection]], [[psoriasis]], [[Darier disease]], [[seborrhoeic dermatitis]]
	\| Stains = PASD -ve (to r/o fungal infections)		\| Stains = PASD -ve (to r/o fungal infections)
	\| IHC =		\| IHC =
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	\| Assdx = HIV infection - recalcitrant PRP		\| Assdx = HIV infection - recalcitrant PRP
	\| Syndromes =		\| Syndromes =
	\| Clinicalhx = Classic adult - self-limited exfoliative, erythematous dermatitis that starts over the head and neck and extends downwards forming orange plaques with spared islands of normal skin, follicular hyperkeratosis, palmar involvement with orange hyperkeratosis.		\| Clinicalhx = Classic adult - self-limited exfoliative, erythematous dermatitis that starts over the head and neck and extends downwards forming orange plaques with spared islands of normal skin, follicular hyperkeratosis, palmar involvement with orange hyperkeratosis
	\| Signs =		\| Signs =
	\| Symptoms =		\| Symptoms =
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	==Associated Diagnoses==		==Associated Diagnoses==
	*HIV infection - recalcitrant PRP		*[[HIV infection]] - recalcitrant PRP.

	===Images===		===Images===
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	[[Category:Diagnosis]]		[[Category:Diagnosis]]
			[[Category:Dermatopathology]]

Sarah: /* Histologic DDx */

2014-09-29T11:46:06Z

Histologic DDx

← Older revision		Revision as of 11:46, 29 September 2014
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	*Psoriasis vulgaris <ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref> - thinned suprapapillary plates, hypogranulosis, neutrophils in the stratum corneum, dilated papillary dermal blood vessels, acantholysis absent		*Psoriasis vulgaris <ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref> - thinned suprapapillary plates, hypogranulosis, neutrophils in the stratum corneum, dilated papillary dermal blood vessels, acantholysis absent
	*Lichen simplex chronicus - usually a localized process, not a widespread process.		*Lichen simplex chronicus - usually a localized process, not a widespread process.
	*Darier disease - acantholysis is prominent with corps ronds and grains, follicular plugging absent		*Darier disease - acantholysis is prominent with corps ronds and grains, follicular plugging absent.
			*Pemphigus vulgaris - PRP with extensive acantholysis could mimic - IF will be negative in PRP
			*Hailey-Hailey - Falling brick wall pattern of acantholysis.
	*Seborrhoeic dermatitis - more spongiotic, often with neutrophils.		*Seborrhoeic dermatitis - more spongiotic, often with neutrophils.
	*[[Dermatophtosis\|Fungal infection]].		*[[Dermatophtosis\|Fungal infection]].

Sarah: /* Histologic DDx */

2014-09-29T11:40:46Z

Histologic DDx

← Older revision		Revision as of 11:40, 29 September 2014
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	==Histologic DDx==		==Histologic DDx==
	*PRP is easy to miss - clinical history (r/o PRP) usually ~~provides the best clue~~.		*PRP is easy to miss - clinical history (r/o PRP) usually needed to prompt correct diagnosis.
	*Psoriasis vulgaris.<ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref> - thinned suprapapillary plates, hypogranulosis, neutrophils in the stratum corneum, dilated papillary dermal blood vessels, acantholysis absent		*Psoriasis vulgaris <ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref> - thinned suprapapillary plates, hypogranulosis, neutrophils in the stratum corneum, dilated papillary dermal blood vessels, acantholysis absent
	*Lichen simplex chronicus.		*Lichen simplex chronicus - usually a localized process, not a widespread process.
	*Darier disease - acantholysis is prominent with corps ronds and grains, follicular plugging absent		*Darier disease - acantholysis is prominent with corps ronds and grains, follicular plugging absent
	*Seborrhoeic dermatitis - more spongiotic, often with neutrophils.		*Seborrhoeic dermatitis - more spongiotic, often with neutrophils.

Sarah at 11:37, 29 September 2014

2014-09-29T11:37:21Z

← Older revision		Revision as of 11:37, 29 September 2014
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	==Histologic DDx==		==Histologic DDx==
	*Psoriasis vulgaris.<ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref>		*PRP is easy to miss - clinical history (r/o PRP) usually provides the best clue.
	*Darier disease.		*Psoriasis vulgaris.<ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref> - thinned suprapapillary plates, hypogranulosis, neutrophils in the stratum corneum, dilated papillary dermal blood vessels, acantholysis absent
	*Seborrhoeic dermatitis.		*Lichen simplex chronicus.
			*Darier disease - acantholysis is prominent with corps ronds and grains, follicular plugging absent
			*Seborrhoeic dermatitis - more spongiotic, often with neutrophils.
	*[[Dermatophtosis\|Fungal infection]].		*[[Dermatophtosis\|Fungal infection]].

Sarah at 11:27, 29 September 2014

2014-09-29T11:27:32Z

← Older revision		Revision as of 11:27, 29 September 2014
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	Features:<ref name=pmid24783259>{{Cite journal \| last1 = Marrouche \| first1 = N. \| last2 = Kurban \| first2 = M. \| last3 = Kibbi \| first3 = AG. \| last4 = Abbas \| first4 = O. \| title = Pityriasis rubra pilaris: clinicopathological study of 32 cases from Lebanon. \| journal = Int J Dermatol \| volume = 53 \| issue = 4 \| pages = 434-9 \| month = Apr \| year = 2014 \| doi = \| PMID = 24783259 }}</ref>		Features:<ref name=pmid24783259>{{Cite journal \| last1 = Marrouche \| first1 = N. \| last2 = Kurban \| first2 = M. \| last3 = Kibbi \| first3 = AG. \| last4 = Abbas \| first4 = O. \| title = Pityriasis rubra pilaris: clinicopathological study of 32 cases from Lebanon. \| journal = Int J Dermatol \| volume = 53 \| issue = 4 \| pages = 434-9 \| month = Apr \| year = 2014 \| doi = \| PMID = 24783259 }}</ref>
	*Alterating [[orthokeratosis]] and [[parakeratosis]] - known as "checkerboard pattern".		*Alterating [[orthokeratosis]] and [[parakeratosis]] - known as "checkerboard pattern".
	*Marked uniform [[acanthosis]] with broad dermal papillae and broad epidermal ridges		*Marked uniform [[acanthosis]] with broad dermal papillae and broad epidermal ridges.
	*Follicular plugging.		*Follicular plugging.
	*+/-Eosinophils (common).		*+/-Eosinophils (common).
	*Scattered foci of [[~~Acantholysis~~]].<ref name=pmid23286804/>		*Scattered foci of [[acantholysis]].<ref name=pmid23286804/>
			*Occasional mild spongiosis.

	DDx:		==Histologic DDx==
	*[[Dermatophyosis\|Fungal infection]].
	*Psoriasis vulgaris.<ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref>		*Psoriasis vulgaris.<ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref>
	*Darier disease.		*Darier disease.
	*Seborrhoeic dermatitis.		*Seborrhoeic dermatitis.
			*[[Dermatophtosis\|Fungal infection]].

			==Associated Diagnoses==
			*HIV infection - recalcitrant PRP

	===Images===		===Images===

Sarah at 11:21, 29 September 2014

2014-09-29T11:21:41Z

← Older revision		Revision as of 11:21, 29 September 2014
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	\| Caption =		\| Caption =
	\| Synonyms =		\| Synonyms =
	\| Micro = alterating [[orthokeratosis]] and [[parakeratosis]] (known as "checkerboard pattern"), marked uniform acanthosis with broad dermal papillae and broad epidermal ridges, , +/-eosinophils (common), follicular plugging, scattered foci of [[acantholysis]] (common), occasional mild spongiosis		\| Micro = alterating [[orthokeratosis]] and [[parakeratosis]] (known as "checkerboard pattern"), marked uniform [[acanthosis]] with broad dermal papillae and broad epidermal ridges, , +/-eosinophils (common), follicular plugging, scattered foci of [[acantholysis]] (common), occasional mild spongiosis
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[Dermatomycosis\|fungal infection]], Psoriasis, Darier disease, seborrhoeic dermatitis		\| LMDDx = [[Dermatomycosis\|fungal infection]], Psoriasis, Darier disease, seborrhoeic dermatitis
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	\| Assdx = HIV infection - recalcitrant PRP		\| Assdx = HIV infection - recalcitrant PRP
	\| Syndromes =		\| Syndromes =
	\| Clinicalhx =Classic adult - self-limited exfoliative, erythematous dermatitis that starts over the head and neck and extends downwards forming orange plaques with spared islands of normal skin, follicular hyperkeratosis, palmar involvement with orange hyperkeratosis.		\| Clinicalhx = Classic adult - self-limited exfoliative, erythematous dermatitis that starts over the head and neck and extends downwards forming orange plaques with spared islands of normal skin, follicular hyperkeratosis, palmar involvement with orange hyperkeratosis.
	\| Signs =		\| Signs =
	\| Symptoms =		\| Symptoms =
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	Features:<ref name=pmid24783259>{{Cite journal \| last1 = Marrouche \| first1 = N. \| last2 = Kurban \| first2 = M. \| last3 = Kibbi \| first3 = AG. \| last4 = Abbas \| first4 = O. \| title = Pityriasis rubra pilaris: clinicopathological study of 32 cases from Lebanon. \| journal = Int J Dermatol \| volume = 53 \| issue = 4 \| pages = 434-9 \| month = Apr \| year = 2014 \| doi = \| PMID = 24783259 }}</ref>		Features:<ref name=pmid24783259>{{Cite journal \| last1 = Marrouche \| first1 = N. \| last2 = Kurban \| first2 = M. \| last3 = Kibbi \| first3 = AG. \| last4 = Abbas \| first4 = O. \| title = Pityriasis rubra pilaris: clinicopathological study of 32 cases from Lebanon. \| journal = Int J Dermatol \| volume = 53 \| issue = 4 \| pages = 434-9 \| month = Apr \| year = 2014 \| doi = \| PMID = 24783259 }}</ref>
	*Alterating [[orthokeratosis]] and [[parakeratosis]] - known as "checkerboard pattern".		*Alterating [[orthokeratosis]] and [[parakeratosis]] - known as "checkerboard pattern".
			*Marked uniform [[acanthosis]] with broad dermal papillae and broad epidermal ridges
			*Follicular plugging.
	*+/-Eosinophils (common).		*+/-Eosinophils (common).
	*~~Follicular plugging.~~		*Scattered foci of [[Acantholysis]].<ref name=pmid23286804/>
	*[[Acantholysis]].<ref name=pmid23286804/>

	DDx:		DDx:
	*[[~~Dermatomycosis~~\|Fungal infection]].		*[[Dermatophyosis\|Fungal infection]].
	*Psoriasis vulgaris.<ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref>		*Psoriasis vulgaris.<ref name=pmid18418089>{{Cite journal \| last1 = Brinster \| first1 = NK. \| title = Dermatopathology for the surgical pathologist: a pattern based approach to the diagnosis of inflammatory skin disorders (part I). \| journal = Adv Anat Pathol \| volume = 15 \| issue = 2 \| pages = 76-96 \| month = Mar \| year = 2008 \| doi = 10.1097/PAP.0b013e3181664e8d \| PMID = 18418089 }}</ref>
			*Darier disease.
			*Seborrhoeic dermatitis.

	===Images===		===Images===

Sarah at 11:13, 29 September 2014

2014-09-29T11:13:32Z

← Older revision		Revision as of 11:13, 29 September 2014
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	\| Caption =		\| Caption =
	\| Synonyms =		\| Synonyms =
	\| Micro = alterating [[orthokeratosis]] and [[parakeratosis]] (known as "checkerboard pattern"), +/-eosinophils (common), follicular plugging, [[acantholysis]] (common)		\| Micro = alterating [[orthokeratosis]] and [[parakeratosis]] (known as "checkerboard pattern"), marked uniform acanthosis with broad dermal papillae and broad epidermal ridges, , +/-eosinophils (common), follicular plugging, scattered foci of [[acantholysis]] (common), occasional mild spongiosis
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[Dermatomycosis\|fungal infection]]		\| LMDDx = [[Dermatomycosis\|fungal infection]], Psoriasis, Darier disease, seborrhoeic dermatitis
	\| Stains = PASD -ve (to r/o fungal infections)		\| Stains = PASD -ve (to r/o fungal infections)
	\| IHC =		\| IHC =
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	\| Grossing =		\| Grossing =
	\| Site = [[skin]] - see ''[[inflammatory skin disorders]]''		\| Site = [[skin]] - see ''[[inflammatory skin disorders]]''
	\| Assdx =		\| Assdx = HIV infection - recalcitrant PRP
	\| Syndromes =		\| Syndromes =
	\| Clinicalhx =		\| Clinicalhx =Classic adult - self-limited exfoliative, erythematous dermatitis that starts over the head and neck and extends downwards forming orange plaques with spared islands of normal skin, follicular hyperkeratosis, palmar involvement with orange hyperkeratosis.
	\| Signs =		\| Signs =
	\| Symptoms =		\| Symptoms =

Michael at 06:47, 24 September 2014

2014-09-24T06:47:46Z

← Older revision		Revision as of 06:47, 24 September 2014
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	==Stains==		==Stains==
	*[[PASD stain\|PASD]] -ve for fungal organisms.<ref name=pmid23286804/>		*[[PASD stain\|PASD]] -ve for fungal organisms.<ref name=pmid23286804/>
			<!-- comment out the following
	==IHC==		==IHC==

	==Molecular==		==Molecular==

	==Sign out==		==Sign out== -->

	==See also==		==See also==
	*[[Inflammatory skin disorders]].		*[[Inflammatory skin disorders]].