Difference between revisions of "Dermal cysts"
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(→Collagenous fibroma: fix format, fix sp.) |
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===General=== | ===General=== | ||
*Benign. | *Benign. | ||
*Used to be known as '' | *Used to be known as ''desmoplastic fibroblastoma''. | ||
Epidemiology: | |||
*May be on the lip. | *May be on the lip. | ||
===Microscopic=== | |||
Features:<ref>URL: [http://www.dermatologyoutlines.com/dermskintumornonmelanocytic.html#collagenousfibroma http://www.dermatologyoutlines.com/dermskintumornonmelanocytic.html#collagenousfibroma]. Accessed on: 19 March</ref><ref name=Ref_Sternberg4_161>{{Ref Sternberg4|161}}</ref> | |||
*Acellular stroma with abundant collagen. | |||
Notes: | |||
* | *'''No''' nuclear atypia. | ||
==Dermatomyositis== | ==Dermatomyositis== | ||
Revision as of 16:30, 19 March 2011
Dermal cysts happen and are common. Dermatopathologists can diagnose 'em.
Cysts
Common types:[1]
- Epidermal cyst (sebaceous cyst) -- most common.
- Pilar (tricheilemmal) cyst.
- Dermoid cyst.
- Ganglion cyst.
- Milicem.
EM, SJS, TEN
- SJS and TEN are on a spectrum, EM is considered separate.
Erythema multiforme (EM)
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
Rx causes of SJS:
- NSAIDs,
- anticonvulsants,
- sulfonamides,
- penicillins.
TEN more severe form SJS.
Definition:
- >30% sheet-like epidermal detachment, diffuse erythema, severe mucous membrane involvement
- most TEN (80%) Rx-related, only 50% of SJS Rx-related
Venous lake
- Dilated vein.
Microscopic
Features:[2]
- Lined by endothelium.
- Blood in lumen.
- +/-Fibrin in lumen.
DDx:
- Angiokeratoma.
- Ectatic superficial dermal vessels.
- Irregular acanthosis.
- Longer rete ridges.
Neurofibromatosis (von Recklinghausen's disease)
Etiology
- Genetic - autosomal dominant disorder.
Management
- Follow for malignant transformation of neurofibroma --> neurofibrosarcoma.
Treatment
- Excise suspicious lesions & lesions that are painful.
Collagenous fibroma
General
- Benign.
- Used to be known as desmoplastic fibroblastoma.
Epidemiology:
- May be on the lip.
Microscopic
- Acellular stroma with abundant collagen.
Notes:
- No nuclear atypia.
Dermatomyositis
Gross
- Have lesions on the knuckle - Gottron's papulle
Histology
- Lymphocytic interface dermatitis (inflammation at the dermal-epidermal junction).
- Loss of rete ridges.
Systemic lupus erythematosus
- Lymphocytic interface dermatitis.[5]
Familial benign pemphigus
- AKA Hailey-Hailey disease. Was described by two brothers - that's why it is Hailey-Hailey.[6]
Etiology
- Autosomal dominant with incomplete penetration.[6]
- Desmosomal defect - due to mutation in the gene ATP2C1.[6]
Clinical
- Chest.
- Intriginous regions (?sp).
- Typically presents individual in their 30s and 40s.[6]
Histology
- Hair folicles spared.
- Epidermis thickened.
DDx
- May resemble pemphigus vulgaris.
Epidermal inclusion cyst
- AKA epidermal cyst.
General
- Very common.
Microscopic
Feature:
- Cyst lining has a granular layer - key feature.[7]
- Trapped collagen bundles at edge of lesion with surrounded by fibroblasts.
- Keratin.
Image:
DDx:
- Dermatofibrosarcoma - if lesion is large.
- Pilar cyst - no granular layer.
See also
References
- ↑ TN07 D5
- ↑ Weedon's Skin Pathology. 3rd Ed. P.895.
- ↑ URL: http://www.dermatologyoutlines.com/dermskintumornonmelanocytic.html#collagenousfibroma. Accessed on: 19 March
- ↑ Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 161. ISBN 978-0781740517.
- ↑ JAH 20 Feb 2009.
- ↑ 6.0 6.1 6.2 6.3 http://emedicine.medscape.com/article/1063224-overview
- ↑ URL: http://emedicine.medscape.com/article/1058907-diagnosis. Accessed on: 18 March 2011.