Difference between revisions of "Dermal cysts"
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'''Dermal cysts''' | '''Dermal cysts''' are common in [[dermatopathology]]. Dermatopathologists can diagnose 'em. | ||
==Cysts== | ==Cysts== | ||
| Line 15: | Line 15: | ||
===Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)=== | ===Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)=== | ||
Rx causes of SJS: | Rx causes of SJS: | ||
*NSAIDs | *NSAIDs. | ||
* | *Anticonvulsants. | ||
* | *Sulfonamides. | ||
* | *Penicillins. | ||
TEN more severe form SJS. | TEN more severe form SJS. | ||
Definition: | Definition: | ||
*>30% sheet-like epidermal detachment, diffuse erythema, severe mucous membrane involvement | *>30% sheet-like epidermal detachment, diffuse erythema, severe mucous membrane involvement. | ||
* | *Most TEN (80%) Rx-related, only 50% of SJS Rx-related. | ||
==Venous lake== | ==Venous lake== | ||
| Line 42: | Line 42: | ||
==Neurofibromatosis (von Recklinghausen's disease)== | ==Neurofibromatosis (von Recklinghausen's disease)== | ||
{{Main|Neurofibromatosis}} | |||
===Etiology=== | ===Etiology=== | ||
*Genetic - autosomal dominant disorder. | *Genetic - autosomal dominant disorder. | ||
Revision as of 16:37, 19 March 2011
Dermal cysts are common in dermatopathology. 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)
Main article: Neurofibromatosis
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
Familial benign pemphigus
- AKA Hailey-Hailey disease. Was described by two brothers - that's why it is Hailey-Hailey.[7]
Etiology
- Autosomal dominant with incomplete penetration.[7]
- Desmosomal defect - due to mutation in the gene ATP2C1.[7]
Clinical
- Chest.
- Intriginous regions (?sp).
- Typically presents individual in their 30s and 40s.[7]
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.[8]
- 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 February 2009.
- ↑ Crowson AN, Magro CM, Mihm MC (April 2008). "Interface dermatitis". Arch. Pathol. Lab. Med. 132 (4): 652–66. PMID 18384217. http://www.archivesofpathology.org/doi/full/10.1043/1543-2165%282008%29132%5B652%3AID%5D2.0.CO%3B2.
- ↑ 7.0 7.1 7.2 7.3 http://emedicine.medscape.com/article/1063224-overview
- ↑ URL: http://emedicine.medscape.com/article/1058907-diagnosis. Accessed on: 18 March 2011.