Difference between revisions of "Dermal cysts"

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(split-out EM, SJS, TEN)
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*Lymphocytic interface dermatitis.<ref>JAH. 20 February 2009.</ref>
*Lymphocytic interface dermatitis.<ref>JAH. 20 February 2009.</ref>
*Basal layer vacuolation.<ref name=pmid18384217>{{cite journal |author=Crowson AN, Magro CM, Mihm MC |title=Interface dermatitis |journal=Arch. Pathol. Lab. Med. |volume=132 |issue=4 |pages=652–66 |year=2008 |month=April |pmid=18384217 |doi= |url=http://www.archivesofpathology.org/doi/full/10.1043/1543-2165%282008%29132%5B652%3AID%5D2.0.CO%3B2}}</ref>
*Basal layer vacuolation.<ref name=pmid18384217>{{cite journal |author=Crowson AN, Magro CM, Mihm MC |title=Interface dermatitis |journal=Arch. Pathol. Lab. Med. |volume=132 |issue=4 |pages=652–66 |year=2008 |month=April |pmid=18384217 |doi= |url=http://www.archivesofpathology.org/doi/full/10.1043/1543-2165%282008%29132%5B652%3AID%5D2.0.CO%3B2}}</ref>
==Familial benign pemphigus==
*AKA ''Hailey-Hailey disease''. Was described by two brothers - that's why it is ''Hailey-Hailey''.<ref name=emed_hailey>[http://emedicine.medscape.com/article/1063224-overview http://emedicine.medscape.com/article/1063224-overview]</ref>
===Etiology===
*Autosomal dominant with incomplete penetration.<ref name=emed_hailey/>
*Desmosomal defect - due to mutation in the gene ''ATP2C1''.<ref name=emed_hailey/>
===Clinical===
*Chest.
*Intriginous regions (?sp).
*Typically presents individual in their 30s and 40s.<ref name=emed_hailey/>
===Histology===
*Hair folicles spared.
*Epidermis thickened.
===DDx===
*May resemble pemphigus vulgaris.


==Epidermal inclusion cyst==
==Epidermal inclusion cyst==

Revision as of 17:40, 9 September 2011

Dermal cysts are common in dermatopathology. Dermatopathologists can diagnose 'em.

Cysts

Common types:[1]

Epidermal necrosis

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

Features:[3][4]

  • Acellular stroma with abundant collagen.

Notes:

  • No nuclear atypia.

Dermatomyositis

See: Neuromuscular_pathology#Dermatomyositis.

Gross

  • Have lesions on the knuckle - Gottron's papulle

Microsopic

Features:

  • Lymphocytic interface dermatitis (inflammation at the dermal-epidermal junction).
  • Loss of rete ridges.

Systemic lupus erythematosus

  • Lymphocytic interface dermatitis.[5]
  • Basal layer vacuolation.[6]

Epidermal inclusion cyst

  • AKA epidermal cyst.

General

  • Very common.

Microscopic

Features:

  • Cyst lining has a granular layer - key feature.[7]
  • Trapped collagen bundles at edge of lesion with surrounded by fibroblasts.
  • Keratin.

Image:

DDx:

Pilar cyst

  • AKA trichilemmal cyst.

General

  • Very common.

Microscopic

Features:

  • Keratin.
  • Cyst lining has no granular layer - key feature.
  • Trapped collagen bundles at edge of lesion with surrounded by fibroblasts.

DDx:

See also

References

  1. TN07 D5
  2. Weedon's Skin Pathology. 3rd Ed. P.895.
  3. URL: http://www.dermatologyoutlines.com/dermskintumornonmelanocytic.html#collagenousfibroma. Accessed on: 19 March
  4. 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.
  5. JAH. 20 February 2009.
  6. 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. URL: http://emedicine.medscape.com/article/1058907-diagnosis. Accessed on: 18 March 2011.