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pemphigus vulgaris
Hailey-Hailey diseaseとは、adnexal epitheliumに同様の変化があるかどうかが鑑別になる。PVは、同様の変化を認める。
sweet syndrome acute febrile neutrophilic dermatosisであり、組織学的に真皮上層の著明な浮腫と真皮網状層のneutrophilsおよびnuclear dust の著明な浸潤。 leukocytoclastic vasculitisは、血管壁にfibrinの沈着があるが、sweet syndromeにはそれを認めない。
Lichen striasis clue :alignment of infiltrates of lymphocytes within the reticular dermis along epithelial and nonepithelial structure of adneca and some individual necrotic epidermal keratinocytes(sometimes clusters of them) in the setting of spongiotic,lichenoid ,or psoriasiform changes. perifolliculitisは、lichen nitidusには認められない。
erythema annulare centrifugum tight cuff of small round cells surrounds the vessels of the superficial and deep plexuses. mature small lymphocytes no vasculitis cuffing;袖口様白血球集合(血管の周囲への様々な白血球の集簇) superficial and deep perivascular infiltrates without vascular damage or vasculitis lymphocyte predominant
erythema chronicum migrans Lyme disease plasma cell;peripheries of lesions eosinoohiles;center of the lesions superficial and deep perivascular infiltrates without vascular damage or vasculitis mixted cell predominant
perivascular dermatitis superficial lymphohistiocytic infiltrate 1)pigmented purpuric dermatitis(schamberg's disease) extravasated erythrocytes 2)some viral exanthems 3)gyrate erythema,superdicial verivascular cuff formation 4)tinea versicolor abundant hyphae and spores within the cornified layer 5)erythrasma(紅色陰癬) corynebacteria within cornified layer pitted keratosis 6)postinflammatory pigmentary alteration
souce of damage to skin was external preponderance of necrotic keratinocytes in upper outer portion of epidermis
some morbilliform drug eruption like EEM but absence of necrotic keratinocytes
chronic radiodermatits closely resemble those of lichen sclerosis et atrophicus large atypical fibroblast in papillary dermis is clue of defferentiation.
lichen planus like keratoses 1)focal presence of parakeratosis, 2)focal absence or diminution of granular layer 3)plasma cell and eosinophils in the lichenoid infiltrate
lichen planus like solar keratosis atypical keratinocyte
the specimen comes from the leg thick walled capillaries and venules
crust (serum+parekeratosis) the presence of a crust in the absence of erosion or ulceration implies preceding spongiosis.
pityriasis rosea tyoical :focal parekeratosis,spongiosis,slight epidermal hyperplasia,edema of papillary dermis.superficial perivascular lymphohidtiocytic infiltrate with varying numbers of extravasated erythrocytes. multinucleateed epithelial cells superficial perivascular,spongiotic
Gianotti-Crosti syndrome spongiotic foci ehthin epidermis may contain some atypical lymphocytes superficial perivascular,spongiotic
lichen striatus vacuolar alteration at the dermoepidermal junction spongiosis dyskeratotic cells parakeratosis superficial perivascular,spongiotic
superficial perivascular dermatitis eosinophilic spongiosis 1)incontinentia pigmenti 2)acute allargic contact dermatitis 3)arthropod reaction 4)pemphigoid 5)pemphigus vulgaris superficial perivascular dermatitis
lichen simplex chronics collagen in vertical streaks is diagnostic histologic sign of prolonged rubbing of skin.
prurigo nodularis the lesion merely represent dome shaped caricatures of the lesions of lichen simplex chronicus. a kind of lichen simplex chronicus
picker's nodule eroded or ulcerated nodular lesions,in consequence of having been both rubbed and picked a kind of lichen simplex chronics
lamellar ichthyosis 1)prominent compact laminated orthokeratosis 2)psoriasiform hyperplasia 3)superficial perivasucular infiltration 4)normal granular layer superficial perivascular dermatitis ,psoriasiform
necrobiosis lipoidica palisaded granuloma degenerated collagen , necrotizing vasculitis that involves small blood vessels in mid and lower dermis., no mucin
Miescher's granuloma(granuloma disciformis of the face) histologically like granuloma annulare but asteroid bodies,no significant mucin and little and no collagen degenaration