paul k. shitabata, m.d. dermatopathology institute · allergic contact dermatitis nummular...
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Epidermal Reaction PatternsOrthokeratosis
Spongiosis
AcanthosisParakeratosis
Hyperkeratosis
Modify by Inflammatory Cell
type
Epidermal/DermalReaction Patterns Superficial perivascular Superficial and deep perivascular Nodular and diffuse Intraepidermal vesicular and pustular Subepidermal vesicular
Epidermal ChangesSpongioticBallooning
Psoriasiform/Lichenoid
Epidermal Changes Interface
No Epidermal ChangesPerivascular
Intestitial
Superficial/Deep
Superficial Perivascular No Epidermal Changes
Tinea versicolorDermatophytosis ErythrasmaPitted keratolysis Vitiligo Schamberg's disease Viral exanthemsDrug eruption (one type)Urticaria, lateErythema figuratum, superficial
Superficial Perivascular/Interstitial No Epidermal Changes
Schamberg's diseasePUPPP
Dermatitis herpetiformisLinear IgA dermatosisDermatitis herpetiformis-like drug eruptionsAcute discoid lupus erythematosus/SLELeukocytoclastic vasculitisErythema marginatum
Superficial Perivascular/Interstitial No Epidermal Changes
Bullous pemphigoid/Herpes gestationis, urticarialPemphigus vulgaris, urticarialArthropodPUPPP
Urticaria Postinflammatory
pigmentary alterationMacular amyloidosis
Urticaria pigmentosaBrachioradial pruritis
Superficial Perivascular Psoriasiform
PsoriasisAllergic contact dermatitisNummular dermatitisDyshidrotic dermatitis Pityriasis rubra pilaris Seborrheic dermatitis
Superficial Perivascular Psoriasiform
Dermatophytosis Candidiasis
Lichen simplex chronicusPrurigo nodularisAcanthoma fissuratumPressure papule from prosthesisSurfer's nodulesChondrodermatitis nodularis helicis
Superficial PerivascularSpongiotic Psoriasiform
Allergic contact dermatitis
Nummular dermatitisDyshidrotic dermatitisId reactionSeborrheic dermatitis
Nonbullous congenital ichthyosiform erythroderma Lichen striatus
Superficial PerivascularLichenoid/Interface
Lichen planusLichenoid drugPityriasis lichenoides chronica
DLEDermatomyositisGVHEM
Superficial PerivascularPsoriasiform/Lichenoid
Lichen striatusBullous pemphigoidHerpes gestationis, urticarial
Mycosis fungoides
Superficial/DeepNo Epidermal Changes
Polymorphous light eruption, earlyErythema figuratumErythema chronicum migransPernio
Erythema nodosum PMLE DLE, tumid CLL
B-cell lymphoma
Superficial/DeepNo Epidermal Changes
Arthropod insult Erythema chronicum migrans
Scleroderma Leprosy, indeterminate
Superficial/Deep Perivascular and Interstitial
Suppurative folliculitis, periphery
Neutrophilic eccrine hidradenitis
Flea bite Cellulitis Erythropoietic protoporphyria Arthropod Erythema chronicum migrans Well's syndrome
Superficial/Deep Perivascular and Interstitial
Granuloma annulare Necrobiosis lipoidica Interstitial granulomatous
dermatitis with arthritis Mycosis fungoides,
granulomatous
Superficial/Deep Epidermal Lichenoid-Interface
PLEVAFixed drug eruptionDermatophytosis
LyPGVHDLE
Acrodermatitis chronica atrophicans
Mycosis fungoides, plaque
Nodular/Diffuse DermatitisCell Type Diagnosis
Neutrophils Sweets
Eosinophils Well’s, Hypersensitivity
Plasma cells Lyme disease
Histiocytes Granulomatous diseases
Mixed Granuloma faciale
Intraepidermal Vesicular and Pustular Dermatitis
Vesicular Pustular
Ballooning Spongiosis Acantholysis Cleaving Intracorneal Subcorneal
Intraepidermal Spongiosis Allergic contact dermatitis
Nummular dermatitisDyshidrotic dermatitis
Id reactionPhotoallergic dermatitis, earlyDermatophytosisMiliaria rubra Gianotti-Crosti syndrome Pityriasis roseaErythema annulare centrifugum Seborrheic dermatitis
Lichen striatus Pityriasis alba
Mycosis fungoides, macule/patch
Intraepidermal Spongiosis PUPPP
Allergic contact dermatitisNummular dermatitisDyshidrotic dermatitis
Id reaction Bullous pemphigoidHerpes gestationisPemphigus vulgaris, urticarial Incontinentia pigmenti
Toxic erythema of newborn Arthropod assault
Intraepidermal with Acantholysis Pemphigus vulgaris
Pemphigus vegetansPemphigus erythematosusPemphigus foliaceusFogo selvagem
Grover’s disease
IntraepidermalSpongiotic Psoriasiform/Lichenoid
Allergic contact dermatitis Nummular dermatitis Dyshidrotic dermatitis Id reaction Seborrheic dermatitis Nonbullous congenital
ichthyosiform erythroderma Lichen striatus
IntraepidermalSpongiotic Psoriasiform/Lichenoid
Lichen striatus Bullous pemphigoid Herpes gestationis, urticarial MF
Subepidermal Vesicular Dermatosis
Subepidermal
Minimal Mixed Lymphocytes
Neutrophils Neuts/Eos Mast Cells
Subepidermal Vesicular Dermatosis Bullous pemphigoid/Herpes
gestationis Cicatricial pemphigoid Dermatitis
herpetiformis/Linear IgA disease
Subepidermal Vesicular Dermatosis EBA Bullous LE Bullous mastocytosis Bullous amyloidosis Drug reactions LP
Special Categories Vasculitis Alopecia Folliculitis/Perifolliculitis Fibrosing dermatitis Panniculitis
Vasculitis Leukocytoclastic
vasculitis Microscopic arteritis Polyarteritis nodosa Erythema induratum
Alopecia
Non-Inflammatory Inflammatory
Follicle density normal Follicle density decreased Lymphocytes Mixed
AlopeciaNon-Inflammatory
Follicle density normal Androgenic alopecia
Telogen effluviumTrichotillomania
Follicle density decreased Traction alopecia
AlopeciaInflammatory
Alopecia areataLichen planopilaris DLEScleroderma
Folliculitis decalvansTinea capitisMajocchi's granuloma Burns/Radiation
Syphilis Scar
LPPSclerodermaDLE
Folliculitis/Perifolliculitis Infectious (Staph, Strep,
DermatophytosisEndothrix/Ectothrix)
Acne vulgarisAcne rosaceaPerforating disorders
Folliculitis/Perifolliculitis Infundibulofolliculitis
Alopecia mucinosa Perifolliculitis
ScurvyLichen planopilarisDLERosaceaKeratosis pilaris
Fibrosing DermatitisFibrosing Dermatitis
Fibrocytes Increased Fibrocytes Decreased
SclerosisRadiation
ScarScleroderma/Morphea
Antecedents to Fibrosis
UlcerGranulation tissue
Granulomas
Fibrosing Dermatitis Scar Chronic lymphedema Keloid Dermatofibroma Anetoderma Acrodermatitis
chronica atrophicans LSEA/Morphea Radiation sclerosis
Panniculitis Erythema nodosum
Erythema induratum Lupus panniculitis
InfectiousPancreatic fat necrosisLympohmaSubQ fat necrosisPoststeroid panniculitis