Sunday, May 08, 2005

Dermatopathology II

DiseasePathogenesisPathologyClinical Features/ Treatment
Erythema nodosumtrigger: drugs, microorganisms, systemic diseases
drugs: sulfonamides

fibrous septa of subcutaneous tissue - neutrophil inflammation, extravasation of erythrocytes
chronic - septa widened, giant cell macrophages, altered collagen

dome-shaped, tender, nodules on extensor surface of legs
3rd decade, 3xF:M
Erythema induratumMycobacterium tuberculosis

initially lobular panniculitis, vasculitis - ischemic necrosis of fat lobules
dense, chronic inflammatory infiltrate in fat lobules
extensive ischemic necrosis - ulceration of overlying epidermis

chronic, recurrent, subcutaneous plaques or nodules on legs, women

T - systemic steroids

Sclerodermapathcy lymphocytic infiltrate, loss of peri-eccrine fat, plugging of sweat glands, obliteration of hair follicles, subcutaneous fat turns into collagen

fibrosis and tightening of skin
mask face
4xF:M, 30-50y
non-pitting edema of hands or fingers

Granulomatous dermatitislocalized collection of epitheliod macrophages around insoluble antigen
Allergic Contact dermatitis

sensitization - haptens: oleoresins, Langerhans Cells - CD4+ T cells
Elicitation - activated T cells, IFN-gamma - Fas ligand on keritanocytes - apoptosis

spongiotic dermatitis - edema in epidermis
spongiotic vasculitis - vacuoles filled with lymphocytes and macrophages
immune rxn to poison ivy, poison oak, poison sumac

Source: Rubin's Pathology 4th Edition

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