Dermal Inflammation


Fig. 11.1 Sweet syndrome. A,B, Courtesy, Yale Dermatology Residents’ Slide Collection.






Histopathology:


Dense dermal infiltrate of neutrophils, sometimes with papillary dermal edema (Fig. 11.1C)



Pyoderma Gangrenosum (Fig. 11.2)


Any site, but commonly on the legs


image

Fig. 11.2 Pyoderma gangrenosum. A,B, Courtesy, Yale Dermatology Residents’ Slide Collection.

Early lesion is an inflamed pustule (see Fig. 7.14)


Well-developed lesions often ulcerated with a violet–gray undermined border






Histopathology:


Inflamed lesions have a dense dermal infiltrate of neutrophils



Erythema Elevatum Diutinum, Acute Stage (Fig. 11.3)


Symmetric, often acral (extensor surfaces of elbows/hands), red–violet to pink–brown papules and plaques


image

Fig. 11.3 Erythema elevatum diutinum. A, Courtesy, Kenneth Greer, MD. A, From Bolognia JL, Jorizzo JL, Schaffer JV. Dermatology, 3e. London: Saunders, 2012, with permission.





Histopathology:


Infiltrate of neutrophils with vascular damage


Late stage becomes clinically indurated and histologically fibrotic (see Fig. 22.16)



Cellulitis (Fig. 11.4)


Any site, but commonly affects the lower legs


image

Fig. 11.4 Cellulitis (group A streptococci). A, Courtesy, Yale Dermatology Residents’ Slide Collection. A, From Bolognia JL, Jorizzo JL, Schaffer JV. Dermatology, 3e. London: Saunders, 2012, with permission. B, From Guarner J. Skin and soft tissue infections. In: Procop GW, Pritt BS (eds). Pathology of Infectious Diseases. London: Saunders, 2015.

Warm, tender, bright red plaque


Often associated fever and elevated white cell count






Histopathology:


Interstitial infiltrate of neutrophils




Mixed With Neutrophils and Eosinophils or Predominant Eosinophils (Pink–Red)


Wells’ Syndrome (Eosinophilic Cellulitis; Fig. 11.5)


Pink edematous plaques that may resemble cellulitis


image

Fig. 11.5 Wells’ syndrome. A, Courtesy, Yale Dermatology Residents’ Slide Collection.





Histopathology:


Interstitial infiltrate of eosinophils and neutrophils, often with flame figures (collagen encrusted with granular red–purple material)

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Mar 5, 2017 | Posted by in Dermatology | Comments Off on Dermal Inflammation

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