Interface dermatitis altmeyers encyclopedia department. Curtis thompson centrifuging nail specimen debris increases sensitivity of fungus detection dr. Interface dermatitis interface with subepidermal blistering where the snc. Anatomic pathology, or histopathology, refers to the study of the structural and compositional changes that occur in organs and tissues as a result of disease. Histopathology was characterized by an interface dermatitis, focal hydropic degeneration of basal epidermal cells leading to a cleft formation and ulceration, apoptotic keratinocytes, focal thickening of the basement membrane, and a bandlike infiltration of the dermis with lymphocytes and plasma cells. Indian journal of dermatology, venereology and leprology. Dr shashikala krishnamurthy,hod pathology spoke on interface dermatitis.
Histopathology lichenoid dermatitis with superficial and deep perivascular and periadnexal infiltrate lymphocytes variable epidermal changes wednesday, may 22. Interface dermatitis increased elastic fibers within the papillary. Interface dermatitides can be further classified into lichenoid or vacuolar based upon the density and pattern of the associated superficial dermal inflammatory infiltrate. Interface drug reaction c vacuolar interface drug reaction erythema multiforme, stevens johnson syndrome, toxic epidermal necrolysis chemotherapyinduced interface dermatitis fixed drug eruption exanthematous morbilliform drug reaction lupuserythematosuslike drug reaction c lichenoid interface drug reaction. Histopathology lichenoid interface dermatitis spd hemorrhage. Lichenoid tissue reaction or interface dermatitis embrace several clinical conditions, the prototype of which is lichen planus and its variants, drug induced lichenoid dermatitis, special forms of. Ii vacuolar or hydropic change due to basal cell degeneration.
Dermatomyositis dm is conventionally characterized by interface dermatitis id on skin histopathology. A clinicopathological study of interface dermatitis hegde vk. A recent article showed that, as well as areas of cellrich interface dermatitis, loss of sebaceous glands is. The histological assessment of cutaneous vasculitis carlson. Histopathology interface dermatitis with epidermal necrosis, normal stratum corneum interface dermatitis with epidermal necrosis,y suprabasilar acantholysis,y parakeratosis, and dysmaturation wellestablished serologyz pp 1, rat bladder iif, a2ml1,ep, dsg1, and dsg3 pp 1, rat bladder iif, a2ml1,ep1, dsg11, and dsg31. The term interface dermatitis designates a lymphocytic inflammatory response at the dermoepidermal junction with subsequent apoptosis of keratinocytes.
Guidelines of care for the management of atopic dermatitis. Patch testing and histopathology in thai patients with. Media in category histopathology of vacuolar interface dermatitis the following 4 files are in this category, out of 4 total. In addition to above, an unspecific spongiotic dermatitis can be consistent with nummular dermatitis, dyshidrotic dermatitis, id reaction, dermatophytosis, miliaria, gianotticrosti syndrome and pityriasis rosea. The interface dermatitis is characterized by an epitheliotropic, lymphocytic infiltrate which leads to chronic, vacuolar damage of the basal keratinocytes and melanocytes at the epidermis, with signs of apoptosis and its histomorphologically detectable. Superficialdeep follicular involvement inflammatory cell type lichenoid dermatitis. Interface dermatitis can be broadly grouped into two subgroups based on the pattern of the inflammatory infiltrate. This feature is essential to make a diagnosis of an interface dermatitis. All cutaneous agvhd biopsies n6 displayed id manifested by basal vacuolation with shrunken, apoptotic, keratinocytes, cytoid bodies, and pronounced hypergranulosis, a differential diagnostic hallmark of agvhd fig. Lichenoid contact dermatitis is a rare form of noneczematous contact dermatitis with clinical features resembling lichen planus involving potentially skin andor mucosal membranes. Interface dermatitis can also be classified by the intensity of the interface inflammation.
A subset of patients with clinically diagnosed dm have skin biopsies showing spongiotic dermatitis sd, a histopathology more commonly seen in eczema. Clinicohistopathological correlation for diagnosis of lichenoid. To get clinico pathological correlation in lichenoid interface dermatitis which will help in accurate diagnosis by analyzing history, clinical examination as well as. Laboratory studies show elevated aminotransferase values, hypergammaglobulinemia. The following features are characteristic of interface dermatitis. Review my approach to superficial inflammatory dermatoses. Interface dermatitis refers to disruption of the dermalepidermal junction with basal layer vacuolization and associated necrotic keratinocytes. It includes the basal layer of the epidermis, the dermoepidermal junction, the papillary dermis, and the adventitial dermis around the adnexal structures. Increased elastic fibers within the papillary dermisdermis dermal sclerosis. Each category has distinctive morphological features, and is caused by various clinical conditions table 2. Paraneoplastic pemphigus mimicking toxic epidermal necrolysis. Hand, foot, and mouth disease hfmd is a common, selflimited viral exanthem characterized classically by mild fever, small vesicleserosions of the oral mucosa, and painful oval, gray vesicles involving the palms, soles, buttocks, and genitalia of young children. Lupus erythematosus le is an autoimmune connective tissue disease whose precise aetiological basis is at present uncertain, in which the clinical presentations range from a skin rash unaccompanied by extracutaneous stigmata to one comprising progressive multisystem disease. Sontheimer1 a number of uncommon, clinically diverse and poorly understood inflammatory skin diseases are linked by the presence of a set of histopathological elements that have traditionally been referred to as the.
Lichen planus lp is a chronic inflammatory and immunemediated disease that affects the skin, nails, hair, and mucous membranes. Recognition, classification, etiology, and clinicopathological overtones. Oct, 2016 clinical history, histopathology and dif are necessary together for making the diagnosis. The salient histological findings include basal cell vacuolization, apoptotic keratinocytes colloid or civatte bodies, and obscuring of the dermoepidermal junction by inflammatory cells. The data on the histology of cutaneous lesions of drug reaction with eosinophilia and systemic symptoms dress is limited. Interface dermatitis includes numerous skin diseases. Drug reaction with eosinophilia and systemic symptoms, histology, interface dermatitis introduction several years after its original description by chaiken et al. Historically, interface dermatitis has been classified based in part upon the cell type that dominates the infiltrate ie, neutrophilic, lymphocytic, or lymphohistiocytic. Lichenoid contact dermatitis has been reported with color developers, such as paraphenylenediamine and its derivatives, nickel, epoxy resins, aminoglycoside. Interface dermatitis clinicopathologic spectrum achr print issn no.
My approach to superficial inflammatory dermatoses. They typically have a dark, condensed nucleic chromatin pyknosis. Jessica spies interpretation of pathology reports in biopsies for dermatitis dr. Spongiotic eczematous dermatitis catherine barry, d.
A pathologist is a doctor trained in anatomic pathology that examines, describes and interprets pathological specimens to. Dec 23, 2009 extravascular histologies can provide a clue to diagnosis of ctd vasculitis, such as the presence of interface dermatitis e. Sle and dermatomyositis, dermal andor subcutaneous sclerosis in scleroderma, palisaded neutrophilic and granulomatosis dermatitis in rv or lv, and tissue neutrophilia neutrophilic urticaria in sle and sjogrens. Jul 01, 2016 there are various disorders with interface changes like early cutaneous t cell lymphoma mycosis fungoides, vacuolar interface dermatoses etc. Vacuolar interface dermatitis dermatopathology mussen. Adult blaschkitis is a rare, relapsing inflammatory dermatitis that most often presents in middle age. Specific hsv1, hsv2, and vzv in situ hybridization proved the viral origin of the cutaneous lesions. Jan 31, 2017 the term interface dermatitis designates a lymphocytic inflammatory response at the dermoepidermal junction with subsequent apoptosis of keratinocytes. Lichenoid dermatitis is a form of neurodermatitis, characterized by intense pruritus with exudative, weeping patches on the skin scattered irregularly over most of the body, many of which are of the eczematous type and undergo. Interface dermatitis term is used when at low power there is a lichenoid tissue reaction seen showing band of dense inflammatory infiltrates. Taylor, md from the department contact dermatitis is immune mediated allergic and photoaller of dermatology, uni gic contact dermatitis or nonimmune mediated irritant photo versity of arkansas toxic contact dermatitis.
Diagnosis of dm is challenging, with significant delays following initial presentation. Increased mxa protein expression and dendritic cells in. Download file international journal of scientific study. Interface dermatitis, histopathology, haematoxylin and eosin. Similar for erythema multiforme minor and major vacuolar alteration of the basal keratinocytes, which may progress to frank subepidermal vesiculation figs. They can also be classified based on the histology as vacuolar interface. A case of eczema coxsackium with erythema multiformelike. The histopathology is a cellpoor interface dermatitis mild lymphocytic exocytosis, apoptosis of keratinocytes in the basal cell layer and to a lesser extent in the stratum spinosum. Histopathology of drug eruptions general criteria, common.
Interface dermatitis with vacuolar interface lesions. Lichenoid tissue reaction, also known as interface dermatitis includes conditions in which the primary pathology involves the interface, that is the dermoepidermal junction. Interface dermatitis along blaschkos lines linear dermatoses are fascinating entities that likely reflect embryologically derived cutaneous mosaicism, even when they occur after childhood. Recent advances in our understanding of the pathophysiological basis of le bring hope for novel therapeutic approaches. Spongiotic dermatitis spongiotic dermatitis is defined by the presence of epithelial intercellular oedema. Characteristic histological pattern of diffuse superficial dermatitis detectable in etiopathogenetically different inflammatory dermatoses. Patch testing should be conducted in all cases that present with ad or lpp. Interface dermatitis includes diseases in which the primary pathology involves the dermoepidermal junction. Clinicopathologic correlation and determination of histomorphologic changes associated with various lichenoid ifd of the skin. The salient histological findings include basal cell.
Histopathological study of interface dermatitis with its clinical. Clinicohistopathological correlation for diagnosis of. The term interface dermatitis refers to the finding in a skin biopsy of an inflammatory infiltrate that abuts or obscures the dermoepidermal junction. I mild or dense inflammatory infiltrate composed of mainly mononuclear cells. Interface dermatitis ifdlichenoid tissue reactions are among the most frequently presenting disorders in dermatology, which in common have a constellation of histopathological features but varied clinical presentation. It is not an actual lichen, and is only named that because it looks like one.
An epidermotypic model of interface dermatitis reveals. Clinicohistopathologic study of lichenoid interface dermatitis. My approach to superficial inflammatory dermatoses journal. Interface lichenoid inflammation between epidermisdermis v. Histopathological spectrum of interface dermatitis and its. Table 4 gender distribution of cases diagnosed as interface dermatitis on histopathology types of interface dermatitis male female no of cases detected frequency lichen planus and variants fig no 1,2,3,4 20 38 58 67. These include allergiccontact dermatitis, atopic dermatitis,33 nummular.
A pathologist is a doctor trained in anatomic pathology that examines, describes and interprets pathological specimens to arrive at a specific finding or diagnosis. Coxsackievirus a16 cva16 and enterovirus 71 are the most frequently implicated pathogens. Brehmeranderson, 2006 which need to be differentiated from lichenoid interface dermatoses in which histopathology is a valuable asset. Pdf diagnosis of interface dermatitis still remains a challenge in. Vulvar inflammatory dermatoses for the nondermatopathologist. Cutaneous histopathology of lupus erythematosus diagnostic. This leads to vacuolization of the basement membrane zone, which, in its most severe form, may result in cleft formation. Panniculitis inflammation of dermis mainly lobules vs.
Interface dermatitisclinicopathologic spectrum ip arch. A recent article showed that, as well as areas of cellrich interface dermatitis, loss of sebaceous glands is a typical. This study examines the utility of objective histopathological studies in the evaluation of adult patients with erythroderma. The histopathology is unspecific in approximately 35%40% of the cases, and direct immunofluorescence is needed, showing deposition of iga in the papillary dermis in a granular or fibrillar pattern. Aih is characterized by prominent interface hepatitis and varying degrees of lobular hepatitis. It is characterized by polygonal, flattopped, violaceous papules and plaques with overlying, reticulated, fine white scale wickhams striae, commonly affecting dorsal hands, flexural. Interface dermatitis, lichenoid tissue reaction, and expression of fasl and ifn. Lichenoid tissue reaction ltr or interface dermatitis ifd is some of the commonly encountered clinical and histological presentations in dermatology and pathology. The term interface dermatitis refers to the finding in a skin biopsy of an inflammatory infiltrate that abuts or obscures the dermoepidermal junction dej. Lichenoid dermatitis is a histological term that refers to a combination of histological findings that is close to those of lichen planus 1. Curtis thompson centrifuging nail specimen debris increases sensitivity of fungus detection. Jul 01, 2011 interface dermatitis with vacuolar alteration at dermal epidermal junction.
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