Virtual Microscopy > Skin > Histopathology of Skin Diseases
Case 1
A 54-year-old male with a history of alcohol abuse presented with red, scaly skin lesions on the elbows and knees. Recently he developed more of these, after he started indulging in alcohol again. Now also his frontal hairline is involved. A biopsy from one of the lesions was taken.
Slides: [lesion biopsy] [normal skin]
- [Review the representative section of his skin lesion.] What is the basic pathologic process: is it neoplastic or inflammatory? Which compartments of the skin is involved?
- Are cells invading the epidermis and which cell type do you see? Why do you think the lesions are red and scaly on clinical examination?
- Are all layers of the normal epidermis represented in the section from the diseased skin? If one layer is missing, how do you explain this?
- What is the histological differential diagnosis and how do you differentiate the entities from each other?
Case 2
An 18-year-old female visits her dermatologist complaining of sleepless nights secondary to severe itching. On clinical examination the popliteal fossae and the antecubital areas show a coarse, red skin with excoriation marks. A punch biopsy was performed.
Slides: [punch biopsy] [punch biopsy (additional section)]
- [Review the representative section of the skin lesion.] What is the basic pathologic process: is it neoplastic or inflammatory? Which compartments of the skin is involved?
- How does the epidermis differ from normal skin? Are all skin layers represented in this punch biopsy from the lesion?
- What is the cause of these lesions?
- What is the histological differential diagnosis and how do you differentiate the entities from each other?
Case 3
An 83-year-old former farm worker visits his family practitioner with a slowly growing single lesion on his nose. On clinical examination the lesion has a rolled over border, dilated blood vessels at the periphery and a central invagination. An excisional biopsy was performed.
Slides: [lesion biopsy]
- [Review the representative section of the skin lesion.] What is the basic pathologic process: is it neoplastic or inflammatory? Which compartments of the skin is involved?
- Does the lesion have similarities with normal embryonic structures appearing during normal development? What are the dark appearing "dots" within the islands of blue-staining cells? Why are clefts between the lesion and surrounding stroma?
- In which age groups do those lesions most likely appear?
- What is the histopathological differential diagnosis and how do you differentiate the entities from each other?
Case 4
A 64-year-old woman developed numerous well-circumscribed, dark lesions mostly on her trunk, which can be removed easily with a fingernail exposing a normal, oozing, sometimes bleeding skin surface. She was recently diagnosed with an adenocarcinoma of the stomach. A biopsy of one of the lesions was performed.
Slides: [lesion biopsy]
- [Review the representative section of the skin lesion.] What is the basic pathologic process: is it neoplastic or inflammatory? Which compartments of the skin is involved?
- How does this lesion differ from the one presented in case 3? Why are numerous of these lesions seen in a patient with adenocarcinoma?
- What is the histopathological differential diagnosis and how do you differentiate the entities from each other?
Case 5
A 47-year-old woman visited her dermatologist presenting with a dome-shaped, flesh-colored lesion on her right cheek. A shave biopsy was performed.
Slides: [lesion biopsy]
- [Review the representative section of the skin lesion.] What is the basic pathologic process: is it neoplastic or inflammatory? Which compartments of the skin is involved?
- How do these lesions typically evolve over a lifetime? Can they become malignant?
- What is the histopathological differential diagnosis and how do you differentiate the entities from each other?
Case 6
A 65-year-old male presented with numerous itchy, slightly scaly patchy lesions on his buttocks. He reported that they evolved two years ago. They improve when he is pursuing his nudist activities each year in the Mediterranean during his summer vacations.
Slides: [lesion biopsy]
- [Review the representative section of the skin lesion.] What is the basic pathologic process: is it neoplastic or inflammatory? Which compartments of the skin is involved?
- What diagnostic methods would you use as a pathologist to support the diagnosis made on the hematoxylin and eosin stained sections?
- What are the main features, which differentiate this case from case 2?
- What is the histopathologic differential diagnosis and how do you differentiate the entities from each other?
