Dr Richard Carr

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Multiple levels examined Serum extravasate within mounds of parakeratosis A small collection of subcorneal neutrophils Mild to moderate acanthosis Mild patchy spongiosis Exocytosis of lymphocytes Mild superficial perivascular lymphocytic infiltrate Occasional eosinophils Confusing overlap features Cannot definitely exclude psoriasis BUT most of the features fit best with a spongiotic dermatitis and the presence of eosinophils would raise the possibility of a drug reaction Suggest discussion at MDT! RAC3257
Follow-Up • Joint dermatology review favoured autoeczematisation (id reaction) to stasis dermatitis / eczema • BUT…... – Patch testing positive for chromium, cobalt and nickel – He works with metals as a grinder and assembler Final Diagnosis CONTACT DERMATITIS
Page 1 and 2:
Histological Approach to the Diagno
Page 3 and 4:
•Definitions •General Approach
Page 5 and 6:
Definititions: Psoriasiform Epiderm
Page 7 and 8:
Akerman: Algorithmic Approach • I
Page 9 and 10:
Diagnostic Approach to Inflammatory
Page 11 and 12:
Diagnostic Approach to Inflammatory
Page 13 and 14:
LEARNING POINTS Dermatologists rare
Page 21 and 22: Lever • Mutli-author has it’s d
Page 23 and 24: Mckee & Calonje 4 th 2012 • Clini
Page 27 and 28: Excoriation only...
Page 29 and 30: Lichenification (Lichen Simplex Chr
Page 31 and 32: Lichen Simplex Chronicus • Locali
Page 33 and 34: Nodular Prurigo / Pseudoepithelioma
Page 35: F86 Left ankle lesion. Biopsy prove
Page 40 and 41: Diagnosis Polypoid eccrine poroma w
Page 42 and 43: Spongiotic Dermatoses 42
Page 44 and 45: Eczematous (Spongiotic) Dermatitis
Page 46 and 47: Eczematous (Spongiotic) Dermatitis:
Page 48 and 49: Subacute/Chronic Spongiotic Psorias
Page 50 and 51: M85. Raised annular patch with cent
Page 52 and 53: Discoid (Nummular) Dermatitis • S
Page 54 and 55: Acute spongiotic vesicular dermatos
Page 56 and 57: Autosensitization (Id) Reaction •
Page 58 and 59: Learning Points • Dermatologist u
Page 60 and 61: Mounds of parakeratosis (with neutr
Page 62 and 63: Seborrhoeic Dermatitis 2 • Sharpl
Page 64 and 65: M63. Two year hx itchy rash. Improv
Page 66 and 67: RAC3257
Page 70 and 71: Contact Dermatitis Suggested by his
Page 72 and 73: Other Conditions with • Pityriasi
Page 74 and 75: Layered parakeratosis with neutroph
Page 76 and 77: Diagnosis Dermatophytosis PAS
Page 78 and 79: Spongiotic: Variants 1. Eosinophili
Page 80 and 81: F80. Urticated blistering eruption,
Page 82 and 83: Neutrophilic Spongiosis • Irritan
Page 84 and 85: • PROBLEM • Psoriasis (Reiter
Page 86 and 87: Layered parakeratosis Increased & m
Page 88 and 89: F57. Trunk. Generalised pustular ra
Page 90 and 91: Generalised (eruptive / pustular)
Page 92 and 93: F61. Hip. Small areas of itchy red
Page 94 and 95: Not suggestive or eczematous or DH
Page 96 and 97: Psoriasis Early • Parakeratotic m
Page 98 and 99: Layered parakeratosis Absent granul
Page 100 and 101: Psoriasis v’s Eczematous Acral /
Page 102 and 103: RAC2963
Page 104 and 105: Diagnosis Chronic hyperplastic muco
Page 106 and 107: Psoriasis: Differential Diagnosis
Page 108 and 109: Focal parakeratosis Intact granular
Page 110 and 111: Pityriasis Rubra Pilaris • Burnin
Page 112 and 113: PRP: Follicular Papules • Conical
Page 114 and 115: M65. Ankle. Chronic liver disease.
Page 116 and 117: “Marked hyper- and parakeratosis
Page 118 and 119:
Acrodermatitis Enteropathica (Zinc
Page 120 and 121:
Necrolytic Migratory Erythema Rev.
Page 122 and 123:
Thank-You • Dr Phillip Mckee •
Page 124 and 125:
• PAS for fungi Special Stains
Page 126 and 127:
Immunos • Pan-keratin for macular
Page 128:
Tips • Artefacts may dominate app
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Dr Richard Carr

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