Image of the Month:

The Society has switched to a digital slide format for Image of the Month. A link to the whole slide scan is sent to all members at the beginning of the month. Please consider joining the Society to enjoy this activity and other benefits of membership. Click here to learn more.

 

December 2017

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A 50-year female presented with an asymptomatic erythematous indurated plaque measuring 2 x1 cm on the chin since 1 year. What is your diagnosis?

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Case contributed by Dr V Ramesh

Chromoblastomycosis

There is pseudoepitheliomatous hyperplasia in the epidermis. The dermis shows granulomas, mostly tuberculoid and few suppurative with presence of thick- walled, round, golden-brown fungal cells (sclerotic bodies / muriform cells / Medlar bodies / copper penny bodies) singly and in clusters within giant cells and lying free.Fungi divide by septation rather than budding.
Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissues, usually affecting the limbs at the inoculation site. Causative agents include pigmented fungi found in soil, wood and decaying plant material such as Fonsecaea pedrosi, Phialophora verrucosa, Fonsecaea compacta, Cladophialophora carrionii, Rhinocladiella aquaspersa. Incidence of chromoblastomycosis is greatest in tropical and subtropical regions. Barefooted farmers account for almost 75% of patients with this disease. Commonest clinical presentation is a slowly progressive verrucous plaque over the extremities. Satellite lesions may be present. Rarely, squamous cell carcinoma develops within longstanding cases.

November 2017

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A 52 year male presented with an asymptomatic skin-colored nodule on the right cheek for 8 years. What is your diagnosis?

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Case contributed by Dr Geeti Khullar

Chondroid syringoma

A well circumscribed, lobulated mass centered in deep dermis or subcutaneous fat, with a prominent chondroid or myxoid stroma enveloping benign bland appearing epithelial and myoepithelial cells that form secondary structures which include glands and ducts, cysts, reticular lace-like network, keratinous cysts and foci of squamous differentiation. Other cells present include plasmacytoid, low cuboidal, spindle, clear cell, cells with follicular, pilomatrical differentiation and mature adipocytes. Though typically chondromyxoid, the background may be focally hyaline. Calcification / ossification may occur. Mitoses are sparse, necrosis is absent.
Chondroid syringoma is a benign tumor of the sweat glands with a myxoid stroma showing cartilaginous metaplasia. Morphologically it is identical to pleomorphic adenoma / benign mixed tumor of the salivary gland. It is most often seen in middle aged men, commonly on the nose, followed by cheek and upper lip.

 

October 2017

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A 56 year old male presented with a whitish plaque in right buccal mucosa. What is your diagnosis?

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Case contributed by Dr Mithilesh Chandra

Chronic hyperplastic candidiasis

Acanthosis, parakeratosis, neutrophilic infiltration in the upper layers and numerous fungal buds and pseudohyphae which can be distinctly seen without PAS stain also and mild dysplastic changes in the lower layers of epithelium.
Chronic hyperplastic candidiasis is a chronic inflammatory condition of oral mucosa caused generally by Candida albicans. Clinically it presents as a homogenous white lesion or a speckled or nodular lesion. Microscopically it is characterized by acanthosis, parakeratosis of epithelium and neutrophilic infiltration of parakeratotic layer, which is considered a diagnostic feature. Many cases show dysplastic changes of the epithelium if left untreated for long. Rare cases with dysplasia can progress to malignancy. Hyphae present perpendicular to the epithelium are demonstrated better with the help of PAS stain. Submucosa shows variable intensity of chronic inflammation.

 

September 2017

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A 17-year old female presented with 1 year history of recurrent fever accompanied with asymptomatic erythematous rash over trunk and limbs and arthritis of ankle and wrist joints. RA factor and ANA are negative. What is your diagnosis?

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Case contributed by Dr Geeti Khullar

Adult onset Still's disease

There are multiple necrotic keratinocytes lying singly and in aggregates mainly in the upper layers of the epidermis, including the stratum corneum. The upper dermis shows perivascular and interstitial neutrophil-rich inflammatory infiltrate.
Adult onset Still's disease (AOSD) is a rare systemic autoinflammatory disorder, characterised by quotidian or double‐quotidian spiking fever with an evanescent rash, arthritis, and multiorgan involvement. Skin findings accompany the disease in nearly 90% of the cases. The typical rash is an evanescent, salmon‐pink, maculopapular eruption, predominantly found on the proximal limbs and trunk, with rare involvement of the face and distal limbs. A more persistent rash that tends to be photodistributed, hyperpigmented, often in a linear configuration, sometimes in a rippled pattern is referred to as the atypical eruption of AOSD. Consistent laboratory abnormalities include leukocytosis with neutrophilia and hyperferritinemia. Yamaguchi's criteria have been shown to be the most sensitive for diagnosis.
Erythema marginatum associated with rheumatic fever is a type of annular erythema, which is an important histological differential. It shows dyskeratotic keratinocytes all over the epidermis and presence of neutrophils and nuclear dust in the dermal papillae.

 

August 2017

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Image 1 on left: A 45 year old female presented with multiple papulonodular skin coloured lesions on face varying in size from 0.3-1cm for last 10 months. What is your diagnosis?

Image 2 on right: A 40-year old male presented with a single nodule on the scalp for 2 years. What is your diagnosis?

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Image 1: Case contributed by Dr. Mithilesh Chandra

Granuloma faciale

Dense cellular infiltrate, often with a nodular outline, occupies the mid dermis. Deep dermis and subcutaneous fat may be involved. Typically spares the immediate subepidermis and hair follicles, forming a Grenz zone. Infiltrate is polymorphic, containing eosinophils, neutrophils and an admixture of plasma cells, mast cells and lymphocytes. Red cell extravasation is often present. Blood vessels appear dilated and their walls are infiltrated by eosinophils and fibrin deposition. Older lesions may show fibrosis and hemosiderin deposition. In late stage, histology resembles erythema elevatum diutinum.

Image 2: Case contributed by Dr. Shipra Agarwal

Cylindroma
Poorly circumscribed dermal tumor composed of irregularly shaped islands and cords of basaloid cells surrounded by conspicuous eosinophilic hyaline bands which are PAS positive and diastase resistant. Droplets of similar hyaline material may be present in the cell nests. Most of the tumor islands have two cell types: a peripheral cell with a dark-staining nucleus and a tendency for palisading, and a larger cell with a vesicular nucleus more centrally located. Small duct-like structures are sometimes present. The stroma is composed of loosely arranged collagen. Areas resembling spiradenoma will sometimes be present, and there may also be tumor lobules with overlap features between these two entities.

 

July 2017

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A 22 year old male presented with swelling of the face for past 4 years. What is your diagnosis?

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Subcutaneous phycomycosis. Culture grew Conidiobolus

The epidermis displays follicular plugging and irregular acanthosis. The superficial and mid dermis shows moderate interstitial infiltrates of lymphocytes, plasma cells, eosinophils, histiocytes and few neutrophils and multiple granulomata composed of aggregates of epithelioid histiocytes, lymphocytes with a few multinucleated type giant cells. Also seen deeper in the deep dermis and subcutis are many broad thin walled aseptate fungal hyphae surrounded by smudgy acellular eosinophilic material (Splendore Hoepli phenomenon). There are extensive areas of hyalinisation.
Differential diagnoses: Well's disease and Basidiobolomycosis.
In Well's disease the clear spaces on H&E can resemble the flame figures of eosinophilic cellulitis but are negative on PAS and GMS stains.
Basidiobolomycosis is also an entomophthoromycosis like conidiobolomycosis but is seen predominantly on the skin and subcutaneous tissue and GIT. Conidiobolomycosis is seen in the head and neck region predominantly in the skin of face and sinuses. All entomophthorales look similar on H&E but are different on culture. Entomophorales is seen in immunocompetant individuals unlike zygomycetes which is seen in immunocompromised individuals.

 

June 2017

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A 17-year-old girl reported with alopecia of the scalp over the parietal area of 6 months duration. An area almost 4 cm in diameter was seen with some black dots and sparse hair. What is your diagnosis?

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Case contributed by Dr. V Ramesh

Tinea capitis (endothrix)

Hyphae invade the hair shafts. Rounded and boxlike arthrospores are found mainly within the hair shaft in endothrix infections (when they surround the hair shaft like a sheath it signifies ectothrix infection). Endothrix infections are usually caused by T. tonsurans or violaceum. Although hyphae invade the shaft in both types of infection, they may not be evident in hairs plucked from an endothrix infection because the more superficial hyphae rapidly break up into arthrospores and destroy the keratin of the hair shaft. When plucked, the weakened shaft typically breaks at a relatively superficial point so that only the arthrospores are seen. At times the dermis may show chronic inflammation or giant cells around degenerated hair shafts (not seen in this histopathologic picture).

 

May 2017

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A 35 year old male presented with swelling and itching of the tattoo mark on the forearm for 3 months. What is your diagnosis?

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Case contributed by Dr. Mithilesh Chandra

Lichenoid tattoo reaction

As tattooing practices increase, delayed-type inflammatory reactions represent an uncommon adverse event to tattoo pigments. Different reaction patterns, such as eczematous, lichenoid, granulomatous and pseudolymphomatous reactions, have been reported, especially in association with metals contained in red tattoo pigments. The lichenoid tissue reaction to red organic tattoo pigment shows the prototypical features of a cytotoxic inflammatory response to foreign substances (xenobiotics). The lichenoid papular reaction to an organic red tattoo ink, is characterized by an intense mononuclear infiltrate dominated by CD8(+) T cells and CD56(+) lymphocytes and is distributed in the superficial dermis around the red pigment and in the epidermis.

 

April 2017

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A 72 year old female presented with a nodular lesion 4x4mm in size on her lower lip for 4 years. What is your diagnosis?

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Case contributed by Dr. V Ramesh

Venous lake

The section shows a slightly stretched normal epidermis. The upper dermis shows a large dilated vascular channel with a fibrous wall. The smaller one is lined by flat endothelial cells. A recanalising thrombus is seen to partially occlude the large vessel. The findings suggest a dilated venular segment.
Venous lakes are vascular anomalies of the nature of ectasias. The lesions are dark blue and occur over the facial areas and neck of elderly persons. In this patient it was seen in the lower lip of a young adult. These lesions bleed on trauma and are frequently mistaken for pyogenic granuloma.

 

March 2017

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A 51 year old female presented with grouped papules on the dorsum of both hands. What is your diagnosis?

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Granuloma annulare

Three histological patterns are seen- interstitial (most common), necrobiotic and sarcoidal or tuberculoid. In the necrobiotic form, areas of necrobiosis or altered collagen are surrounded by histiocytes and lymphocytes in superficial and mid-dermis. The rim of histiocytes forms a palisade. Multinucleate giant cells are also present. The necrobiotic area contains mucin, which is seen as basophilic stringy material between the collagen bundles.
Granuloma annulare is a necrobiotic disorder that presents as skin colored to erythematous grouped papules that coalesce to form annular and arciform plaques. The clinical variants include localized, generalized, perforating and subcutaneous forms. The hands, feet, arms and legs are the sites of predilection.

 

February 2017

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A 45 year old female presented with papular lesions all over the body for past 8 months. What is your diagnosis?

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Case contributed by Dr. Mithilesh Chandra

Verruca plana

Focal epidermal hyperplasia with hyperkeratosis, parakeratosis and may have trichilemmal keratinisation. Koilocytes are present in upper spinous layer. These cells are keratinocytes and appear as polyhedral or rounded cells with cytoplasmic vacuole, large cytoplasmic eosinophilic aggregates and pyknotic nuclei. Older lesions may lack cytoplasmic changes. Viral nuclear inclusions are basophilic. Involuting lesions may have chronic inflammatory infiltrates in dermis and epidermis with degenerative epithelial changes. Diagnosis can be confirmed by in situ hybridization for HPV.
Verruca plana is also called flat wart and is usually due to HPV10. Clinically it presents as flat, skin coloured papules which occur in crops / clusters on face and hands. Lesions usually resolve in 6-24 months

 

January 2017

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A 22 year old lady presented with a hyperpigmented non-tender papulonodular lesion measuring 0.5-1 cm in the suprapubic region since 4 months. What is your diagnosis?

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Reticulohistiocytoma

The epidermis is unremarkable. The dermis shows diffuse infiltration with large mononucleated and multinucleated histiocytes, some of which show clear vacuolated cytoplasm and others show moderate to abundant eosinophilic cytoplasm (oncocytic). Amidst these, there are many mature lymphocytes. The periphery of the lesion is well demarcated and shows fibroblastic proliferation. On immunohistochemistry these cells are positive for CD 68 and they are negative for CD 117 and CD1 a.

 

December 2016

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A 23 year old man presented with pigmented macules in a reticulate pattern on the flexural skin from birth. What is your diagnosis?

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Case contributed by Dr Sudheer Arava

Follicular Dowling-Degos disease

Biopsy showed prominent thin finger like elongation of the rete ridges with increased basal cell pigmentation. There is thinning of the suprapapillary plate. Centre of the lesion shows a dilated hair follicle with similar findings. Dermis is unremarkable. There is no increase in the melanocytes.

 

November 2016

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Case contributed by Dr. Subhra Dhar

Paget's disease of breast

Infiltration of epidermis by the characteristic Paget's cells which are malignant glandular epithelial cells with enlarged hyperchromatic nuclei often having a discernible nucleoli. The cytoplasm is pale to clear and may even contain mucin. The cells do not form intercellular bridges with the adjacent prickle cells. Paget's cells are often located in the basal region of the epidermis where they may lie either as single cells or as clusters of cells forming gland like structures or nests. Because of shrinkage artefact, cells may appear to lie within intraepidermal lacunae. The underlying dermis shows variable telangiectasia and inflammation. An underlying invasive /in- situ ductal carcinoma is found in >90% of patients of Paget's disease.
Paget's disease of breast is often mistaken for benign skin conditions clinically as symptoms are like those of eczema. The lesions are scaly, crusty and associated with redness, itching and tingling sensation.

 

October 2016

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Case contributed by Dr Meenakshi Batrani & Dr Asha Kubba

Infantile digital fibromatosis (inclusion body fibromatosis), also known as Reye’s tumour.

Non-encapsulated dermal tumour composed of interlacing fascicles of myofibroblastic spindle cells and dense collagenous stroma. The hallmark finding is round or ovoid, eosinophilic, 3- to 10µm intra-cytoplasmic paranuclear inclusion bodies which stain red with the Masson trichrome stain (shown here) and purple with phosphotungstic acid-hematoxylin. On IHC cells are positive for SMA (shown here), Calponin and Desmin.
It is a relatively rare disease with approximate prevalence of 2.5%. It is a benign, spontaneously regressing, fibrous tissue tumour of infancy and childhood that commonly appears in the first year of life and may be present at birth in one-third of cases. It has a tendency to local recurrence without bony invasion or metastasis. Single or multiple, firm reddish-pink slowly growing nodules, about 2 cm in size are present on the extensor aspects of the phalanges of the last four fingers or toes, sparing the thumb and great toe. Lesions are characteristically asymptomatic; if large, they may result in limited joint mobility and functional deformity of the digit.

 

 

September 2016

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Case contributed by Dr Inchara YK

Nodular hidradenoma

Section shows skin with a well-circumscribed, dermal based solid-cystic neoplasm which is vertically oriented. The neoplasm is composed of round to polygonal cells arranged in nests, sheets, papillae and tubules. These cells have a central, round nuclei and abundant clear to eosinophilic cytoplasm. Some cells have a plasmacytoid morphology. Intervening areas of hyalinisation noted. Foci of cystic change and haemorrhage are seen. There is no evidence of nuclear atypia/ mitosis / necrosis.
Hidradenoma is a rare, benign adnexal neoplasm presenting as an asymptomatic solitary papule or nodule. They have no predeliction for site/ age or sex. Contrary to earlier belief, these are mostly apocrine in nature. Architecturally, the neoplasm may be exo/endophytic, solid/cystic often with connection to the infundibula. Solid areas comprise of round to polygonal cells with tubules lined by double row of epithelial cells. Cystic areas show eosinophilic secretions. Cytologically, spectrum of differentiation of the epithelial cells may be noted such as clear cell, squamoid, mucinous, plasmacytoid and sebaceous. Differential diagnosis: Metastatic renal cell carcinoma to the skin also has clear cells, but the striking vascularity and absence of infundibular connection helps to differentiate.

 

 

August 2016

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Case contributed by Dr Gayatri R & Dr Inchara YK

Histoid leprosy

The epidermis is atrophic. A subepidermal clear zone is seen. The dermis shows a diffuse infiltrate composed of plump, spindle shaped cells arranged in storiform pattern admixed with foamy histiocytes and lymphocytes. No nerves are identified. The Fite stain showed numerous acid fast bacilli. These can be recognised even in the H&E stained section as negative images with a bluish hue within the histiocytes.
Histoid leprosy, a spindle cell lesion, is a close mimic of dermatofibroma. It was describe by Wade in 1963. It commonly involves extremities, back, buttocks and face. It is seen in patients who do not respond to MDT, treated irregularly or rarely, may be de novo. It differs from classic lepromatous leprosy by the presence of spindle shaped cells, which are also histiocytes. Dermatofibroma usually has keloidal collagen at the periphery, is not as well delineated and the Fite stain is negative.

 

July 2016

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Case submitted by Dr Rajalakshmi T

Glomangioma

The epidermis is unremarkable. The dermis shows a neoplasm comprising of many ectatic thin walled vessels surrounded by cells exhibiting round nuclei and moderate amount of granular eosinophilic cytoplasm. Mitotic figures are infrequent.
Glomangioma is the commonest variant of glomus tumor. In contrast to the solid nests of glomus cells in the latter, the former consists of layers of glomus cells surrounding dilated, cavernous vascular channels. They are also termed glomuvenous malformations by some.

 

June 2016

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Case submitted by Dr Inchara YK

Alopecia areata

Sections from scalp show hair follicles with the bulbs situated in the deep dermis, none are evident in the subcutis. They appear to be catagen follicles that are miniaturised. There is a moderate peri-bulbar lymphocytic infiltrate (swarm of bees) and peri-bulbar fibrosis. A single fibrous stela is seen, accompanied by lymphocytes. The epidermis and rest of the dermis are unremarkable.
The presence of an exclusive peri-bulbar lymphocytic infiltrate is virtually diagnostic for alopecia areata (AA), the density of which is variable. All follicles appear to be in the same stage of catagen, reflecting the time of assault by the lymphocytes.
In chronic/long-standing lesions, inflammation can be minimal or absent. Progressive miniaturisation of follicles may ensue, simulating androgenetic alopecia. Finally, only fibrous tracts (stelae) remain, that contain remnants of glassy catagenic basement membrane and melanophages.

 

May 2016

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Case submitted by Dr Mithilesh Chandra

Tubular apocrine adenoma

This is a benign dermal adnexal neoplasm of apocrine derivation, also called apocrine adenoma, tubular adenoma, tubulopapillary hidradenoma, papillary tubular adenoma. Most common location is scalp, typically in women. Associated with organoid nevus, nevus sebaceus of Jadassohn and syringocystadenoma papilliferum. Rarely occurs on nose, eyelid, leg, trunk, axilla, chest, external auditory meatus, cheek, vulva. Clinically asymptomatic, sometimes smooth, sometimes irregular, well-defined nodule.
It is a well circumscribed dermal neoplasm that may extend into subcutis. Lobular pattern of dermal and subcutaneous tubular apocrine structures often encased by a fibrous, sometimes hyalinized stroma. Lobules have dilated, variably sized tubules lined by two layers of epithelial cells. Decapitation secretion by apical layer. Cuboidal to columnar cells with eosinophilic cytoplasm and round bland nuclei. Often hyaline and clear cell change. May show cyst formation with papillae or pseudopapillae protruding into the lumen. Variable overlying epidermal hyperplasia. Rare connection with overlying epidermis.

 

April 2016

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Case submitted by Dr Rajalakshmi T

Granuloma faciale

Section shows flattened epidermis. The dermis shows a nodular and interstitial infiltrate of lymphocytes, neutrophils, few eosinophils and scant nuclear dust. Focal extravasated RBCs are noted. Prominent vasculature is noted with thin wiry short fascicles of collagen accompanied by fibrocytes. There is no fibrinoid necrosis of the vessel walls. Special stains performed: PAS and Fite stains showed no additional findings.
Granuloma faciale (GF) is a chronic expression of leucocytoclastic vasculitis ocurring on the face. Essentially, GF and Erythema elevatum diutinum (EED) are the same pathologic process, differing only by the anatomic site of occurrence. While GF occurs on the face, EED occurs on the extremities. They present as papules/ plaques or nodules and have a protracted course. Fully developed lesions show a nodular/ diffuse inflammatory infiltrate comprising of neutrophils, lymphocytes, eosinophils, plasma cells and a few histiocytes throughout the dermis accompanied by nuclear "dust". Prominent vasculature accompanied by short fascicles of wiry collagen and numerous fibrocytes are seen in the dermis. Fibrin is not demonstrable in the blood vessels unless it is an early lesion. In very late lesions histiocytes are prominent.Granuloma faciale is a misnomer as granulomas are not characteristic of this lesion (although it may be present in a rare instance). An ancient terminology for EED is "Extracellular cholesterosis" as some late lesions may show extracellular deposits of cholesterol. Another term which is no longer in vogue is "Toxic hyaline" used by some authors to describe the fibrin in the vessel walls of EED.

 

 

March 2016

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Case contributed by Dr Inchara YK and Dr Poonam Panjwani

Morphea

Section shows thickened and crowded collagen bundles in the dermis with a mild perivascular and periadnexal lymphocytic infiltrate with occasional plasma cells. The adnexal structures are pulled up and the epidermis is atrophic.
A good clue on scanning magnification is the "square" shape of the biopsy. Early lesions can show a significant amount of perivascular, interstitial infiltrate of plasma cells and lymphocytes (at times, eosinophils). Alterations in collagen may be subtle in such lesions, making them appear "pinker" than normal. In fully developed lesions, one appreciates the characteristic thickened, crowded collagen bundles, that also frequently extend to the subcutaneous septae. Nevertheless, the space between them is present, albeit narrowed. This is in contrast to the homogenization seen in lichen sclerosus et atrophicus, a superficial expression of morphea. In late stages (i.e. atrophoderma of Pacini and Pierini), the spaces are well seen, as the collagen fibres thin out.
The differentials include Scleredema adultorum of Buschke, which shows presence of increased dermal mucin and absence of inflammatory infiltrate and chronic GvHD.
It is important to understand the terms fibrosis and sclerosis. Fibrosis results from proliferation of fibrocytes, as seen in scars and keloids. In sclerosis, the spaces between collagen are obliterated, as in LSEA. Morphea does not satisfy either of the two definitions, although included under the category of fibrosing diseases. That is some food for thought!

 

February 2016

 

Case submitted by Inchara YK

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January 2016

Case submitted by Poonam Panjwani and Inchara YK

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A 60 yr old lady with history of fever since 5 days and vesicular rash since 3 days. On examination there are multiple small vesicles (grouped) and pustules on an erythematous base over the chest, back and groin.

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December 2015

Case submitted by Gnanapriya and Suravi Mohanty

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This is a biopsy from a 19-year-old girl with a pigmented nodular lesion on the back, present since birth.

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November 2015

Case submitted by Mani Makhija, Urszula Carr and Steven Kossard

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This was an incidental finding in an excision of basal cell carcinoma.

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October 2015

Case submitted by Subhra Dhar

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A 26-year-old lady presented with a superficial, firm swelling in the neck measuring around 1 cm in diameter.

What is your diagnosis?

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September 2015

Case submitted by Inchara YK

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This biopsy is from a nodule on the foot in a middle-aged man.

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August 2015

Case submitted by Inchara YK

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This biopsy is from a nodule on the little finger in a 42-year-old woman.

What is the diagnosis? Name the special histochemical stain which is positive in this condition.

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July 2015

Case submited by Poonam Panjwani and Rajalakshmi T

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A 6 month old baby presented with scaly plaques on the face.
What is your interpretation?

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June 2015

Case submited by Mani Makhija and Vibhu Mendiratta

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A 45-day-old child presented with tender indurated swellings over shoulder, forearm and buttocks. Biopsy was done from the shoulder lesion.

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May 2015

Case submitted by Inchara YK

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April 2015

Case submitted by Rajalakshmi T

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What are structures highlighted in this image of a H&E stained section? What is this phenomenon called?

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March 2015

Case submitted by M Ramam

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Identify the round, brown structures seen in the image. What is their significance?

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February 2015

Case submitted by Meenakshi Batrani and Asha Kubba

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This patient presented with recurrent crops of erythematous papules on the extensor surface of arms, thighs, legs and on buttocks. Lesions regressed leaving behind depigmented, varioliform scars. Biopsy was taken from the buttock.

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January 2015

Case submitted by Inchara YK and Marjorie Correa

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This was submitted as a "skin tag" excised from the cheek.

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December 2014

Case submitted by Poonam and Rajalakshmi T

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November 2014

Case submitted by Avninder Singh

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A 32 year old woman presented with erythematous and edematous plaques on her legs and flanks of 8 days duration that were associated with itching and burning sensation.

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October 2014

Case submitted by Inchara YK

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A 38-year-old woman presented with a nodule in the abdominal wall.

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September 2014

Case submitted by Poonam Panjwani and Rajalakshmi T

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A 40-year-old man presented with itchy, erythematous plaques on neck, trunk and axilla.

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August 2014

Case submitted by Achyut Pokharel

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July 2014 (Year 3, Number 1) !

Case submitted by Mani Makhija

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A 40-year-old lady presented with a lesion on the buttock.

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June 2014

Case submitted by Isha Garg, Inchara YK

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A 40-year-old man presented with a hyperpigmented plaque on the scalp since 1 year.

What is your diagnosis?

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May 2014

Case submitted by I S Reddy, Anuradha S

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April 2014

Case submitted by Rajalakshmi T, Isha Garg

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A 30-year-old man presented with multiple skin-colored papules over nasolabial folds and forehead since 7 years.

What is your diagnosis? Identify the structure within the circle in the third image.


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March 2014

Case submitted by Inchara YK, Rajalakshmi T

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A 64-year-old lady presented with a single nodule on the chest wall.

What is your diagnosis?


Click here for the answer.

 

February 2014

Case submitted by Avninder Singh, V Ramesh

febthumbnail Click on the thumbnail to see a larger image in a new window

Identify the structure seen within the cell.


Click here for the answer.

 

January 2014

Case submitted by Mani Makhija and Hemamalini Aiyer

januarythumbnail Click on the thumbnail to see a larger image in a new window

An 18 year old boy presented with progressive myoclonic epilepsy and decline in cognition. The image is from a PAS stained section of a skin biopsy.

What is your diagnosis?

Click here for the answer.

 

December 2013

Case submitted by M Ramam, Manoj Singh

december thumbnail Click on the thumbnail to see a larger image in a new window

What is your diagnosis?

Click here for the answer

 

November 2013

Case submitted by M Ramam, Manoj Singh

november thumbnail Click on the thumbnail to see a larger image in a new window

What is your diagnosis?

Click here for the answer.

 

October 2013

Case submitted by Meenakshi Batrani, Asha Kubba

october thumbnail1 october thumbnail2 october thumbnail3 Click on the thumbnail to see a larger image in a new window

What is your diagnosis?

Click here for the answer.

 

September 2013

Case submitted by B Vijaya

sepimagetn1 sepimagetn2 Click on the thumbnail to see a larger image in a new window

A 40 year old woman presented with a nodule on the palm.

One image is H&E and the other a special stain.

What is your diagnosis?

Click here for the answer.

 

August 2013

Case submitted by Rajalakshmi T and Inchara YK

august thumbnail Click on the thumbnail to see a larger image in a new window

Which of the images labelled A to D in the composite is the odd one out, and why?

Click here for the answer

 

July 2013

Case submitted by Meenakshi Batrani, Asha Kubba

julythumbnail1 julythumbnail2 Click on the thumbnails to see larger images in a new window

What is your diagnosis?

Click here for the answer.

 

June 2013

Case submitted by I S Reddy, G Swarnalata

june thumbnail Click on the thumbnail to see a larger image in a new window

The inset provides a higher power image of a section of the slide.

What is your diagnosis?

Click here for the answer.

May 2013

Case submitted by Rajiv Joshi

maytn1 maytn2 Click on the thumbnails to see larger images in a new window

These are both images of the same slide, one at medium power and the other at high power to show the composition of the infiltrate.

What is your diagnosis?

Click here for the answer.

April 2013

Case submitted by I S Reddy, G Swarnalata

april image thumbnail Click on the thumbnail to see a larger image in a new window

What is your diagnosis?

Click here for the answer

March 2013

Case submitted by V Ramesh, Avninder Singh

march thumbnail Click on the thumbnail to see a larger image in a new window

What is your diagnosis?

Click here for the answer.

February 2013

Case submitted by Sonu Nigam

february thumbnail Click on the thumbnail to see a larger image in a new window

What is your diagnosis?

Click here for the answer.

January 2013

Case submitted by V Ramesh, Avninder Singh

january image thumbnail Click on the thumbnail to see a larger image in a new window

What is your diagnosis?

Click here for the answer.

December 2012

Case submitted by M Ramam, Manoj Singh

December thumbnail Click on the thumbnail to see a larger image in a new window

What is your diagnosis?

Click here for the answer.

November 2012

Case submitted by M Ramam, Manoj Singh

November Thumbnail 1November Thumbnail 2Click on the thumbnails to see larger images in a new window

These are low and high power images of the same slide.

What is your diagnosis?

Click here for the answer.

October 2012

Case submitted by M Ramam, Manoj Singh

October Image of the Month thumbnail Click on the thumbnail to see a larger image in a new window.

What is your diagnosis?

Click here for the answer

September 2012

Case submitted by M Ramam, Manoj Singh

September Image Thumbnail Click on the thumbnail to see a larger image in a new window.

What is your diagnosis?

Click here for the answer.

August 2012

Case submitted by M Ramam, Manoj Singh

Thumbnail for August Click on the thumbnail to see a larger image in a new window.

What is your diagnosis?

Click here for the answer.

July 2012

Case submitted by M Ramam, Manoj Singh

July 2012 Image of the Month Click on the thumbnail to see a larger image in a new window.

What is your diagnosis?

Click here for the answer.

 

What is Image of the Month?

A photomicrograph is sent to all members of the Society once a month and diagnoses are invited. The correct diagnosis and the names of the first 3 persons who got it right are emailed a week later.

Non-members who are on the Society mailing list also receive the image but after a delay of 3 days.

The image is also emailed to ACAD-IADVL, the academic discussion group of our Sister Society, the Indian Association of Dermatologists, Venereologists and Leprologists.

To join the Society and receive the image along with other members, click here.

To join the mailing list, send an email to dermatopathologysocietyofindia@gmail.com

To find out more about our sister society, the Indian Association of Dermatologists, Venereologists and Leprologists, click here.