It is a symbiotic fungusalga characterised by flattopped organisms. As said old is gold holds true for the histopathological analysis for the diagnosis of the spectrum of disorders that come in lichenoid interface dermatitis. Histology hyperkeratosis, follicular plugging, vacuolar interface dermatitis, bmz thickening, dermal mucin, pigment incontinence patchy perivascular and periadnexal inflammation perifollicular lymphoid infiltrates involve the isthmus inflammation of fibrous tract remnants creates dense vertical columns of. The term interface dermatitis refers to the finding in a skin biopsy of an inflammatory infiltrate that abuts or obscures the dermoepidermal junction dej. In patients with biopsies of interface dermatitis showing concomitant vasculitis potential vascular cofactors contributing to vascular injury should be explored in the setting of sle these vascular cofactors include antiphospholipid antibodies and cryoglobulins, antiendothelial cell antibodies crowson an, magro c.
As is true with similar histologic reactions affecting the nasal planum, gingiva, or. Interface hepatitis piecemeal necrosis is a process of inflammation and erosion of the hepatic parenchyma at its junction with portal tracts or fibrous septa the term interface hepatitis was introduced because the death of hepatocytes probably involves apoptosis rather than, or as well as, necrosis, and because it takes place at the parenchymalconnective tissue interface. The components of this interface include the basal layer of the epidermis, the dermoepidermal junction, the papillary dermis, and the adventitial dermis around the adnexal structures. If neither parakeratosis nor eosinophils are noted, the changes are consistent with lichen planus. The characteristic atopic reaction to patch tests with human dander and the naturally occurring lesions of the disease atopic dermatitis resemble each other grossly in the occurrence of papules, papulovesicles, redness and slight desquamation and in. It most often occurs on the sides of the fingers but can also be found on the chest or arms.
Unter einer interfacedermatitis versteht man eine entzundliche dermatose, bei. New entities in dermatopathology diagnostic histopathology. When epidermal changes are present, they are further subdivided into spongiotic dermatitis, interface dermatitis, and psoriasiform dermatitis fig 2 2. Normal skin histology explained by a dermatopathologist. Cutaneous drug eruption with an interface dermatitis pattern due to.
Histology is a critical component in diagnosis of inflammatory disorders clinician must provide an appropriate biopsy clinical correlation is essential to narrowing the differential. Coxsackievirus a16 cva16 and enterovirus 71 are the most frequently implicated pathogens. 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. The sawtooth rete ridge pattern typically of lichen planus is sometimes seen, but lichenoid keratosis more frequently shows broadened, irregular rete ridges. The term interface dermatitis refers to the finding in a skin biopsy of an inflammatory infiltrate that abuts or. Interface dermatitis, histopathology, haematoxylin and eosin. Mann, mdc lebanon, new hampshire and durham, north carolina. Rosacea and eczema are two skin conditions that are fairly commonly found throughout the world. Lichen planus lp is a chronic inflammatory and immune mediated disease that affects the skin, nails, hair, and mucous membranes. A number of uncommon, clinically diverse and poorly understood inflammatory skin diseases are linked by the presence of a set of histopathological elements. Histopathology lichenoid dermatitis with superficial and deep perivascular and periadnexal infiltrate lymphocytes variable epidermal changes wednesday, may 22.
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. Lichenoid interface dermatitis, see comment comment. The most common histopathologic pattern of drug eruptions is a vacuolar interface dermatitis. Erythrocyteextravasation, telangiectasia, and basement. Miller, md, a muhammad zainulabideen, md,b joan paul, md, mph,c anne. It is characterized by polygonal, flattopped, violaceous papules and plaques with overlying, reticulated, fine white scale wickhams striae, commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. 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. A galike pattern has been described in association with some systemic diseases. The extent of interface changes varies greatly, from extensive vacuolar alteration at the dermoepidermal junction and many necrotic keratocytes at all levels of the epidermis, as in most cases of fixed drug eruption and toxic epidermal necrolysis, to focal and. Lichenoid interface dermatitis with neither eosinophils nor parakeratosis may also be seen in blk lichen planuslike keratosis, lichenoid drug eruption, lichenoid gvhd, hypertrophic lupus erythematosus, and lichenoid regression of lentigo maligna. 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. Interface dermatitis includes diseases in which the primary pathology involves the dermoepidermal junction. Historically, interface dermatitis has been classified based in part upon the cell type that dominates the infiltrate ie, neutrophilic, lymphocytic, or lymphohistiocytic. Additional imaging procedures in 14 cats and postmortem examination in two cats did not detect neoplasia.
Histopathology of drug eruptions general criteria, common. This lecture offers an alternative understanding of interface dermatitis. In polymorphic light eruption, sections show a superficial and deep perivascular lymphocytic infiltrate figure 1. The extent of interface changes varies greatly, from extensive vacuolar alteration at the dermoepidermal junction and many necrotic keratocytes at all levels of the epidermis, as in most cases of fixed drug eruption and toxic epidermal necrolysis, to focal and very. Interface dermatitis includes conditions in which the primary pathology involves the interface, i. Ga is more patchy than igdr with discrete collections of histiocytes with central mucin. Inflammatory skin disease every pathologist should know steven d. Interface dermatitis, lichenoid dermatitis, vacuolar alteration. Pdf a number of uncommon, clinically diverse and poorly understood inflammatory skin diseases are linked by the presence of a set of histopathological. Cutaneous pathology issn 03036987 the cutaneous pathology of lupus erythematosus. Because of the work of herman pinkus,1 who ordered inflammatory skin diseases by reaction patterns eg, lichenoid, eczematous, and psoriasiform dermatitis.
Trichoscopic features reveal enlarged tortuous capillaries, peripilar casts, tufting with three or more hair shafts emerging together, and. Vacuolar interface dermatitis sparse lymphocytes tagging the dermalepidermal junction. I mild or dense inflammatory infiltrate composed of mainly mononuclear cells. Interface dermatitis, lichenoid disorders, lichen planus. This lecture is aimed at dermatologists and pathologiststhose in. Interface dermatitis joshi r indian j dermatol venereol leprol. Interface dermatitis includes numerous skin diseases.
A clinico pathological study of interface dermatitis iosr journal. 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 lichenoid tissue reaction interface dermatitis ltrifd. 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. Pdf diagnosis of interface dermatitis still remains a challenge in. Inflammatory skin disease every pathologist should know. Pdf on oct 1, 2014, suguna b v and others published diagnosis of interface dermatitis still remains a challenge in dermatopathology find, read and cite all the research you need on researchgate. They are characterised by a particular type of inflammation found on histology. Histopathology has always been useful in differentiating the various diagnoses with similar clinical appearance. The prototypic skin disease in this category is lichen planus. This feature is essential to make a diagnosis of an interface. Lichenoid tissue reaction ltr or interface dermatitis ifd is some of the commonly encountered clinical and histological presentations in dermatology and pathology.
A case of eczema coxsackium with erythema multiformelike. What are lichenoid disorders lichen is found growing on trees and elsewhere in the garden or forest. Dermatologic diseases characterized by pathology at the dermo epidermal. The following features are characteristic of interface dermatitis. Interface dermatitis joshi r indian j dermatol venereol. However, the ltrifd can also be seen in skin disorders. Interestingly, in addition to an expected cellpoor in. A histological pattern, not a distinct clinical entity due to drug eruption, actinic keratosis, lupus erythematosus, acute graft versus host disease, regressing melanoma and dermatofibroma. Histopathology revealed interface dermatitis, mural interface folliculitis and sebaceous adenitis indistinguishable from findings in thymoma. It is more common in patients who receive only intermittent sun exposure and typically consists of crops of papules, vesicles or plaques histology of polymorphic light eruption. Histopathology of punch biopsy specimens from the left side of the chest.
Recent advances in our understanding of the pathophysiological basis of le bring hope for novel therapeutic approaches. In the dermis the most striking lesion was the interface dermatitis composed of mainly cd3 lymphocytes and varying amounts of mast cells and plasma cells. The salient histological findings include basal cell vacuolization, apoptotic keratinocytes colloid or civatte bodies, and obscuring of the dermoepidermal junction by inflammatory cells. The salient histological findings include basal cell vacuolization, apoptotic.
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 lichenoid tissue reactioninterface dermatitis ltrifd. Histology spongiosis eosinophils psoriasiform hyperplasia. Histopathology two types of hle lesions have been described. Pdf diagnosis of interface dermatitis still remains a. Histopathological study of interface dermatitis with its clinical.
An interface dermatitis reaction, also known as autoeczematization, is an itchy rash with small, waterfilled blisters that is caused in response to a primary infection, usually fungal. Case report a case of eczema coxsackium with erythema multiformeelike histopathology in a 14yearold boy with chronic graftversushost disease patricia k. Recognition, classification, etiology, and clinicopathological overtones virendra n sehgal 1, govind srivastava 2, sonal sharma 3, shruti sehgal 4, prashant verma 5 1 dermato venereology skinvd center, sehgal nursing home, panchwati, delhi, india 2 skin institute, school of dermatology, greater kailash, new delhi, india 3 department of. Histopathology images of lichen planus and diagram of variants of lichen planus. Sanchez np, peters ms, winkelmann rk 1981 the histopathology of lupus. Lichenoid skin disorders got their name from their appearance also flat topped and often somewhat scaly. There is most often a dense lichenoid lymphohistiocytic infiltrate, as in lichen planus.
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