Atlas of dermatopathology: Granulomatous Slack Skin

+ Introduction

+ Using this atlas

+ Conditions of using this atlas

+ Technical notes

+ Hardware

+ Software

+ How to use the atlas

+ Navigating through the text pages

+ Controlling the pictures

+ Logos and labels

+ What will you need to use the atlas

+ Bugs, problems

+ Netscape

+ Microsoft Internet Explorer

+ Some other Internet resources concerning dermatopathology and pathology

+ Literature

+ The literature used to prepare this atlas

+ Publications concerning the atlas

+ Support

+ Skin biopsy

+ Examples of special stainings

+ Polarization

+ Immunofluorescence

+ Direct Immunofluorescence

+ Pemphigus vulgaris and its variants (immunofluorescence)

+ Bullous pemphigoid (immunofluorescence)

+ Pemphigoid (herpes) gestationis (immunofluorescence)

+ Dermatitis herpetiformis Duhring (immunofluorescence)

+ Lupus erythematosus (SLE, CDE a SCLE); (immunofluorescence)

+ Sharp's syndrome

+ Lichen ruber planus (immunofluorescence)

+ Vasculitis, immunocomplex type (immunofluorescence)

+ Porphyria cutanea tarda (PCT) and hepatopathies (immunofluorescence)

+ Indirect immunofluorescence

+ Antinuclear antibodies (ANA)

+ Endomysial antibodies

+ Antibodies aganist neutrophilic cytoplasm (ANCA)

+ Non-tumorous skin diseases

+ Diseases of the Epidermis

+ Ichthyosis

+ Ichthyosis vulgaris

+ Ichthyosis lamellaris

+ X-linked ichthyosis

+ Epidermolytic hyperkeratosis

+ Ichthyosis acquisita

+ Keratosis palmoplantaris, palmoplantar keratoderma

+ Ectodermal dysplasia

+ Psoriasis

+ Psoriatic erytroderma

+ Palmoplantar psoriasis and palmoplantar pustulosis

+ Generalized pustular psoriasis of Zumbusch

+ Lingua geographica

+ Psoriatiform keratosis

+ Infantile acropustulosis

+ Darier's disease

+ Porokeratosis

+ Acrokeratoelastoidosis

+ Pityriasis rubra pilaris

+ Glucagonoma syndrome

+ Acrodermatitis enteropathica

+ Blistering diseases

+ Classification

+ Impetigo

+ Staphylococcal scalded skin syndrome

+ Subcorneal pustular dermatosis of Sneddon-Wilkinson

+ Peeling skin syndrome

+ Acute generalized exanthematous pustulosis (AGEP)

+ Pemphigus vulgaris

+ Pemphigus vegetans

+ Neonatal pemphigus

+ Pemphigus erythematosus Senear-Usher

+ Pemphigus foliaceus

+ Paraneoplastic pemphigus

+ IgA pemphigus

+ Hailey-Hailey (Familial benign pemphigus)

+ Transient acantholytic dermatosis (of Grover)

+ Herpes zoster, varicella, Herpes simplex

+ Herpes simplex

+ Eczema herpeticatum Kaposi Juliusberg

+ Herpes zoster, varicella

+ Bullous pemphigoid

+ Cicatricial pemphigoid

+ Pemphigoid (herpes) gestationis

+ Porphyria cutanea tarda

+ Pseudoporphyria

+ Bulla in diabetes

+ Dermatitis herpetiformis Duhring

+ IgA linear dermatosis

+ Erythema multiforme

+ Toxic epidermal necrolysis of Lyell

+ Stevens-Johnson syndrome

+ Graft versus host reaction

+ Epidermolysis bullosa

+ Epidermolysis bullosa dystrophica

+ Epidermolysis bullosa acquisita

+ Artifical clefts in basaliomas

+ Allergic contact dermatitis, acute

+ Dyshidrotic dermatitis

+ Eczema atopicum (dermatitis atopica)

+ Subacute and chronic (eczem) dermatitis

+ Microbial eczema

+ Granuloma gluteale infantum

+ Toxic contact (irritative) dermatitis, acute

+ Toxic contact (irritative) dermatitis, chronic

+ Seborrhoic dermatitis

+ Pityriasis amiantacea

+ Changes caused by rubbing, scratching and pressure

+ Lichen simplex

+ Strophulus

+ Prurigo gestationis

+ Prurigo nodularis

+ Prurigo senilis

+ Atopic dermatitis

+ Picker's nodule

+ Excoriation

+ Chronic pressure (hip)

+ Amputation stump

+ Granuloma fissuratum

+ Pressure necrosis

+ Tyloma, callus

+ Clavus

+ Morsicatio buccarum

+ Perivascular infiltration of upper dermis

+ Pityriasis lichenoides Mucha Habermann

+ Pityriasis lichenoides acuta

+ Pityriasis lichenoides chronica

+ Pityriasis rosea Gibert

+ Diffuse infiltration infiltration of the upper dermis

+ Lichen ruber planus

+ Lichen verrucosus (hypertrophicus)

+ Lichen ruber, vesicular

+ Lichen planopilaris

+ Lichen planus like keratosis (benign lichenoid keratosis)

+ Lichenoid drug reaction

+ Lichen nitidus

+ Lichen striatus

+ Erythema dyschromicum perstans

+ Poikiloderma Rothmund Thomson

+ Poikiloderma vasculare atrophicans

+ Infiltration of the upper and deep corium

+ Erythema annulare centrifugum (erythema figuratum)

+ Erythema gyratum repens

+ Lymphocytic infiltrate of Jessner-Kanof

+ Urticaria

+ Pruritic urticarial papules and plaques of pregnancy (PUPPP)

+ Well's syndrome

+ Hypereosinophilic syndrome

+ Granuloma faciale (eosinophilicum)

+ Erythema elevatum diutinum

+ Sweet's syndrome

+ Behcet's disease

+ Pyoderma gangrenosum

+ Granulomatous processes of deeper corium

+ Granuloma annulare

+ Granuloma annulare, deep

+ Granuloma multiforme

+ Annular elastolytic granuloma

+ Necrobiosis lipoidica

+ Granulomatosis disciformis Miescher

+ Rheumatoid nodule

+ Chondrodermatitis nodularis chronica helicis

+ Polychondritis recurrens

+ Sarcoidosis

+ Erythema induratum Bazin

+ Foreign body granulomas

+ Silicone granuloma

+ Cat scratch disease

+ Cheilitis granulomatosa Miescher Melkerson Rosenthal

+ Intersticial granulomatous dermatitis

+ Crohn's disease, skin changes

+ Connective tissue disorders

+ Lupus erythematosus

+ Lupus erythematodes, acute

+ Acute neonatal lupus erythematodes

+ Lupus erythematodes, subacute

+ Lupus erythematodes, chronic

+ Lupus erythematodes profundus

+ Dermatomyositis

+ Osteoarthritis, Heberden nodes

+ Scleroderma, morphea

+ Diffuse scleroderma

+ Localized scleroderma, morphea

+ Lichen sclerosus et atrophicus

+ Pachydermoperiostosis

+ Eosinophilic fasciitis

+ Fibromatosis

+ Infantile digital fibromatosis (inclusion body fibromatosis)

+ Intravascular fasciitis

+ Desmoid type fibromatosis, desmoid

+ Striae distensae

+ Skin graft

+ Perforating collagenosis

+ Disorders of elastic fibres

+ Anetoderma

+ Mid dermal elastolysis

+ Actinic degeneration of the corium

+ Pseudoxanthoma elasticum

+ Focal linear elastosis

+ Elastosis perforans serpiginosa

+ Vasculitides

+ Leukocytoclastic vasculitis

+ Other vasculitides

+ Polyarteritis nodosa

+ Eosinophilic vasculitis

+ Churg Strauss syndrome

+ Wegener's granulomatosis

+ Thrombangiitis obliterans (Bürger)

+ Livedo vasculitis

+ Disseminated intravascular coagulopathy (DIC)

+ Giant cell arteritis of Horton (temporal)

+ Purpura

+ Thrombotic thrombocytopenic purpura of Moschowitz

+ Urticarial vasculitis

+ Vasculitis and mycotic sepsis

+ Chronic venous insufficiency

+ Venous varices

+ Ulcus cruris

+ Superficial thrombosis

+ Superficial thrombophlebitis

+ Cutis marmorata, livedo reticularis, livedo racemosa

+ Cryoglobulinemia

+ Cryoglobulinemia in monoclonal gamapathy

+ Mixed cryoglobulinemia

+ Acrocyanosis

+ Malignant atrophic papulosis of Degos

+ Lymphedema

+ Lymphangitis

+ Acute lymphangitis

+ Sclerosing lymphangitis of the penis

+ Panniculitis

+ Erythema nodosum

+ Panniculitis arteficialis (factitial)

+ Calcifying panniculitis

+ Panniculitis caused by cold

+ Eosinophilic panniculitis

+ Lipomembranous panniculitis

+ Traumatic panniculitis

+ Panniculitis caused by steroids

+ Pancreatic panniculitis

+ Other panniculitides

+ Deposition of foreign material in the dermis

+ Amyloidosis

+ Systemic (secondary) amyloidosis

+ Mucinoses

+ Generalized myxedema in hypothyreosis

+ Pretibial myxedema

+ Reticular erythematous mucinosis

+ Papular mucinosis

+ Scleredema

+ Scleromyxedema

+ Myxoma

+ Digital myxoid cyst

+ Calcium deposits

+ Chronic dermatomyositis

+ Subepidermal calcifying nodule

+ Calcinosis scroti

+ Tumoriform calcinosis

+ Calciphylaxis

+ Dystrofic dermal calcifications

+ Osteoma cutis

+ Progressive osseous heteroplasia

+ Gout, arthritis uratica

+ Hemosiderin

+ Tatoo

+ Amalgam tatoo

+ Argyrosis

+ Titanium pigmentation

+ Deposits of corticosteroids in the dermis

+ Ochronosis

+ Colloid milium

+ Subcutaneous emphysema

+ Tumorous infiltration of the corium

+ Urticaria pigmentosa

+ Histiocytosis X

+ Metastatic infiltration of the dermis

+ Paget's carcinoma of the breast

+ Extramammary Paget's disease

+ Epidermal spread of colonic adenocarcinoma

+ Bacterial, mycotic and parazitic diseases; viruses

+ Bacterial inflammations with suppuration, pyodermia

+ Erosive pustulosis of the head

+ Erysipelas

+ Sepsis (bacterial)

+ Erysipeloid

+ Ecthyma

+ Orf

+ Angulus infectiosus

+ Aphta

+ Phlegmone, gangrene

+ Erythrasma

+ Pitted keratolysis

+ Borreliosis

+ Erythema chronicum migrans

+ Borreliosis (acrodermatitis chronica atrophicans)

+ Adnate listeriosis

+ Nail infection caused by Pseudomonas

+ Mycobacteria, actinomycetes

+ Tuberculosis cutis

+ Scrophuloderma

+ Lupus vulgaris

+ Reaction to BCG vaccination or sensitivity tests

+ Papulonecrotic tuberculid

+ Diseases caused by atypical mycobacteria

+ Leprosy

+ Actinomycosis

+ Madura foot

+ Rhinoscleroma

+ Francisella tularensis, tularemie

+ Mycotic diseases

+ Superficial tinea

+ Candidosis

+ Tinea nigra

+ Dermatophyton

+ Follicular mycosis

+ Deep mycotic processes

+ Cryptococcosis

+ Sporotrichosis

+ Onychomycosis

+ Paronychia candidomycetica

+ Diseases caused by parasites

+ Leishmaniasis

+ Demodicosis

+ Scabies

+ Larva migrans

+ Myiasis

+ Tungiasis

+ Pediculosis capitis

+ Pediculosis pubis

+ Pediculosis corporis

+ Cheyletielosis

+ Insect bite reaction

+ Tick

+ Trombicula autumnalis, Harvest mite

+ Injuries caused by animals

+ Bat bite reaction

+ Injury by stingray

+ Hand, foot and mouth disease

+ Gianotti Crosti syndrome

+ Diseases of hair follicles

+ Acne vulgaris

+ Rosacea

+ Dermatitis perioralis

+ Lupus miliaris disseminatus faciei

+ Alopecia

+ Alopecia areata

+ Diffuse alopecia

+ Defluvium

+ Pseudopelade of Brocq

+ Alopecia in lupus erythematodes

+ Follicular mucinosis (alopecia mucinosa)

+ Primary follicular mucinosis

+ Secondary follicular mucinosis in mycosis fungoides

+ Alopecia androgenica

+ Trichotillomania

+ Tration alopecia

+ Other diseases of hair follicles

+ Purulent folliculitis

+ Folliculitis keloidalis nuchae

+ Folliculitis decalvans, folliculitis abscedens et suffodiens, tufted hair folliculitis

+ Ostiofolliculitis (superficial folliculitis)

+ Perforating folliculitis

+ Eosinophilic pustular folliculitis, eosinophilic pustulosis

+ Eosinophilic pustulosis Ofuji

+ Keratosis pilaris

+ Lichen spinulosus

+ Trichostasis spinulosa

+ Ulerythema ophryogenes

+ Pili recurvati

+ Tufted hair

+ Plica polonica

+ Cutis verticis gyrata

+ Fox-Fordyce syndrome

+ Diseases of the nails

+ Posttraumatic onycholysis

+ Psoriatic onycholysis

+ Onychoschisis

+ Onychogryphosis

+ Onychophagia

+ Pterygium unguis

+ Unguis incarnatus

+ Foveolae unguis

+ Leuconychia striata

+ Melanonychia striata

+ Syndrome Laugier Hunziker

+ Twenty nail dystrophy

+ Disorders of the sweat glands

+ Hidradenitis axillaris (suppurativa)

+ Eccrine hidradenitis with neutrophils

+ Eccrine hidradenitis with neutrophils after chemotherapy

+ Miliaria

+ Necroses of eccrine sweat glands

+ Myoclonic epilepsy

+ Clear cell metaplasia of eccrine ducts

+ Syringomucinous metaplasia

+ Mucinous metaplasia

+ Sweat gland hyperplasia

+ Exogenic alterations of the skin

+ Scar

+ Cauterisatio

+ Combustio (burns)

+ Congelatio (frostbite)

+ Livedo e calore, erythema ab igne

+ Dermatitis artefacta

+ Arteficial dermatitis, caused by spray

+ Haematoma

+ Radiodermatitis

+ Radiodermatitis acute

+ Radiodermatitis, chronic

+ Phototoxic and photoallergic reactions

+ Berloque dermatitis

+ Syndrome Favre-Racouchot

+ Actinic damage of the skin

+ Metabolic and nutrition problems

+ Pellagra

+ Rachitis, avitaminosis D

+ Scorbut, avitaminosis C

+ Drug reactions

+ Lichenoid drug eruptions

+ Eczematoid drug reaction

+ Drug reaction, multiform type

+ Fixed drug reaction

+ Toxoallergic reaction

+ Vesicular drug reaction

+ Pustular drug reaction

+ Folliculitis caused by EGFR inhibitors therapy

+ Antagonists of TNF-α therapy

+ Therapy by tyrosinkinase inhibitors

+ Necrotising drug reaction

+ Other drug reactions

+ Coumarin necrosis, coumarin caused bleeding

+ Striae after prolonged therapy by corticosteroids

+ Organoid nevi and malformations of the skin

+ Nevus sebaceus (Jadassohn)

+ Epidermal nevus

+ Ichthyosis hystrix (widespread linear epidermal nevus)

+ Inflammatory linear verrucous epidermal nevus (ILVEN)

+ Nevus comedonicus

+ Familial dyskeratotic comedones

+ White sponge nevus of oral mucosa

+ Nevus lipomatosus

+ Nevus collagenicus

+ Fibrous hamartoma of infancy

+ Aplasia cutis congenita

+ Disorders of melanin pigmentation

+ Vitiligo

+ Hypomelanosis guttata

+ Pityriasis alba

+ Albinism

+ Melasma, chloasma

+ Ephelides, freckles

+ Melanocytic macule of the lip or genital

+ Dowling-Degos disease

+ Notalgia paresthetica

+ Melanodermatitis toxica, melanosis Riehl

+ Incontinentia pigmenti

+ Nevus achromicus

+ Other lesions

+ Fistula, sinus tract

+ Skin tumors

+ Diagnostic key to the most common epitelial skin tumors

+ Benign epidermal tumors

+ Seborrhoic keratosis

+ Melanoacanthoma

+ Dermatosis papulosa nigra

+ Lentigo solaris

+ Ink-spot lentigo

+ PUVA lentigo

+ Melanosis of Becker (Becker's nevus)

+ Stucco keratosis

+ Acrokeratosis verruciformis Hopf

+ Hyperkeratosis lenticularis perstans of Flegel

+ Confluent and reticulated papillomatosis

+ Acanthosis nigricans

+ Keratotic processes

+ Multiple minute digitate keratoses

+ Postirradiation hyperkeratoses

+ Minute aggregate keratoses

+ Waxy dermatosis

+ Warty dyskeratoma (solitary Darier's disease)

+ Acantholytic acanthoma

+ Verrucous affections caused by papillomavirus (HPV)

+ Verruca vulgaris

+ Verruca filiformis

+ Verruca plantaris

+ Verruca plana

+ Epidermodysplasia verruciformis

+ Condyloma acuminatum

+ Focal epithelial hyperplasia Heck, multifocal papillomavirus epithelial hyperplasia (MPVEH)

+ Hirsutes papillares

+ Bowenoid papulosis of the genitalia

+ Inverted follicular keratosis

+ Molluscum contagiosum

+ Arsenical keratosis

+ Large cell acanthoma

+ Epidermolytic acanthoma

+ Knuckle pads

+ Keratoacanthoma

+ Pale cell acanthoma

+ Pale cell papulosis

+ Pseudoepitheliomatous hyperplasia

+ Follicular induction

+ Sebaceous induction

+ Malignant epidermal tumors

+ Solar keratosis

+ Actinic cheilitis

+ Bowen's intraepidermal carcinoma

+ Bowen's disease, pagetoid

+ Queyrat's disease

+ Vulval intraepithelial neoplasia (VIN III.)

+ Dysplasia/in situ carcinoma from basaloid cells

+ Cornu cutaneum

+ Trichilemmal cornu cutaneum

+ Basalioma

+ Metatypic carcinoma (spinobasocellular)

+ Squamous cell carcinoma

+ Verrucous carcinoma

+ Giant condylomata of Buschke-Loewenstein

+ Basaloid, cloacogenic carcinoma

+ Lymphoepithelioma-like carcinoma of the skin

+ Adnexal tumors

+ Tumors of the hair follicle

+ Hair follicle nevus

+ Aberrant follicle

+ Trichofolliculoma

+ Trichoadenoma

+ Dilated pore of Winer

+ Pilar sheath acanthoma

+ Trichoepithelioma, superficial trichoblastoma

+ Trichoblastoma

+ Desmoplastic trichoepithelioma

+ Tricholemmoma

+ Desmoplastic tricholemmoma

+ Trichomatricoma (pilomatrixoma)

+ Trichomatrical carcinoma

+ Folliculosebaceous hamartoma

+ Tumor of the follicular infundibulum

+ Trichodiscoma

+ Perifollicular fibroma

+ Tumors of the sweat glands

+ Axillar heterotopia of mammary glands

+ Eccrine nevus

+ Apocrine nevus (hyperplasia)

+ Eccrine angiomatous hamartoma

+ Cylindroma

+ Spiradenoma

+ Nodular hidradenoma

+ Cystic nodular hidradenoma

+ Apocrine hidradenocarcinoma

+ Syringoma

+ Papillary eccrine adenoma

+ Apocrine nevus

+ Mammary gland anal polyp

+ Chondroid syringoma

+ Syringocystadenoma papilliferum

+ Hidradenoma papilliferum

+ Tubular apocrine adenoma

+ Adenoma of the nipple

+ Poroma

+ Eccrine poroma

+ Hidroacanthoma simplex

+ Dermal duct tumor

+ Poroma, malignant (porocarcinoma)

+ Syringofibroadenoma

+ Intraepidermal epithelioma of Borst Jadassohn

+ Microcystic adnexal carcinoma

+ Adenoid cystic carcinoma

+ Eccrine carcinoma

+ Mucinous carcinoma of the skin

+ Fibroadenoma

+ Sebaceous tumors

+ Ectopic sebaceous glands

+ Nevus sebaceus (of Jadassohn)

+ Sebaceous hyperplasia

+ Sebaceous hyperplasia of the penis

+ Sebaceous adenoma

+ Sebaceoma, sebaceous epithelioma

+ Muir-Torre syndrome

+ Combined adnexal tumor

+ Cowden syndrome

+ Mesenchymal tumors

+ Sclerosing fibroma

+ Dermatofibroma (histiocytoma of the skin)

+ Dermatomyofibroma

+ Atypical fibroxantoma

+ Dermatofibrosarcoma protuberans

+ Bednar tumor, pigmented dermatofibrosarcoma protuberans

+ Malignant fibrous histiocytoma, pleomorphic sarcoma

+ Giant cell fibroblastoma

+ Skin tags

+ Fibroepithelial polyp

+ Supernumerary digit

+ Supranumerary nipple

+ Accessory tragus

+ Fibrous papule of the nose (face)

+ Acral fibrokeratoma

+ Acquired periungal fibrokeratoma

+ Vestibular papules of the vulva

+ Focal dermal hypoplasia of Golz

+ Keloid

+ Lipoma

+ Common lipoma

+ Spindle cell and pleomorhic lipoma

+ Lipomatosis

+ Angiolipoma

+ Angiomyolipoma

+ Liposarcoma

+ Vascular tumors

+ Benign vascular tumors

+ Capillary hemangioma

+ Cavernous hemangioma

+ Sinusoidal hemangioma

+ Venous lake

+ Blue rubber bleb nevus syndrome

+ Naevus simplex

+ Nevus flammeus

+ Arteriovenous malformation

+ Venous malformation

+ Cutis marmorata teleangiectatica

+ Angioma serpiginosum

+ Ectatic superficial capillaries in areas of solar degeneration of elastic fibres

+ Congenital teleangiectatic erythema (Bloom's syndrome)

+ Osler Weber Rendu hereditary haemorrhagic telangiectasia

+ Spindle cell hemangioma

+ Angiokeratoma

+ Granulation tissue

+ Intravascular hemangioma of Masson

+ Granuloma pyogenicum

+ Senile hemangioma

+ Acquired tufted hemangioma

+ Microvenular hemangioma

+ Verrucous hemangioma

+ Targetoid hemosiderotic hemangioma

+ Nevus araneus

+ Acral arteriovenous hemangioma

+ Cherry hemangioma

+ Epithelioid hemangioma (angiolymphoid hyperplasia)

+ Kimura disease

+ Bacillary angiomatosis

+ Acroangiodermatitis

+ Nevus anemicus

+ Nodi hemorrhoidales

+ Vascular dilatation

+ Vascular tumors of borderline malignancy

+ Epithelioid hemangioendothelioma

+ Retiform hemangioendothelioma

+ Kaposiform hemangioendothelioma

+ Malignant tumors of blood vessels

+ Dabska tumor (papillary hemangioendothelioma)

+ Kaposi's sarcoma

+ Angiosarcoma

+ Tumors of lymphatic vessels

+ Lymphangioma

+ Glomus tumor

+ Glomangioma

+ Hemangiopericytoma

+ Tumors of the smooth muscle

+ Pilar leiomyomas

+ Angioleiomyoma

+ Genital leiomyomas

+ Leiomyosarcoma

+ Rhabdomyoma, rhabdomyomatous mesenchymal hamartoma

+ Adenoma (angiofibroma) sebaceum Pringle

+ Pearly penile papules

+ Histiocytic tumors and proliferations

+ Xanthoma

+ Juvenile xanthogranuloma

+ Necrobiotic xanthogranuloma

+ Reticulohistiocytoma

+ Benign cephalic histiocytosis

+ Giant cell tumor of the tendon sheath

+ Giant cell tumor of the skin or soft tissue

+ Histiocytic sarcoma

+ Neurogenic tumors

+ Benign neurogenic tumors

+ Neurofibroma

+ Recklinghausen's disease

+ Schwannoma (neurilemmoma)

+ Traumatic neuroma

+ Neurohamartoma

+ Neurothekeoma

+ Granular cell tumor, Abrikosoff

+ Malignant neurogenic tumors

+ Epithelioid sarcoma

+ Lymphomas

+ WHO classification of skin lymphomas

+ Pseudolymphoma, lymphocytoma

+ B cell pseudolymphoma

+ T cell pseudolymphoma

+ Cutaneous lymphoproliferative infiltrates other than lymphomas

+ Insect bite reaction

+ Sinus histiocytosis with massive lymphadenopathy Rosai-Dorfman

+ Leishmaniasis

+ Angioimmunoblastic lymphadenopathy

+ Skin lesions in nodal lymphomas

+ T cell lymphomas

+ Small plaque parapsoriasis

+ Large plaque parapsoriasis

+ Mycosis fungoides

+ Folliculotropic mycosis fungoides

+ Granulomatous Slack Skin

+ Pagetoid reticulosis Worringer Kolopp

+ Sézary syndrome

+ CD 30+ T cell lymphoproliferative disorders of the skin

+ Lymphomatoid papulosis

+ Anaplastic large cell lymphoma T

+ Subcutaneous panniculitis-like alpha/beta T cell lymphoma

+ Primary cutaneous peripheral T cell lymphoma, unspecified

+ CD8 positive T cell lymphoma (cytotoxic)

+ T cell receptor gamma/delta chain positive cutaneous lymphoma

+ Pleomorphic small to medium-sized T cell lymphoma

+ NK cell lymphoma (CD56+)

+ Adult T cell lymphoma

+ Syringolymphoid hyperplasia with alopecia

+ Pleomorphic medium-sized and large T cell lymphoma (HTLV-1 +/-)

+ Juvenile granulomatous cutaneous T cell lymphoma

+ B cell rich T cell lymphoma

+ Angiocentric and angiodestructive lymphoma

+ T zone lymphoma, Lennert and Mohri

+ Intravascular T lymphoma

+ B cell lymphomas

+ Follicular lymphoma

+ Secondary skin infiltration in nodal follicular lymphoma

+ Marginal zone lymphoma

+ Marginal zone lymphoma, immunocytoma variant

+ Marginal zone lymphoma, plasmocytoma variant

+ Large cell diffuse B cutaneous lymphoma

+ Large B cell diffuse lymphoma, leg type

+ Large cell diffuse B lymphoma, other than leg type

+ T cell rich B cell lymphoma

+ Intravascular B lymphoma

+ Lymphoblastic lymphoma B

+ Lymphomatoid granulomatosis (Liebow)

+ Lymphatic leukemia B

+ Mantle cell lymphoma

+ Burkitt lymphoma

+ Acute hematopoietic malignancies

+ Blastic NK cell lymphoma CD4+/CD56+ hematodermic neoplasm

+ Precursor lymphoblastic leukemia/lymphoma

+ Precursor lymphoblastic leukemia/lymphoma B

+ Precursor lymphoblastic leukemia/lymphoma T

+ Hodgkin's disease of the skin

+ Skin infiltrates in granulocytic malignancies

+ Acute myeloic leukemia

+ Myelosarcoma

+ Chloroma

+ Melanocytic tumors

+ Melanocytic nevus

+ Common melanocytic nevi

+ Lentigo simplex

+ Junctional melanocytic nevus

+ Compound melanocytic nevus

+ Dermal nevus

+ Speckled lentiginous nevus, nevus spilus

+ Balloon cell nevus

+ Halo nevus

+ Melanocytic nevus with clonal proliferation

+ Eczematized melanocytic nevus

+ Recurrent melanocytic nevus

+ Melanocytic nevus on a skin graft

+ Melanocytic nevus in pregnancy

+ Giant melanocytic nevus

+ Deep penetrating nevus

+ Nevus Spitz

+ BAP-1 negative melanocytic nevus

+ Pigmented spindle cell nevus (Reed)

+ Blue nevus

+ Blue nevus of common type, of dendritic melanocytes

+ Cellular blue nevus

+ Special forms of blue nevi

+ Combined nevi

+ Melanocytic nevus of the conjunctiva

+ Melanoma

+ Lentigo maligna

+ Lentigo maligna melanoma

+ Intraepidermal melanoma (melanoma in situ)

+ Superficial spreading melanoma, SSM

+ Superficial spreading melanoma, vertical growth

+ Nodular melanoma

+ Nevoid melanoma

+ Acrolentiginous and mucosal melanoma

+ Melanoma ex nevo

+ Balloon cell melanoma

+ Small cell melanoma

+ Desmoplastic melanoma

+ Melanoma developing within congenital nevus, child, 6 years

+ Melanoma of the conjunctiva

+ Melanoma metastases

+ Merkel cell carcinoma

+ Cysts of the skin and subcutis

+ Cysts with epithelial lining

+ Cysts with lining of epidermal type

+ Epidermal (infundibular) cyst

+ Epidermal cyst combined with HPV infection

+ Epidermal verrucous cyst combined with HPV infection

+ Epidermal inclusion cyst

+ Hair matrix cyst

+ Epidermal proliferating cyst

+ Trichilemmal cyst

+ Proliferating trichilemmal cyst

+ Dermoid cyst

+ Cystic teratoma

+ Cystic teratoma of the ovary

+ Pigmented follicular cyst

+ Steatocystoma multiplex

+ Skin keratocyst

+ Vellus hair cyst

+ Cystis colli mediana, thyreoglossal duct cyst

+ Giant comedo

+ Milium

+ Preauricular sinus (pit)

+ Thymic cyst

+ Bronchogenic cyst

+ Branchial cleft cyst

+ Cutaneous ciliated cyst of the lower limbs

+ Vulval mucinous and ciliated cyst

+ Gartner's duct cyst

+ Endometriosis

+ Median raphe cyst

+ Hidrocystoma

+ Eccrine hidrocystoma

+ Apocrinne hidrocystoma (and its papillary variant)

+ Apocrine cystadenoma (papillary)

+ Non-epithelial cysts, pseudocysts

+ Ganglion, synovial cyst

+ Digital mucous cyst

+ Mucocele

+ Pilonidal sinus

+ Pseudocyst of the auricle

+ Parasitic cyst

+ Soft tissue lesions

+ Some lesions of the oral cavity

+ Dermatovenerology

+ Syphilis

+ Gonorrhea

+ Trichomonas vaginalis

+ Pathology of the foreskin, phimosis, balanitis

+ Balanitis

+ Balanitis plasmocellularis Zoon

+ Balanitis circinata

+ Phimosis, paraphimosis, frenulum breve and other lesions of the penis

+ Collection of histological slides by prof. Günter Burg

+ Collection of histological slides by prof. Werner Kempf

+ Collection of histological slides of dr. Ram Chandra Adhikari

Granulomatous Slack Skin

Clinical signs

very rare disease
bulky, hanging folds of lax skin in flexural areas
age: 20 – 50 years, very rare in childhood

Histology

Nodular and diffuse infiltrate in all levels of the dermis. Epidermotropism is usually lacking.

Small, well differentiated T lymphocytes, similar to those in mycosis fungoides. In addition multinucleated giant cells are scattered throughout the infiltrate.

Elastic fibres in papillary and reticular dermis are lost. Fragments of these fibres can be found in the cytoplasm of some giant cells.

Immunophenotype and genetic features:

small lymphocytes have T helper phenotype: CD3+, CD4+, CD8-, CD30-
giant cells: lysozym+, S100+, CD68+ but vimentin-, MAC387-
clonal TCR gene rearrangement can be demonstrated in most cases

Granulomatous slack skin (2397)

Pictures

Granulomatous slack skin: Granulomatous slack skin, HE 20x (2394) Granulomatous slack skin, HE 20x (2395) Granulomatous slack skin, HE 40x (2396) Granulomatous slack skin, HE 40x (2397) Granulomatous slack skin (lymphoma), HE 40x (2212)

Another case: Granulomatous slack skin, HE 20x (4368) Granulomatous slack skin, HE 60x (12886)