Pathology
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Atlas of dermatopathology
Josef Feit, Hana Jedličková, Günter Burg, Luděk Matyska, Spasoje Radovanovic et al.
Index
Contents
Authors
ExpSys: non-tumors
ExpSys: tumors
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+ Introduction
+ Literature
+ Support
+ Skin biopsy
+ Non-tumorous skin diseases
+ Skin tumors
+ Cysts of the skin and subcutis
+ Soft tissue lesions
+ Some lesions of the oral cavity
+ Dermatovenerology
+ 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
Lichen simplex
Etiology

Caused by long lasting rubbing and scratching of the pruritic skin. The original cause for the pruritus usually cannot be determined (can be caused by psychiatric disturbance as well).

Clinical signs
  • main units:
    • prurigo simplex (strophulus)
    • prurigo subacuta et chronica (hepatica, diabetica, uremica, lymphatica, gestationis etc.)
    • prurigo nodularis of Hyde
  • symetrical lesions on the extremities, upper back
  • neck, arms, legs (esp. sites within reach of the patient)
  • urticarial papules, seropapules, nodules, excoriations, pigment changes, atrophic scars
  • severe pruritus
  • prolonged course
Pictures

Prurigo chronica with depigmented scars: Prurigo, Clinical picture (1099)

Further examples of prurigo simplex:

Histology

Hyperkeratosis (usually without parakeratosis), acanthosis, hypergranulosis, fibrosis and increased number of dilated capillaries of the upper corium. Practically no spongiosis, infiltrate none or slight. Sometimes excoriations are found, sometimes only tiny subepidermal deposits of fibrin. In such lesions exocytosis and parakeratosis can be present.

Pictures

Lichen simplex: Lichen simplex chronicus, HE 10x (572) Lichen simplex chronicus, HE 40x (573)

Another case: Lichen simplex chronicus, HE 40x (4184)

Excoriation: Excoriation, HE 40x (4767)

Excoriation, fresh prurigo: Prurigo, excoriation, HE 20x (5410)

Prurigo: Prurigo, HE 20x (5246)

Prurigo simplex, chronic papular urticaria: Prurigo simplex, HE 40x (10895)

Pruritus vulvae, susp. corynebacteria infection: Pruritus vulvae, bacteria, HE 60x (14572) Pruritus vulvae, bacteria, HE 60x (14573) Pruritus vulvae, bacteria, Gram 60x (14571) Pruritus vulvae, bacteria, PAS 60x (14574)

Strophulus
Prurigo gestationis