Dermpath-India

Site created by

Dr Sampurna Roy MD

       

http://www. histopathology-india.net/dermpath.htm

    

 

Custom Search

Pathology of Prurigo Nodularis                   

Dr Sampurna Roy MD

"Skin lesion characterized by Pseudo-Epitheliomatous Hyperplasia"

Dermatopathology Quiz Case No. 51

Diagnosis: Prurigo Nodularis

Skin Appendage Tumour

     

http://www.   histopathology-india.net/SAClass.htm

 March  2014

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

submit to reddit

 

Histopathology-India.net

Surgical-Pathology.com

Pathology-India.com

Pathopedia-India.com

Pancreatic Pathology Online

Gall Bladder Pathology Online

Paediatric Pathology Online

Paraganglioma-Online

Endocrine Pathology Online

Eye Pathology Online

Ear Pathology Online

Cardiac Path Online

Lung Tumour-Online

Mesothelioma-Online

Pulmonary Pathology Online

Nutritional Pathology Online

Environmental Pathology Online

Pathology Quiz Online

Dermpath-India

GI Path Online

Soft Tissue Pathology

Case Index

Infectious Disease Online; INDEX: A-D ; INDEX: E-L ; INDEX: M-P INDEX: Q-Z ; FUNGAL DISEASE ; VIRAL DISEASE.

E-book - History of  Medicine with special reference to India.

Dermatopathology Cases

Basic Pathology Blog

diagnostichistopathology. blogspot.com

 

Cutaneous Deposits

Calcinosis Cutis

Cutaneous Ossification (Osteoma Cutis)

Cartilaginous Lesions of the Skin

Lipoid Proteinosis

Pathology of Colloid Milium

Gout

Silicone granulomas


Prurigo nodularis is an uncommon lesion that presents as extremely pruritic nodules with a  wide anatomical distribution but particularly on extensor aspects of limbs.

Often lesions are multiple but solitary nodules can occasionally occur.

Lesions tend to be symmetrical and are associated with excoriations.

Females are more often affected than males.

Many authors consider this condition as part of the spectrum of lichen simplex.

Atypical mycobacteria may be a contributing factor in prurigo nodularis.

Microscopic features: 

Histopathology reveals psoriasiform hyperplasia or pseudo-epitheliomatous hyperplasia  ;

Marked hyperkeratosis with hypergranulosis and focal parakeratosis ;

Occasional spongiosis and exocytosis of mononuclear cells;

Scale crust formation in association with changes of excoriation (fibrin deposition and cellular debris) ;

Prominent hyperplasia of hair follicles;

Mild fibosis of papillary and superficial dermis and telangiectasia ;

Mild to moderate perivascular mononuclear inflammatory cell infiltrate composed of lymphocytes, histiocytes and plasma cells ;

Nerve hyperplasia as reported in the past is not usually a feature.

 

Differential diagnosis: Diagnosis is not difficult if the biopsy is big enough.

In small biopsies differential diagnosis include Keratoacanthoma and other causes of pseudo-epitheliomatous hyperplasia.

Note:   Pseudoepitheliomatous (pseudocarcinomatous) hyperplasia :  This is a benign pathological reaction pattern, histologically  characterized by bulbous thickening of  squamous epithelium (follicular infundibula and acrosyringium).

There is abrupt transition  beween lesion and adjacent epidermis. The cells have abundant often glassy cytoplasm.

Pseudoepitheliomatous hyperplasia is seen in the following conditions:

Chronic irritation ;  skin trauma ;  dermal inflammatory processes like  chromomycosis ;    aspergillosis ;  pyoderma, Prurigo nodularis ; Granuloma fissuratum and in associatiation with chondrodermatitis nodularis helicis ; Spitz nevus , melanoma, overlying granular cell tumour and cutaneous T cell tumour .

 

                            

Further reading:

Prurigo nodularis and dialyzer membrane.

Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patients. 

Prurigo nodularis: a review.

Increased nerve growth factor- and tyrosine kinase A-like immunoreactivities in prurigo nodularis skin -- an exploration of the cause of neurohyperplasia.

Eosinophil cationic protein- and eosinophil-derived neurotoxin/eosinophil protein X-immunoreactive eosinophils in prurigo nodularis.

Light and electron microscopic immunohistochemical observations of p75 nerve growth factor receptor-immunoreactive dermal nerves in prurigo nodularis.

Helicobacter pylori and prurigo nodularis.

Histamine-containing mast cells and their relationship to NGFr-immunoreactive nerves in prurigo nodularis: a reappraisal.

Syringomatous changes of eccrine sweat ducts associated with prurigo nodularis.

Histopathological and bacteriological findings in prurigo nodularis.

Mycobacteria in prurigo nodularis: the cause or a consequence?

Merkel cells and prurigo nodularis.  

Mast cells, neutrophils, and eosinophils in prurigo nodularis.  

Demonstration by S-100 protein staining of increased numbers of nerves in the papillary dermis of patients with prurigo nodularis.

Granulomatous Reaction Pattern of the Skin

Granuloma Annulare

Necrobiosis Lipoidica

Necrobiotic Xanthogranuloma   

Rheumatoid Nodule

Lupus Vulgaris

Cutaneous Sarcoidosis

Melkersson Rosenthal Syndrome

Annular Elastolytic Giant Cell Granuloma

Skin lesion in Crohn's Disease

Blastomycosis-like pyoderma

Foreign body granuloma

Rosacea

Interstitial   Granulomatous   Dermatitis

Interstitial   Granulomatous Drug Reaction

 

Benign sweat gland tumours

Hydrocystoma -Eccrine/Apocrine

Hamartomas:

Eccrine/Apocrine naevus

Eccrine Angiomatous Hamartoma

Porokeratotic eccrine ostial naevus

Syringocystadenoma Papilliferum

Hidradenoma Papilliferum

Nipple Adenoma

Syringoma

Spiradenoma

Cylindroma

Chondroid  Syringoma  

Poroma

Hidradenoma

Apocrine adenoma

Papillary eccrine adenoma

Syringofibroadenoma

Malignant sweat  gland tumour 

Microcystic adnexal carcinoma

Eccrine epithelioma

Adenoid cystic carcinoma

Mucinous carcinoma

Primary extramammary Pagetís disease

Porocarcinoma

Digital papillary adenocarcinoma

Hidradenocarcinoma

Apocrine adenocarcinoma

Eccrine ductal carcinoma

Spiradenocarcinoma

 

   Disclaimer  ;  Privacy Policy  ; Advertising Policy  ;  E-mail 

           Copyright © 2014  histopathology-india.net
           All rights reserved