 | Your DermAtlas query returned at least 10 ImagesClick on the IMAGE to see an enlargement.The number of images has been limited to 10 per page. |
Next Result Set  |
| | Your DermAtlas query returned at least 10 ImagesClick on the IMAGE to see an enlargement.The number of images has been limited to 10 per page. |
| Next Result Set |
 © 2001-2009, DermAtlas | Image Name: | calcinosis_cutis_1_090401 | File Type: | jpg | |
| Diagnosis: | CALCINOSIS CUTIS | Category: | deposition disorders / Metabolic disorders | ||
| Body Site: | elbow | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | Several white rock-hard papules are present on the extensor surface of one elbow. There were no other clinical findings. | ||||
| Comments: | This 10 year old girl presented with several rock-hard papules on the elbow region. These developed over months to years and were asymptomatic. She has no other medical problems. Calcinosis cutis is often dystrophic calcification, and in this location, likely secondary to trauma. Systemic disorders, such as dermatomyositis, in a child, may present with calcinosis cutis. Systemic hypercalcemia is a rare cause of calcinosis cutis in a child. | ||||
| Related Images: | calcinosis_cutis_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | calcinosis_cutis_2_090401 | File Type: | jpg | |
| Diagnosis: | CALCINOSIS CUTIS | Category: | deposition disorders / Metabolic disorders | ||
| Body Site: | elbow | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There are collections of basaloid granular material in the superficial dermis, with overlying epidermal hyperplasia. The material is basophilic and refractile, consistent with calcium (pyrophosphate). | ||||
| Comments: | This 10 year old girl presented with several rock-hard papules on the elbow region. These developed over months to years and were asymptomatic. She has no other medical problems. Calcinosis cutis is often dystrophic calcification, and in this location, likely secondary to trauma. Systemic disorders, such as dermatomyositis, in a child, may present with calcinosis cutis. Systemic hypercalcemia is a rare cause of calcinosis cutis in a child. | ||||
| Related Images: | calcinosis_cutis_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | lichen_amyloidosis_1_090401 | File Type: | jpg | |
| Diagnosis: | LICHEN AMYLOIDOSIS | Category: | deposition disorders / papulosquamous eruptions | ||
| Body Site: | shin | Age: | 25 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The epidermis is acanthotic and papillomatous. There is hypergranulosis and orthokeratotic hyperkeratosis. Eosinophilic amorphous material collects in the dermal papillae. | ||||
| Comments: | This biopsy from a 25 year old woman was submitted to rule out hypertrophic lichen planus. She had hyperkeratotic and almost verrucous plaques on her shins. They were pruritic. This biopsy has a low power look of lichen simplex chronicus, which is a typical finding in lichen amyloidosis. The amyloid collects in the dermal papillae and consists of keratins. It is likely related to LSC as both are associated with chronic rubbing. | ||||
| Related Images: | lichen_amyloidosis_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | lichen_amyloidosis_2_090401 | File Type: | jpg | |
| Diagnosis: | LICHEN AMYLOIDOSIS | Category: | deposition disorders / papulosquamous eruptions | ||
| Body Site: | shin | Age: | 25 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The eosinophilic amorphous material, or amyloid, collects in the dermal papillae, accentuated around vessels. It is acellular. The overlying epidermis is acanthotic. | ||||
| Comments: | This biopsy from a 25 year old woman was submitted to rule out hypertrophic lichen planus. She had hyperkeratotic and almost verrucous plaques on her shins. They were pruritic. This biopsy has a low power look of lichen simplex chronicus, which is a typical finding in lichen amyloidosis. The amyloid collects in the dermal papillae and consists of keratins. It is likely related to LSC as both are associated with chronic rubbing. | ||||
| Related Images: | lichen_amyloidosis_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | amalgam_tattoo_1_090401 | File Type: | jpg | |
| Diagnosis: | TATTOO, AMALGAM / TATTOO | Category: | deposition disorders / dental/oral disorder / hyperpigmentation | ||
| Body Site: | mouth, floor of | Age: | 59 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The mucosa appears normal. In the submucosa, there is an ill-defined hyperpigmented area. | ||||
| Comments: | This 59 year old woman had a pigmented lesion biopsied from the floor of her mouth to rule out melanoma. This is a common scenario for amalgam tattoos. These lesions develop when metals from dental work leach into the soft tissues. Common metals implicated are silver, mercury, aluminum, etc. On histology, the pigment may be black, brown, or golden. The main differential diagnosis is a melanocytic lesion, like a blue nevus, but the tattoo pigment is acellular and often accentuated on elastic fibers. | ||||
| Related Images: | amalgam_tattoo_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | amalgam_tattoo_2_090401 | File Type: | jpg | |
| Diagnosis: | TATTOO, AMALGAM / TATTOO | Category: | deposition disorders / dental/oral disorder / hyperpigmentation | ||
| Body Site: | mouth, floor of | Age: | 59 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The pigment is golden brown, with variably-sized fibers. The pigment appears extracellular and is accentuated in an elastin pattern. Black granular pigment was found more superficially (not shown). There is no significant inflammatory response. | ||||
| Comments: | This 59 year old woman had a pigmented lesion biopsied from the floor of her mouth to rule out melanoma. This is a common scenario for amalgam tattoos. These lesions develop when metals from dental work leach into the soft tissues. Common metals implicated are silver, mercury, aluminum, etc. On histology, the pigment may be black, brown, or golden. The main differential diagnosis is a melanocytic lesion, like a blue nevus, but the tattoo pigment is acellular and often accentuated on elastic fibers. | ||||
| Related Images: | amalgam_tattoo_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | lichen_amyloidosis_1_070423 | File Type: | jpg | |
| Diagnosis: | LICHEN AMYLOIDOSIS | Category: | papulosquamous eruptions / deposition disorders | ||
| Body Site: | back | Age: | 60 years | ||
| Contributors: | Alde Carlo Gavino, MD Greg Hosler, MD, PhD | ||||
| Description: | Histologic section of skin shows mild deposition of hyalinized amorphous material within the papillary dermis. There is hyperkeratosis, mild acanthosis, focal dyskeratosis, and prominent pigment incontinence. | ||||
| Comments: | This 60-year old woman presented with pruritic, hyperkeratotic plaques on her back. The clinical differential diagnosis included lichen amyloidosis versus lichen simplex chronicus. Lichen amyloidosis belongs to the family of skin-limited amyloidoses which also includes macular amyloidosis and biphasic amyloidosis. The typical clinical presentation is that of severely pruritic papules and plaques on the shins or extensor surfaces of the arms of dark-colored individuals. The amyloid deposits are of keratin type (keratins 1, 5, 10, and 14) and are believed to originate from the epidermis, break through the basement membrane, and finally settle in the papillary dermis. Lichen amyloidosis is thought to result from repetitive scratching of an underlying, severely pruritic condition. | ||||
| Related Images: | lichen_amyloidosis_2_070423 | ||||
 © 2001-2009, DermAtlas | Image Name: | lichen_amyloidosis_2_070423 | File Type: | jpg | |
| Diagnosis: | LICHEN AMYLOIDOSIS | Category: | papulosquamous eruptions / deposition disorders | ||
| Body Site: | back | Age: | 60 years | ||
| Contributors: | Alde Carlo Gavino, MD Greg Hosler, MD, PhD | ||||
| Description: | Higher power view demonstrates hyalinized amorphous material deposited within and expanding the papillary dermis, reducing the rete ridges into thin septae. | ||||
| Comments: | This 60-year old woman presented with pruritic, hyperkeratotic plaques on her back. The clinical differential diagnosis included lichen amyloidosis versus lichen simplex chronicus. Lichen amyloidosis belongs to the family of skin-limited amyloidoses which also includes macular amyloidosis and biphasic amyloidosis. The typical clinical presentation is that of severely pruritic papules and plaques on the shins or extensor surfaces of the arms of dark-colored individuals. The amyloid deposits are of keratin type (keratins 1, 5, 10, and 14) and are believed to originate from the epidermis, break through the basement membrane, and finally settle in the papillary dermis. Lichen amyloidosis is thought to result from repetitive scratching of an underlying, severely pruritic condition. | ||||
| Related Images: | lichen_amyloidosis_1_070423 | ||||
 © 2001-2009, DermAtlas | Image Name: | amyloidoma_1_061101 | File Type: | jpg | |
| Diagnosis: | AMYLOIDOSIS, SYSTEMIC | Category: | deposition disorders / cutaneous sign of systemic disease | ||
| Body Site: | back | Age: | 63 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | At first glance, the slide appears washed out. Upon closer inspection, the slide is so pale because of the deposition of abundant amorphous pink material. This material forms large nodules within the dermis and is accentuated around vessels. There is a cracking artifact. | ||||
| Comments: | This middle-age man slowly developed a large nodule on his lower back. Amyloidosis occurs in a variety of forms. Primary amyloidosis of the skin can present as macular amyloidosis, lichen amyloidosis (keratin amyloid, or AK), or nodular amyloidosis. In the nodular type, there are often conspicuous plasma cells and the amyloid is of the AL (light chain) type. This was an unusual case for the skin. It formed a large mass, or amyloidoma, with associated osteoma cutis. The patient is currently being evaluated for systemic disease but so far the work-up has been negative. Amyloid can be detected by Congo Red stains conventionally. One can also detect its autofluoresence (orange color) or enhance it with a thioflavin T stain. Immunohistochemical stains for amyloid P, SAA, light chain, or keratin may also be of help. Our case stained for amyloid P and SAA. | ||||
| Related Images: | All related Images amyloidoma_3_061101 amyloidoma_2_061101 | ||||
 © 2001-2009, DermAtlas | Image Name: | amyloidoma_2_061101 | File Type: | jpg | |
| Diagnosis: | AMYLOIDOSIS, SYSTEMIC | Category: | deposition disorders / cutaneous sign of systemic disease | ||
| Body Site: | leg | Age: | 63 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | A Congo Red stain highlights the amyloid orange. In this view, fragments of bone from a large focus of metaplastic bone are evident. | ||||
| Comments: | This middle-age man slowly developed a large nodule on his lower back. Amyloidosis occurs in a variety of forms. Primary amyloidosis of the skin can present as macular amyloidosis, lichen amyloidosis (keratin amyloid, or AK), or nodular amyloidosis. In the nodular type, there are often conspicuous plasma cells and the amyloid is of the AL (light chain) type. This was an unusual case for the skin. It formed a large mass, or amyloidoma, with associated osteoma cutis. The patient is currently being evaluated for systemic disease but so far the work-up has been negative. Amyloid can be detected by Congo Red stains conventionally. One can also detect its autofluoresence (orange color) or enhance it with a thioflavin T stain. Immunohistochemical stains for amyloid P, SAA, light chain, or keratin may also be of help. Our case stained for amyloid P and SAA. | ||||
| Related Images: | All related Images amyloidoma_3_061101 amyloidoma_1_061101 | ||||
| Next Result Set |
    Books by the Dermatlas Editors | © DermAtlas, Johns Hopkins University; 2000-2009 |
Link directly to this page: http://DermAtlas.med.jhmi.edu/derm/result.cfm?Category=101755851