Rl81a85434 2007

616.5--dc22 2006051482

Visit the Informa Web site at www.informa.com

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This book is dedicated to the memory of my Dad, George H. Grant, D.D.S. who died on June 8, 2006 at noon and to my husband, Barry D. Kels, M.D., J.D. They are both gentle yet strong, demonstrate an absolute love of life and family, and my greatest supporters. In their arms, I have learned what it means to feel safe and secure. My Dad was the first man in my life that I loved with every ounce of my being and my husband is my second and last.

I am also indebted to my loving Mother, Charlotte Grant, who has been my role model for caring, grace and dignity and to my adored children, Joanna Kels Albright and Captain Charles Grant Kels, USAF. Their love has enveloped me and my love for them has given me great joy.

Preface

Why one more book on dermatopathology? Certainly there are many outstanding encyclopedic textbooks already written and even recently updated. Why one more atlas? Hopefully you will agree that this book is different. We have tried to pair clinical and histologic photographs to enhance the reader's appreciation for clinical-pathological correlation. In addition, this text is meant to be user friendly whether you are approaching dermatopathology from a background of dermatology or pathology. Herein we hope to share with you our enthusiasm as well as the helpfulness of clinical-pathological as well as pathological-clinical correlation. Ideally after reading through some of our examples, the next time you look through the microscopic oculars at a skin slide, you will ask yourself "how would this lesion look clinically?" Conversely, when you examine a skin lesion or rash in vivo, you will ask yourself "how would this look under the microscope?" Once you ask yourself these questions enough times, it will become automatic and so helpful to you in developing your differential lists, you will be incredulous that you did not always approach dermato-pathology and dermatology in this manner.

This book is not meant to be a complete review of all skin diseases. It is meant to try to teach you a different approach to the patient and to the biopsy obtained from a patient's skin. One should always be mindful of the clinical-pathologic corollaries that will help improve your diagnostic acumen. I personally hope that in addition to finding this book educational, you will also have some fun. In the words of A. Bernard Ackerman, dermatopathology is "art in vivo"!

The many authors who have contributed to this volume are the thought leaders in our field. They are scattered geographically but share their continued enjoyment in becoming better dermatopathologists. Some of the authors have been my friends, "classmates," colleagues, and teachers since I began my journey in dermatopathology in 1978! Others are younger and compose the next generation of leaders in dermato-pathology. All have brought their enthusiasm to this project for which I am grateful.

I now invite you to "see" skin disease through new oculars! Not only will the journey be fun, but it will make you a better diagnostician whether you treat patients in an office or study slides in a lab.

Jane M. Grant-Kels

Contents

Preface v

Contributors ix

1. A Philosophy of an Approach to a Slide 1

Jane M. Grant-Kels

2. Perivascular Dermatitis 5

Almut Boer

3. Interface Dermatitis 19

Gina Taylor and Edward R. Heilman

4. Psoriasiform and Spongiotic Dermatoses 33

Caroline S. Wilkel

5. Intraepidermal Vesicular and Pustular Dermatitis 41

Antoinette F. Hood

6. Subepidermal Vesiculobullous Dermatitis 57

Anita C. Gilliam and Neil J. Korman

7. Cutaneous Vasculitis 71

J. Andrew Carlson and Henry B. B. Foong

8. Nodular and Diffuse Dermatitis 97

Clifton R. White

9. Granulomatous Dermatitis 105

Jane M. Grant-Kels

10. Follicular Diseases Causing Nonscarring and Scarring Alopecia 131

Diane M. Hoss

11. Panniculitis 149

Leslie Robinson-Bostom

12. Fibrosing Dermatoses 165

Philip E. Kerr and Adrienne B. Berke

13. Benign Epithelial Neoplasms and Cysts 173

Richard L. Spielvogel

14. Premalignant and Malignant Epithelial Neoplasms 191

Jag Bhawan

15. Follicular Neoplasms 209

Ronald P. Rapini

16. Sebaceous Neoplasms 221

Rossitza Lazova

17. Glandular Adnexal (Apocrine and Eccrine) Neoplasms 235

Timothy H. McCalmont

18. Benign Melanocytic Neoplasms 247

Raymond L. Barnhill, Stephen Vernon, and Harold S. Rabinovitz

19. Malignant Melanocytic Neoplasms 279

John C. Maize

20. Fibrohistiocytic Lesions 301

Harry L. Winfield and Bruce R. Smoller

21. Vascular Proliferations 317

Philip E. LeBoit

22. Neural Neoplasms 331

Jennifer M. McNiff

23. Muscle Neoplasms 345

Vijaya B. Reddy

24. Depositions and Dermal Disorders 359

Jeff D. Harvell

25. Fat and Osseous Neoplasms 371

Clay J. Cockerell, Carlos A. Cerruto, and Dusan S. Skiljevic

26. Metastatic Neoplasms 389

George W. Elgart

27. Cutaneous Lymphomas 401

Antonio Subtil and Earl J. Glusac

28. Practical Immunohistochemistry in Dermatopathology 413

Michael J. Murphy

Index 431

Contributors

Raymond L. Barnhill Departments of Dermatology and Pathology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A.

Adrienne B. Berke UCHC Dermatopathology Laboratory, Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, U.S.A.

Jag Bhawan Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, U.S.A.

Almut Boer Dermatologikum Hamburg, Germany

J. Andrew Carlson Divisions of Dermatology and Dermatopathology, Albany Medical College, Albany, New York, U.S.A.

Carlos A. Cerruto Department of Dermatology and Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.

Clay J. Cockerell Department of Dermatology and Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.

George W. Elgart Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, U.S.A.

Henry B. B. Foong Foong Skin Specialist Clinic, Fair Park, Ipoh, Malaysia

Anita C. Gilliam Department of Dermatology, Case Western Reserve University/ University Hospitals of Cleveland, Cleveland, Ohio, U.S.A.

Earl J. Glusac Yale Dermatopathology Laboratory, Departments of Dermatology and Pathology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.

Jane M. Grant-Kels UCHC Dermatopathology Laboratory, Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, U.S.A.

Jeff D. Harvell Bethesda Dermatopathology Laboratory, Silver Spring, Maryland, U.S.A.

Edward R. Heilman SUNY-Downstate Medical Center, Department of Dermatology, Brooklyn, New York, U.S.A.

Antoinette F. Hood Departments of Dermatology, Anatomy and Pathology, Eastern Virginia Medical School, Norfolk, Virginia, U.S.A.

Diane M. Hoss UCHC Dermatopathology Laboratory, Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, U.S.A.

Philip E. Kerr UCHC Dermatopathology Laboratory, Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, U.S.A.

Neil J. Korman Department of Dermatology, Case Western Reserve University/ University Hospitals of Cleveland, Cleveland, Ohio, U.S.A.

Rossitza Lazova Yale Dermatopathology Laboratory, Department of Dermatology and Pathology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.

Philip E. LeBoit Departments of Pathology and Dermatology, University of California, San Francisco, California, U.S.A.

John C. Maize DermaPath Diagnostics, Maize Center for Dermatopathology, Mt. Pleasant, South Carolina and Medical University of South Carolina, Charleston, South Carolina, U.S.A.

Timothy H. McCalmont Department of Clinical Pathology and Dermatology and UCSF Dermatopathology Service, University of California, San Francisco, California, U.S.A.

Jennifer M. McNiff Yale Dermatopathology Laboratory, Department of Dermatology and Pathology, Yale University School of Medicine, New Haven Connecticut, U.S.A.

Michael J. Murphy UCHC Dermatopathology Laboratory, Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, U.S.A.

Harold S. Rabinovitz Departments of Dermatology and Pathology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A.

Ronald P. Rapini Department of Dermatology, University of Texas Medical School and MD Anderson Cancer Center, Houston, Texas, U.S.A.

Vijaya B. Reddy Department of Pathology, Rush University Medical Center, Chicago, Illinois, U.S.A.

Leslie Robinson-Bostom Division of Dermatopathology, Department of Dermatology, Brown Medical School, Rhode Island Hospital, Providence, Rhode Island, U.S.A.

Dusan S. Skiljevic Department of Dermatology and Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.

Bruce R. Smoller Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.

Richard L. Spielvogel Department of Dermatology and Pathology, Drexel University College of Medicine, Philadelphia, Pennsylvania and Institute for Dermatopathology, Conshohocken, Pennsylvania, U.S.A.

Antonio Subtil Yale Dermatopathology Laboratory, Departments of Dermatology and Pathology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.

Gina Taylor SUNY-Downstate Medical Center, Department of Dermatology, Brooklyn, New York, U.S.A.

Stephen Vernon Departments of Dermatology and Pathology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A.

Clifton R. White Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, U.S.A.

Caroline S. Wilkel Roger Williams Medical Center, Providence, Rhode Island, and Department of Medicine, Brown University School of Medicine, Providence, Rhode Island, and Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, U.S.A.

Harry L. Winfield Department of Pathology and Dermatology, Metrohealth Medical Center, Cleveland Skin Pathology Laboratory Inc., Cleveland, Ohio, U.S.A.

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