Histology

A superficial perivascular infiltrate of small lymphoid cells is the most prevalent finding in skin biopsies of SS patients. Larger studies of SS biopsies demonstrated that a subepidermal perivascular or band-like infiltrate composed of predominantly small lymphocytes with or without nuclear atypia is the most common finding in SS,

Figure 3 Palmar hyperkeratosis and erythema.
Figure 4 Sparse lymphocytic infiltrate in the upper dermis with few lymphocytes in the junctional zone.

present in about 40% of cases (8,9). The epidermis often shows psoriasiform acanthosis. Nonspecific findings are present in one-third of the biopsies (10) (Fig. 4). A band-like, variably intense, monomorphous infiltrate of small lymphocytes with or without nuclear atypia was found in approximately 30% of specimens (Fig. 5), whereas epidermotropism and lining-up of lymphocytes with cerebriform nuclei (MF-like pattern) was found in approximately 20-40%, half of which exhibited Pautrier collections (8,10) (Figs. 6 and 7). Pautrier collections are regarded as a specific, but relatively rare, finding in epidermotropic CTCL such as MF and SS (11). Edema is often present in initial stages of epidermotropic CTCL but may be replaced over time by fibrosis of papillary dermis. Occasionally, granulomatous features can be seen in SS lesions (8,12). Both intra-rater as well as inter-rater variability is high in the diagnosis of SS (13). Although Pautrier collections and acanthosis are more frequently present in SS than in MF, histological features do generally not allow differentiation between the two disorders (14,15). Pretreatment of skin lesions with PUVA or steroids may eliminate epidermotropic T-cells and render the

Figure 5 Band-like lymphocytic infiltrate in the upper dermis without epidermotropism.
Figure 6 Perivascular lymphocytic infiltrate with lining up and epidermotropism of atypical lymphocytes as well as initial Pautrier microabscesses.

histologic findings nonspecific. Single apoptotic keratinocytes may indicate previous therapeutic intervention in such biopsies.

Lymph nodes show dermatopathic changes in early stages of the disease, whereas effacement of normal architecture by a dense, diffuse, and monotonous infiltration of small lymphoid cells is found in later specific involvement.

How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.

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  • stuart williamson
    When did cyocell start?
    8 years ago

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