Necrotic Keratinocytes

References:

1. Cabanillas F, Armitage J, Pugh WC, et al. Lymphomatoid papulosis: a T-cell dyscrasia with a propensity to transform into malignant lymphoma. Ann Intern Med 1995; 122(3):210-217.

2. El-Azhary RA, Gibson LE, Kurtin PJ, et al. Lymphomatoid papulosis: a clinical and histopathologic review of 53 cases with leukocyte immunophenotyping, DNA flow cytometry, and T-cell receptor gene rearrangement studies. J Am Acad Dermatol 1994; 30(2 Pt 1):210-218.

3. Gellrich S, Wernicke M, Wilks A, et al. The cell infiltrate in lymphomatoid papulosis comprises a mixture of polyclonal large atypical cells (CD30-positive) and smaller monoclonal T cells (CD30-negative). J Invest Dermatol 2004; 122(3):859-861.

4. Wood GS, Crooks CF, Uluer AZ. Lymphomatoid papulosis and associated cutaneous lymphoproliferative disorders exhibit a common clonal origin. J Invest Dermatol 1995; 105(1):51-55.

Necrotic Keratinocyte
(C)
Necrotic Keratinocytes

Figure 1 Erythema multiforme minor and major. There is obscuration of the dermoepidermal junction with vacuolar alteration of the basal keratinocytes (A and B). Necrotic keratinocytes may be individual or confluent (B). The process may progress to frank subepidermal vesiculation (C). Toxic epidermal necrosis with confluent, full-thickness epidermal necrosis (D). Note the preservation of the basket-weave horn.

Figure 1 Erythema multiforme minor and major. There is obscuration of the dermoepidermal junction with vacuolar alteration of the basal keratinocytes (A and B). Necrotic keratinocytes may be individual or confluent (B). The process may progress to frank subepidermal vesiculation (C). Toxic epidermal necrosis with confluent, full-thickness epidermal necrosis (D). Note the preservation of the basket-weave horn.

Epidermal Necrotic Keratinocytes

Figure 2 Acute graft versus host reaction (GvHR). There is a sparse lymphocytic infiltrate obscuring the dermoepidermal junction (A). Lymphocytes are present in the epidermis (exocytosis) with adjacent individually necrotic keratinocytes (satellite cell necrosis) (B). Chronic GvHR. There is acanthosis of the epidermis with hypergranulosis and a patchy band-like lymphocytic infiltrate. The dermis isfibrotic (C).

Figure 2 Acute graft versus host reaction (GvHR). There is a sparse lymphocytic infiltrate obscuring the dermoepidermal junction (A). Lymphocytes are present in the epidermis (exocytosis) with adjacent individually necrotic keratinocytes (satellite cell necrosis) (B). Chronic GvHR. There is acanthosis of the epidermis with hypergranulosis and a patchy band-like lymphocytic infiltrate. The dermis isfibrotic (C).

Hypergranulosis Dermpath Vacuolar Alteration Fixed Drug Eruption

Figure 3 Systemic lupus erythematosus. There is obscuration of the dermoepidermal junction with vacuolar alteration of the basal keratinocytes with a sparse lymphocytic infiltrate (A and B). Dermatomyositis. This may appear identical to systemic lupus erythematosus. There is a sparse lymphocytic infiltrate with vacuolar alteration of the basal keratinocytes (C). Abundant mucin interposed between the dermal collagen bundles (D). (Continued)

Figure 3 Systemic lupus erythematosus. There is obscuration of the dermoepidermal junction with vacuolar alteration of the basal keratinocytes with a sparse lymphocytic infiltrate (A and B). Dermatomyositis. This may appear identical to systemic lupus erythematosus. There is a sparse lymphocytic infiltrate with vacuolar alteration of the basal keratinocytes (C). Abundant mucin interposed between the dermal collagen bundles (D). (Continued)

Normal Cutaneos Mucin Lbasal Membrane KeritinocytesNecrotic Keratinocytes

Figure 5 Discoid lupus erythematosus. There is a superficial and deep perivascular and periadnexal lymphocytic infiltrate with vacuolar alteration of the basal keratinocytes (A and B). A dense lymphocytic infiltrate surrounds the follicular adnexae with obscuration of the epithelial-stromal junction(C). Note the marked thickening of the basement membrane (D).

Discoid Lupus Basement Membrane

Figure 5 Discoid lupus erythematosus. There is a superficial and deep perivascular and periadnexal lymphocytic infiltrate with vacuolar alteration of the basal keratinocytes (A and B). A dense lymphocytic infiltrate surrounds the follicular adnexae with obscuration of the epithelial-stromal junction(C). Note the marked thickening of the basement membrane (D).

Figure 4 Lichen sclerosus et atrophicus (LS et A), early. There is marked edema of the upper dermis with a patchy, band-like predominantly lymphocytic infiltrate interposed between the altered collagen of the upper dermis and the normal collagen of the lower dermis (A and B). Fully developed LS et A. There is effacement of the rete ridge pattern of the epidermis with vacuolar alteration of the basal keratinocytes and sclerosis of the dermis (C).

Sclerosis Atrophicus Pictures

Figure 6 Pityriasis lichenoides et varioliformis acuta (PLEVA). There is a superficial and deep perivascular lymphocytic Infiltrate that obscures the dermoepidermal junction (A). Neutrophils are in the stratum corneum admixed with degenerated necrotic keratinocytes and parakeratotic corneocytes (B). Necrotic keratinocytes are scattered throughout the epidermis and erythrocytes are interposed between the keratinocytes (C).

Figure 6 Pityriasis lichenoides et varioliformis acuta (PLEVA). There is a superficial and deep perivascular lymphocytic Infiltrate that obscures the dermoepidermal junction (A). Neutrophils are in the stratum corneum admixed with degenerated necrotic keratinocytes and parakeratotic corneocytes (B). Necrotic keratinocytes are scattered throughout the epidermis and erythrocytes are interposed between the keratinocytes (C).

Keratinocytes

Figure 7 Fixed drug eruption. There is obscuration of the dermoepidermal junction with a mixed inflammatory cell Infiltrate composed of lymphocytes numerous eosinophils and neutrophils (A and B). Necrotic keratinocytes can be identified throughout all levels of the epidermis (A) and may tend toward confluence. A mixed perivascular infiltrate can be present in the deep dermis (C).

Figure 7 Fixed drug eruption. There is obscuration of the dermoepidermal junction with a mixed inflammatory cell Infiltrate composed of lymphocytes numerous eosinophils and neutrophils (A and B). Necrotic keratinocytes can be identified throughout all levels of the epidermis (A) and may tend toward confluence. A mixed perivascular infiltrate can be present in the deep dermis (C).

Wedge Shaped Hypergranulosis Wedge Shaped Hypergranulosis

Figure 8 Lichen planus. There Is compact orthokeratosis with no parakeratosis, wedge-shaped hypergranulosis, jagged acanthosis of the epidermis, and a band-like lymphocytic infiltrate obscures the dermoepidermal junction (A-C). Necrotic keratinocytes are in the lower one-third of the epidermis with colloid bodies in the superficial papillary dermis (D).

Figure 8 Lichen planus. There Is compact orthokeratosis with no parakeratosis, wedge-shaped hypergranulosis, jagged acanthosis of the epidermis, and a band-like lymphocytic infiltrate obscures the dermoepidermal junction (A-C). Necrotic keratinocytes are in the lower one-third of the epidermis with colloid bodies in the superficial papillary dermis (D).

Lichen Planus Like Eruption
Figure 9 Lichenoid drug eruption. The histologic presentation can be identical to lichen planus (A). Differentiating features may include focal pararkeratosis, necrotic keratinocytes in all layers of the epidermis, and eosinophils within the infiltrate (B and C).
Lichen Planus Like Keratosis
Figure 10 Lichen planus-like keratosis. The histologic presentation can be identical to lichen planus (A). Differentiating features may include focal parakeratosis (B), and residual solar lentigo at the edge of the lesion (C).
Lichen Planus Like Keratosis Histology
Figure 11 Lichenoid pigmented purpura. There is a band-like lymphocytic infiltrate that does not obscure the dermoepidermal junction (A). Extravasated erythrocytes and/or hemosiderin-laden macrophages are a prominent feature (B and C).
Dermoepidermal JunctionLichen Striatus Histology
Figure 13 Lichen striatus. There is a superficial and deep perivascular and periadnexal lymphohistiocytic infiltrate with a band-like component that obscures the dermoepidermal junction (A). The epidermis is hyperplastic with spongiosis and may show exocytosis of lymphocytes (B).
Lichen Striatus

Figure 14 Secondary syphilis. The histologic presentation can be highly variable. The characteristic features include a superficial and deep perivascular and lichenoid lymphohistiocytic infiltrate obscuring the dermoepidermal junction with acanthosis of the epidermis (A and B). Plasma cells are present in 80% of cases.

Figure 14 Secondary syphilis. The histologic presentation can be highly variable. The characteristic features include a superficial and deep perivascular and lichenoid lymphohistiocytic infiltrate obscuring the dermoepidermal junction with acanthosis of the epidermis (A and B). Plasma cells are present in 80% of cases.

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Responses

  • Maria Berg
    What is necrotic keratinocytes near eyes mean?
    4 years ago
  • zoe
    WHAT IS RARE NECROTIC BASAL KERATINOCYTES?
    2 years ago
  • bisrat
    What is necrotic keratinocytes within the epidermis?
    2 years ago
  • nora
    Is scattered necrotic keratinocytes bad?
    6 months ago
  • cordelia
    What conditions are necrotic keratinocytes seen in?
    3 months ago

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