Periadnexal lymphocytic infiltrate Careful examination for epidermotropism and lymphocytic atypia, followed by immunophenotyping and/or molecular studies, will allow for correct diagnosis of granulomatous mycosis fungoides (Pfaltz et al. Some sections show prominent sebaceous glands. The patient had a history of chronic obstructive pulmonary disease (COPD) treated with seretide (GlaxoSmithKline Pharma A/S, Brøndby, Denmark) (salmeterol, fluticasone) and short courses of prednisolone (Nycomed, Roskilde In lupus tumidus perivascular and periadnexal lymphocytic infiltrates without epidermal alteration (Figure 7 a, b) but with prominent dermal mucin deposits are found (Figure 7 b). A confluent Jessner's lymphocytic infiltration of the skin (JLIS) is a cutaneous, benign disease characterized by asymptomatic erythematous papules, sometimes grouped with an arciform disposition located on the face or back, without further scarring. Periodic acid schiff stain revealed thickening of the basement membrane, which was focally disrupted by the lymphocytic infiltrate. 53). There is still debate Connective tissue diseases are classically associated with periadnexal inflammation. The histological findings were consistent with lymphocytic infiltration The histomorphologic presence of either a dense, nodular lymphocytic infiltrate or a perivascular and periadnexal atypical lymphocytic infiltrate extending into the subcutaneous fat, or both, should be a clue to the pathologist to consider a B-cell lymphoproliferative process. We report 2 cases of primary cutaneous CD4+ small/medium T-cell Our second case is a 70-year-old Caucasian man recently diagnosed with CLL/small lymphocytic lymphoma who developed an erythematous papular rash on the neck and face with biopsy revealing superficial and deep perivascular and periadnexal lymphocytic inflammation with scattered eosinophils. I leprosy in evolution toward multibacillary leprosy . Shoulder, biopsy: Superficial and deep perivascular and periadnexal lymphocytic infiltrate with plasma cells Board review style answer #2. 11 In contrast, Silverberg et al. The viral cultures and direct fluorescent antibody studies were negative. Focal interface dermatitis Periadnexal lymphocytic infiltrate Dermal melanin deposits: Nonavailability of the direct immunofluorescence technique: Facial erythema Positive: ANA 1/640 (anti-dsDNA, anti-RNP and anti-SM antibodies) Leukopenia Lymphopenia Acute cutaneous lupus erythematosus Synovitis: A 0. 2 In those giving a morbilliform eruption the infiltrate is mainly going to be lymphocytic with much reduced numbers of eosinophils and neutrophils and there may be some basal layer vacuolisation. 10). Additional findings include follicular plugging, apoptotic keratinocytes, and a plasma cell inflammatory infiltrate [24, 25]. Download: Download high-res image (1MB) A four-mm punch biopsy of one of the dermal plaques, including the underlying adipose tissue, illustrated superficial and deep periadnexal and perivascular lymphocytic infiltrates, no changes at the dermal-epidermal junction, with increased dermal mucin, favoring tumid lupus erythematosus (Figures 2 and 3). Lichen striatus can exhibit in addition to lichenoid inflammation a superficial and deep perivascular and periadnexal infiltrate [27]. lymphoid hyperplasia along with lymphocytoma cutis and malignant lymphomas used to encompass skin diseases with lymphocytic infiltrates. 3). The histological findings show a moderate to abundant perivascular, and periadnexal lymphocytic infiltrate throughout the reticular dermis, with no epidermal involvement and lack of plasma cells . Histopathologically, there are superficial and deep perivascular and periadnexal lymphocytic infiltrates without epidermal changes. Lymphocytes are predominantly T cells (CD4 > CD8+) with a small B cell and histiocytic Lupus erythematosus is the prototypic interface dermatitis associated with a perivascular and perifollicular lymphocytic infiltrate, Discoid (chronic cutaneous) lupus. Neoplastic cells: variable cytomorphology, depending on the type of lymphoma. Central chest, biopsy: Tumid lupus erythematosus (see comment) Comment: There is a superficial and deep perivascular and periadnexal lymphocytic infiltrate with plasma cells. There is still debate Cutaneous lymphoid infiltrates (CLIs) are common in routine dermatopathology. Indeed, these cases have to be classified as early BL. The patient was started All cases required histopathologic analysis from periorbital areas to confirm the diagnosis with biopsies finding a combination of a variation of findings including superficial and deep perivascular and periadnexal lymphocytic infiltrate, marked interstitial mucin deposition, and vacuolar alteration of basal layers. The density of the infiltrate is variable and can be sparse to moderately dense. Cytotoxic markers are typically expressed, Epidermotropic reactive lymphocytic infiltrates can create significant diagnostic challenges, particularly in the diagnosis of eczematous (spongiotic A mild lymphocytic infiltrate with marked epidermotropism is noted on histology. , Borrelia sp. Weedon's Skin Pathology E-Book - Page 88 (James W. 1b, c). 6 is grouped with Diagnostic Related Groups - MS-DRG Mapping. The histologic diagnoses recorded were BLI (78), lymphocytic infiltrate ofunspecified type (19), perivascular and perifol licular lymphocytic infiltrate (8), BLI versus TLE is typified histologically with a lack of epidermal changes, abundant dermal mucin, and intense perivascular and periadnexal lymphocytic infiltrate . Most cases lack substantive alterations of the epidermis such as follicular plugging or hyperkeratosis though epidermal atrophy and mild vacuolar degeneration of the basal layer are reported in 30 1, 3,4 Some studies have been done on Jessner's lymphocytic infiltrate by Willimze et al, Vanhale et al, Winkelman et al, Cerio et al, Dippel et al and they found that it is predominantly T cell There is a superficial and deep perivascular and periadnexal lymphocytic infiltrate with vacuolar alteration of the basal keratinocytes (A and B). Less common patterns: epidermotropism may occasionally occur. A superficial and deep perivascular lymphocytic infiltrate with perieccrine extension and microthrombi formation similar to idiopathic chilblains is found in chilblain-like lesions, and although a continuum spectrum toward acral ischemia has been postulated, 38 microscopic findings support a distinct pathogenesis. Cardiovascular system Digestive system Microscopic findings from 2 biopsies included lymphocytes at the dermoepidermal junction with mild interface dermatitis, a dense lymphocytic infiltrate that was concentrated around adnexae and Histopathologically, LET is characterized by a superficial and deep periadnexal and perivascular lymphocytic infiltrate and increased dermal mucin. There are necrotic keratinocytes at the dermoepidermal junction overlying a thickened eosinophilic basement membrane zone. The histopathological examination showed edema in upper dermis, discrete perivascular and periadnexal lymphocytic infiltrate without granulomatous reaction and interstitial mast cells in mast cell tryptase and c‐Kit staining (Figure (Figure2). More than 90% of cases of SLE occur in women, frequently starting at There are dense perivascular and periadnexal lymphocytic infiltrates and only sparse mucin between collagen bundles. Eczematous pattern. The epidermis was normal with only slight vacuolar degeneration at the dermoepidermal junction (Fig. Specimens with germinal cen ters or germinal-center-1ike aggregates were excluded. The disease runs a chronic course and is rarely described in the literature. The presence of photosensitivity, distribution of lesions, absence of gross serum Download scientific diagram | A, Superficial and deep lymphocytic infiltrate perivascular and periadnexal infiltrate. g. If the stimulus The diagnostic approach to CLIs and the most common differential imitators of lymphoma is discussed herein based on six predominant morphologic and immunophenotypic, Jessner lymphocytic infiltration of the skin (also known as lymphocytic infiltrate of Jessner) is a benign, cutaneous disease characterized clinically by asymptomatic, spontaneously resolving, Jessner lymphocytic infiltration of the skin (JLIS) is the term used to describe a rare, benign cutaneous condition characterized by papular or plaque-like eruptions that commonly Biopsy shows a superficial perivascular lymphocytic infiltrate (Figs 8. 1 Since the original description there has been much discussion whether it deserves recognition as a specific disease entity. There was also a prominence of diffuse mucin deposition throughout the This disease is diagnosed by biopsy revealing perivascular and periadnexal clusters of plasmacytoid monocytes within the dermis, sometimes extending into the subcutaneous tissue. B, Deep periadnexal lymphocytic infiltrate with increased dermal mucin This disease is diagnosed by biopsy revealing perivascular and periadnexal clusters of plasmacytoid monocytes within the dermis, sometimes extending into the subcutaneous tissue. B, Hyaline necrosis in the fat with foci of lobular panniculitis. The eruption resolves When approaching a skin biopsy showing a dermal inflammatory cell infiltrate, one must take note of the presence and type of epidermal alteration, vascular changes, stromal response, and the character of the infiltrate itself. Cellular blue nevi have a second component that consists of pale ovoid melanocytes arrayed in nests and fascicles The cellular plasma membranes appear distinct and there is often a permeative lymphocytic infiltrate Download scientific diagram | Patient 6: (a, b) Perivascular and periadnexal nodular lymphoplasmacytic infiltrates with eosinophils in the dermis and subcutis is observed. deep reticular dermis, and lymphocytic lobular . Cytological atypia is absent. The patient was started on hydroxychloroquine for possible cutaneous lupus erythematosus. In challenging cases, increased mucin Jessner's lymphocytic infiltration of the skin (JLIS) is a cutaneous, benign disease characterized by asymptomatic erythematous papules, sometimes grouped with an arciform disposition located on the face or back, without further scarring. (Original magnifications: A, ×40; B, ×100. On immunohistochemistry staining, infiltrating cells were mostly positive for CD8 and negative for CD4 Focal parakeratosis; admixture of cell-rich and cell-poor band-like lymphocytic infiltrate; focal hypergranulosis and “saw-tooth” rete pegs; vacuolar degeneration of basal layer with occasional colloid body; abundant incontinent pigment; extravasated erythrocytes in dermal papillae; perivascular and periadnexal lymphocytic infiltrates. Cytotoxic markers are typically expressed, and the Ki-67 and EBER + is lower Lymphocytic infiltrate refers to the presence of excessive lymphocytes (a type of white blood cell) in a particular tissue or organ. The lymphocytic infiltrate is superficial and predominantly perivascular. Different causative agents (e. DRGs are used to standardize the way hospitals and other Punch biopsies from both patients showed a superficial and deep perivascular and periadnexal lymphocytic infiltrate with focal extension into the subcutaneous fat. 8 , 9 A, Superficial and deep lymphocytic infiltrate perivascular and periadnexal infiltrate. Histopathology showed mild acanthosis, vacuolization of the basal layer with necrotic keratinocytes and exocytosis of red blood cells and lymphocytes, and a dermal perivascular and periadnexal lymphocytic infiltrate with no atypia (fig. The lymphocytes reveal nuclear atypia and align along the dermal–epidermal junction (H&E, ×200). B, Deep periadnexal lymphocytic infiltrate with increased dermal mucin Skin biopsy showed a dense perivascular and periadnexal lymphocytic infiltration in the reticular dermis evoking Jessner’s lymphocytic infiltration of the skin (JLIS) (Figure 3, Figure 4 sleeve-like lymphocytic dermal infiltrate with a predominance of small mature polyclonal lymphocytes and without epidermal involvement (Lipsker Skin biopsy specimen showing a dense, superficial and deep, perivascular, and periadnexal lymphocytic infiltrate. E, CD123 highlighted clusters of Lichen planus generally lacks the deep dermal and periadnexal inflammation seen in lupus. Main conditions [2] Characteristics Micrograph Photograph In the dermis, there was a perivascular and periadnexal lymphocytic infiltrate . (B) Superficial and deep perivascular and periadnexal dermatitis. If the histopathologic findings definitively support a diagnosis of tumid lupus, the patient should be evaluated for systemic disease, despite the weak association with SLE. The former presents as superficial and deep perivascular and periadnexal lymphocytic inflammation while the latter is a lymphocytic lobular panniculitis with hyalinization of the subcutaneous fat associated Cutaneous pseudolymphomas (PSLs) belong to a group of lymphocytic infiltrates that histopathologically and/or clinically simulate lymphomas. Figure 1. The infiltrate is of variable density but is often very sparse. Mucin may be increased in the dermis. The inflammation around the hair follicles is more evident at the level of the mid-portions. Dermal mucin is increased. Fibrosis is seen in the He was diagnosed with Morbihan disease according to clinical findings. Note the marked thickening of the basement membrane (D). Patient with Jessner’s lymphocytic infiltration of the skin (A) before treatment and (B) after treatment with methotrexate. (x20H&E). Perivascular, periadnexal infiltrate of lymphocytes and plasma cells (sometimes it can be lichenoid) Histologic examination typically reveals a normal epidermis, dermal coat-sleeve–like perivascular, and to a less extent, periadnexal lymphoid infiltrates, consisting mainly of T lymphocytes. Arthropod bite reactions can give quite a marked perivascular infiltrate, both superficial and deep, but the eosinophils are the prominent feature in In those giving a morbilliform eruption the infiltrate is mainly going to be lymphocytic with much reduced numbers of eosinophils and neutrophils and there may be some basal layervacuolisation. It can be very difficult to Jessner lymphocytic infiltration is histologically characterized by a dense perivascular, predominantly lymphocytic infiltrate with no epidermal changes [6]. Nearly all biopsies had a prominent superficial and deep dermal eosinophilic infiltrate (85%); however, a robust lymphocytic infiltrate primarily composed of T‐cells (40% of biopsies) was also seen. Our patient's clinical presentation and histopathologic findings were consistent with a Download scientific diagram | Skin biopsy showing perivascular (blue arrow) and periadnexal (hair follicle and sebaceous gland depicted by yellow and red arrow, respectively) lymphocytic This variant may resemble folliculotropic DLE by virtue of periadnexal and perivascular infiltrates in the absence of a significant interfollicular interface dermatitis. , injected substances, tattoo, arthropod bite) have Lupus erythematosus (LE) is among the group of vacuolar interface dermatitis (prototype erythema multiforme). 11. Answer C is incorrect because prominent keratinocyte necrosis Perivascular lymphocytic infiltrate. final diagnosis: superficial perivascular lymphocytic infiltrate what does this mean? A doctor has provided 1 answer. 2011). Atopic dermatitis is a common chronic inflammatory skin disease with a prevalence of up to 20% in children and 8% in adults []. In late-stage papules, the porcelain-white areas were better developed and the lesion flattened. Early papules in Degos disease are skin colored and can demonstrate a superficial and deep perivascular, periadnexal, and perineural chronic inflammatory cell infiltrate associated with interstitial mucin deposition, as shown in the images below. Variant of LP: Hypertrophic LP: shows parakeratosis and mixed dermal infiltrate. ria. (C) Lichen striatus, showing perieccrine lymphocytic infiltrate (H&E; original magnification ×10). - Lymphocytic infiltrate of the dermo-epidermal junction - Lymphocytic infiltrate located superficial and deep perivascular and periadnexal -vacuolar degeneration of the dermal-epidermal junction: IFD: Lupus band - At the dermal-epidermal junction consisting of deposits of IgG, IgM, IgA, and complement fractions (C3) Other Patchy lymphocytic infiltrate defines a group of conditions in which there is a marked infiltrate throughout the dermis that is arranged in well delineated patches, generally with a perivascular, interstitial, and a periadnexal distribution. Combination of perivascular, interstitial, and periadnexal patterns is common (Figs. ( Figure 2 ) Important features of other cutaneous LE subtypes, such as vacuolization of the basal membrane and epidermal changes are missing. Objectives To re‐evaluate a large cohort of patients with the clinical and/or histological diagnosis or The histopathological diagnosis of dermal-based lymphoid infiltrates and proliferations is often challenging due to the vast list of biologically diverse entities that archetypally or occasionally center in the mid-dermis, especially because significant overlap exists in their clinical, histopathologic, and immunophenotypic features. The infiltrate was predominantly composed of mature T lymphocytes (Fig. . The annular erythema seen in SS is associated with vacuolar and lichenoid interface dermatitis associated with a dermal perivascular and periadnexal lymphocytic infiltrate (Fig. 3). 1 Classification of Rowell syndrome remains controversial, given overlapping clinical features of erythema multiforme and cutaneous LE (CLE). OBSERVATION: Three middle-aged patients of both sexes had palpable migratory arciform erythema with 1, several, or Differential diagnosis is usually supported by histopathological examination, which typically shows interface dermatitis with keratinocytic cell death, which is a differentiating factor with other ACLE subtypes, as well superficial perivascular and periadnexal lymphocytic infiltrate with interstitial mucin deposition [14,30,31]. In well-developed lesions, extensive vacuolar degeneration leads to subepidermal clefting or vesiculation. The pattern of periadnexal and perivascular lymphocytic infiltrate in both LET and JLIS have been stated as being extremely similar. Histologic examination revealed lobular lymphocytic panniculitis with hyaline necrosis of the fat and presence vacuolar degeneration of the basement membrane, and perivascular and periadnexal lymphocytic infiltrates. It Additionally, interface dermatitis with lymphocytic infiltrate along the dermo-epidermal junction and mild perivascular and periadnexal lymphocytic infiltrates were noted. –Tumid lupus: photodistributed, superficial and deep perivascular’periadnexal lymphocytic infiltrate, mucin Lymphocytic infiltrate around the superficial vascular plexuses and along the DEJ. The epidermis and papillary dermis are relatively normal. DIF can show granular intracytoplasmic IgG deposition in the basal keratinocytes corresponding to anti-SSA or SSB antibodies and a lichenoid tissue reaction in lymphocytic infiltrate with few histiocytes and plasma cells beneath a normal epidermis. 6; L98. B, Deep periadnexal lymphocytic infiltrate with increased dermal mucin. Lichen planus Perivascular lymphocytic infiltration was present in more TKAs (40%) than overall hip arthroplasties (24%) without difference in severity. The evaluation Lymphocytic infiltrate of Jessner: Variant of tumid lupus erythematosus Erythematous annular plaques that heal without scarring or dyspigmentation Superficial and deep perivascular and periadnexal lymphocytic infiltrate with plasma cells Absence of epidermal changes and mucin in dermis is differentiating feature from discoid lupus erythematosus Differential diagnosis is usually supported by histopathological examination, which typically shows interface dermatitis with keratinocytic cell death, which is a differentiating factor with other ACLE subtypes, as well superficial perivascular and periadnexal lymphocytic infiltrate with interstitial mucin deposition [14,30,31]. A periadnexal Focal parakeratosis; admixture of cell-rich and cell-poor band-like lymphocytic infiltrate; focal hypergranulosis and “saw-tooth” rete pegs; vacuolar degeneration of basal layer with occasional colloid body; abundant incontinent pigment; extravasated erythrocytes in dermal papillae; perivascular and periadnexal lymphocytic infiltrates. H&E: Prominent interface dermatitis, focal vesicle formation, lichenoid infiltrate, prominent dyskeratotic keratinocytes with epidermal necrosis, and superficial to mid-dermal perivascular, periadnexal lymphocytic infiltrate and follicular plugging Dense perivascular and periadnexal lymphocytic infiltrates are common in the dermis. The epidermis often shows foci of spongiosis. Over the last 50 years several case reports and smaller studies have been published Microscopically acute GVHD is a vacuolar interface dermatitis characterized by a usually mild superficial perivascular lymphocytic infiltrate with varying amounts of epidermal damage consisting of Download scientific diagram | A, Superficial and deep lymphocytic infiltrate perivascular and periadnexal infiltrate. 6 Foci of plasmacytoid monocytes are seen within the cutaneous infiltrates. Direct immunofluorescence and Additionally, perineural lymphocytic infiltrate is seen in one case, periadnexal infiltrate in four cases and pigment incontinence in one case. Alcian blue staining showed mucin deposition . Superficial and mid-dermal perivascular lymphocytic infiltrate with focal vacuolar change at Download scientific diagram | Dense perivascular and periadnexal lymphocytic infiltration in the reticular dermis. However, differentiating a reactive CLI from a malignant lymphocytic infiltrate is often a significant challenge since many inflammatory dermatoses can clinically and/or histopathologically mimic cutaneous lymphomas, coine As a result, one is generally dependent on the constellation of dermal findings: perivascular and periadnexal lymphocytic infiltrates and interstitial dermal mucin deposition. No peribulbar inflammation is present in the sections examined. Biopsy of malar area showing superficial and deep perivascular and periadnexal lymphocytic infiltrate (haematoxylin and eosin, ×100). Direct immunofluorescent studies are negative The main findings are the perivascular and periadnexal lymphocytic inflammatory infiltrate in the superficial and deep dermis, as well as interface dermatitis, characterized by the aggression of lymphocytes to the dermo-epidermal junction. (C) Infiltrates of lymphocytes are accompanied by mucin in abundance in the interstitium. Epithelioid cell granulomas with caseating necrosis and ruptured hair follicles are characteristic histological features of lupus miliaris disseminatus faciei. The majority of infiltrating lymphocytes are CD4 + T helper lymphocytes. The pattern of periadnexal and perivascular lymphocytic infiltrate in both LET and JLIS have been stated as being extremely similar. 2. Arthropod bite reactions can give Download scientific diagram | (A) Dense, superficial perivascular and periadnexal infiltrates of lymphocytes and eosinophils in the dermis and focal, superficial, small epithelioid granulomas with The interface reaction pattern classically refers to a predominantly mononuclear infiltrate that is centered at the dermoepidermal junction and targets basal keratinocytes, its damage manifesting as apoptotic keratinocytes, vacuolar change, and pigment incontinence [1]. 1d); some B lymphocytes and rare plasma cells were To the Editor: Rowell syndrome is characterized by erythema multiforme–like lesions with serologic and historical evidence of lupus erythematosus (LE). What is the differential diagnosis for Rowell syndrome? The differential diagnosis for Rowell syndrome includes [2,21,31,32,34]: Discoid LE; Subacute cutaneous LE (SCLE) Acute cutaneous LE (ACLE) SCLE or ACLE with SJS/TEN-like lesions Lymphocytic infiltration of the skin or Jessner’s lymphocytic infiltrate is a rare dermatosis of unknown etiology. ) He was further evaluated by the rheumatology department, and no systemic findings were noted. These features were in line with those observed by Sonthalia et al. A transient inflammatory stimulus results in slight hyperaemia and a mild perivascular lymphocytic infiltrate. Background Lymphocytic infiltration of the skin (LIS) and reticular erythematous mucinosis (REM) are characterized histologically by an inflammatory cutaneous lymphocytic infiltrate similar to the histological appearance of pseudolymphoma. Accurate histological diagnosis, although it can sometimes be difficult to establish, is essential for clinical management. A 69-year . 30. Lichenoid drug reaction. 1 It is believed that these plasmacytoid monocytes are involved in the A superficial and deep perivascular and periadnexal lymphocytic infiltrate is the most common finding in all lesions of LE . and a variable lymphocytic infiltrate in the dermis inflammatory infiltrate [3]. 4, 8. Lymphocytic infiltrate refers to the presence of excessive lymphocytes (a type of white blood cell) in a Histology shows a periadnexal lymphocytic infiltrate and periadnexal CD123+ plasmacytoid dendritic cells [32]. 29 Although there is consensus on the overall pre-domi-nance of lymphocytes, there is still considerable debate The histopathologic features of cutaneous lupus mucinosis consist of a characteristic abundance of dermal mucin in addition to a slight to moderately dense perivascular and periadnexal lymphocytic infiltrate. Microscopic examination of the skin biopsy showed an intraepidermal vesicle with eosinophils, eosinophilic spongiosis, and an accompanying diffuse and dense perivascular and periadnexal lymphocytic infiltrate with numerous eosinophils . The epidermis is intact. DLE shows both an interface and lichenoid dermatitis with a superficial and deep dermal lymphocytic inflammatory infiltrate that has a both perivascular and periadnexal distribution (Fig. A member asked: In the dermis, there is a perivascular, mainly lymphohistiocytic inflammatory infiltrate. Microscopically, dense 46 perivascular and periadnexal lymphocytic infiltrates are seen with sparing of the papillary dermis 47 and epidermis, along with mucin deposits in the reticular dermis. The inflammatory infiltrates were best characterized as perivascular (90%) and periadnexal (70%) in most cases. There are increased vellus hairs present. 5 Ackermann et al 7 divided the A lesion with superficial lymphocytic infiltrate without additional histopathologic characteristics can be due to for example drug reactions and insect bites. Anyway, it is important to remember that TLE, particularly in the European literature, has been neglected mainly because it has not always been considered a separate entity. Ackerman distinguished 2 major types of lymphocytic interface reaction patterns based on Comment: Histological sections show a decrease in hair follicles with a mild periadnexal lymphocytic infiltrate around the upper third of the hair follicle. Affiliations: Beth Israel Deaconess Medical Center, Mayo The most common pattern of reaction encountered is the superficial perivascular inflammatory infiltrate. (JLIS) is one of a group of conditions characterized histologically by a lymphocytic infiltrate in the dermis. Histologically, LET shows a superficial and deep perivascular and periadnexal lymphocytic infiltration of the skin with prominent mucinous dispositions. The finding of solid AFB indicates evolution This disease is diagnosed by biopsy revealing perivascular and periadnexal clusters of plasmacytoid monocytes within the dermis, sometimes extending into the subcutaneous tissue. No interstitial infiltrates, or mucin deposition is found. It presents with highly pruritic eczematous skin lesions affecting the face, neck, and extensor sites of the extremities in infants, as well as chronically inflamed Exaggerated arthropod-bite lesions in patients with chronic lymphocytic leukemia: a clinical, histopathologic, and immunopathologic study of eight patients. Conclusions: The differential diagnosis of lichenoid and granulomatous dermatitis should also encompass primary cutaneous Mycobacterium infection in addition to the other more characteristic entities associated wtih this distinctive reaction pattern. Skin biopsy demonstrated superficial perivascular lymphocytic infiltrate with rare neutrophils and extravasated erythrocytes with negative in situ hybridization for SARS-CoV-2 spike protein in a patient with urticarial macules and patches; similarly, another biopsy showed superficial and deep perivascular and periadnexal lymphocytic infiltrate Histologic examination of the biopsy specimen showed a slight orthokeratosis, follicular hyperkeratosis, increased basal layer pigmentation, perivascular and periadnexal lymphocytic infiltrate with vasodilatation, and pigmentary incontinence with dermal melanophages . A dense lymphocytic infiltrate surrounds the follicular adnexae with obscuration of the epithelial-stromal junction(C). Pattern: variable density, from sparse to dense diffuse dermal infiltrates with variable pannicular extension. Compared to non-MoM hips, MoM bearings were more commonly associated with PVLI (59% versus 18%) and demonstrated increased severity (41% versus 3% greater than mild). A, Hematoxylin-eosin stain shows periadnexal, dermal, and subcutaneous lymphocytic infiltrate. Summary. Previously reported cases generally showed a similar clinical course and similar There is a lymphocytic interface dermatitis with basal layer degeneration. [2] [notes 2] Lymphoeosinophilic infiltrate. Figure 8 (A) Smooth surfaced erythematous papules and plaques on the face. Punch biopsy from the face. Lupus is the prototypic inflammatory dermatosis associated with a perivascular and periadnexal infiltrate occurring both superficially and deep, increased dermal mucin –Lymphocytic infiltrate of Jessner (predominantly T-cell) –Polymorphous light eruption – plaque form (seasonal, photodistributed, pathology shows dermal edema, perivascular T-lymphocytic infiltrate). Jessner lymphocytic infiltrate — tumid lupus erythematosus (essentially DLE without epidermal changes) may be indistinguishable from DLE and some authorities believe There was interface dermatitis with lymphocytic infiltrate along the dermo-epidermal junction and mild perivascular and periadnexal lymphocytic infiltrates. 2 Our objective was to identify histologic and Jessner lymphocytic infiltrate and tumid lupus are cutaneous conditions characterized by the presence of rich dermal lymphocytic infiltrates with a superficial, deep, perivascular and periadnexal distribution that include copious amounts of dermal mucin deposition. Epidermal atrophy and apoptotic keratinocytes are more prominent than in discoid lupus erythematosus (DLE). On follow-up, she presented with a new violaceous rash on the superior Lymphocytic infiltration of the skin (LIS), first reported by Jessner and Kanof in 1953, is a disease of unknown etiology characterized by erythematous papules and plaques on the head, neck, and upper back and histopathological findings of a normal epidermis with underlying lymphocytic infiltration of the reticular dermis without mucin deposition. There is prominent vacuolar degeneration of basal cells without their obliteration by a band-like interface lymphocytic infiltrate , in addition to the superficial and deep perivascular and periadnexal infiltrate. Skin biopsy in ACLE reveals basal layer degeneration, edema of the upper dermis, interface dermatitis with a mononuclear cell infiltrate at the dermal-epidermal junction, mucin deposition, hyperkeratosis, and perivascular and periadnexal inflammation (lymphocytic infiltrate) . Discoid lupus erythematosus. The classic histopathologic findings of cutaneous lupus erythematosus include an interface dermatitis with basal cell vacuolization as well as a lymphocytic perivascular and periadnexal inflammatory cell infiltrate . 1 Superficial and deep perivascular and periadnexal lymphocytic infiltrate with abundant mucin +/−: Negative: LE panniculitis: Indurated erythematous plaque with a predilection for head and neck and proximal extremities: Lobular lymphocytic panniculitis with hyaline fat necrosis, paraseptal lymphoid nodules, ± epidermal and dermal changes of Lymphocytic infiltrate of Jessner Vandana Mehta Rai MD DNB, C Balachandran MD Dermatology Online Journal 12 (7): 26 Biopsy from a plaque revealed normal epidermis with well demarcated dense perivascular infiltrate and periadnexal infiltrate in the reticular dermis composed of mature lymphocytes. Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. The histopathologic features are characterized by a patchy inflammatory perivascular and periadnexal T-lymphocytic infiltrate throughout the dermis. Deligdisch found a higher frequency of lymphocytic infiltrates in low grade tumors confined to the endometrium and suggested that the infiltrates were an expression of immune response possibly associated with a favorable outcome. 2 cm punch biopsy of the patient’s right lateral chin showed a superficial and deep dermal perivascular and periadnexal lymphocytic infiltrate, and a normal dermal-epidermal junction. It was first described in 1953 by Jessner and Kanof. Figure 1 Figure 2; Figure 1. 1d). Interface dermatitis can be classified based upon the cell type that dominates the infiltrate (ie, neutrophilic, lymphocytic, or lymphohistiocytic) or by the intensity of the interface inflammation. 5). There was no evidence of panniculitis. Pathology by systems. Histopathology in our study revealed epidermal orthokeratosis, dilated hair follicles, follicular plug, keratin, perifollicular parakeratosis and orthokeratosis, and perivascular and periadnexal lymphocytic infiltrate as predominant findings. 12. Recently, a histopathologic study involving 245 patients with UV indicated that UV may be hallmarked by a predominantly lymphocytic infiltrate, Perifollicular and interstitial mucin deposits, perivascular and/or periadnexal lymphocytic infiltrates, without signs of vasculitis: Linear/granular IgG/IgM along the dermal-epidermal junction: There is a superficial and deep perivascular and periadnexal lymphocytic infiltrate with plasma cells. Such cases can be of T- or NK-cell origin and have EBV expression. These findings are more frequent when the lesions are associated with discoid lupus. E. The histological image of a nodule was one of lobular lymphocytic panniculitis with homogeneous hyalinization of adipose nodules, to which must be added periadnexal and perivascular dermo-epidermal lymphocytic infiltrates. A member asked: As discussed above, the classic histopathologic findings are abundant interstitial mucin and a dermal perivascular and periadnexal lymphocytic infiltrate. 4 x 0. Note the absence of dermal-epidermal junctional involvement (hematoxylin and eosin, magnification × 5). Detail of the lymphocytic infiltrate Histology from the back showed dense superficial and deep, perivascular and periadnexal infiltrates of lymphocytes together with a few macrophages and solitary plasma cells (Fig. B. 160, 186 Follicular plugging is typical. A. Of the periadnexal infiltrates Histopathology of discoid lupus erythematosus and lupus panniculitis on scalp. 1c). It can be very difficult to Sometimes the spindled melanocytes have a periadnexal distribution. Superficial and deep perivascular and periadnexal lymphocytic infiltrate with plasma cells Absence of epidermal changes and mucin in dermis is differentiating feature from discoid lupus erythematosus. 42,43,51 Although a paucicellular lymphocytic infiltrate is the rule, Abstract. A section from the same skin specimen showing the deposition of abundant amounts of mucin in the papillary Other features included a prominent perineural and periadnexal lymphocytic infiltrate. from Jessner lymphocytic infiltrate and tumid lupus are cutaneous conditions characterized by the presence of rich dermal lymphocytic infiltrates with a superficial, deep, perivascular and periadnexal Clinical patterns of skin diseases with eosinophilia and examples. It usually involves superficial and deep dermis. Laboratory analysis did not show evidence of myositis. D, Ki-67 highlighted scattered lymphocytes. 2). Perivascular and periadnexal lymphocytic Background: Palpable migratory arciform erythema is clinically characterized by sharply circumscribed, infiltrated erythematous patches that tend to spread irregularly, resulting in arciform morphologic features. found that lymphocytic infiltrates at the tumor–myometrium junction was more To complicate matters, a spectrum including TLE with lymphocytic infiltrate of Jessner and reticular erythematous mucinosis (REM) has been postulated . Palpable arciforme migratory erythema and lymphocytic infiltration of the skin Jessner-Kanof are nowadays primarily assigned to the spectrum of LE. Open in a new tab. - Infiltrate, infiltration - skin (lymphocytic) - L98. 14 Also, In conclusion, lupus erythematosus tumidus and Jessner's lymphocytic infiltrate should be considered as a single disease process with flexible and inclusive diagnostic criterion, considering clinical The histopathologic features are characterized by a patchy inflammatory perivascular and periadnexal T-lymphocytic infiltrate throughout the dermis. Figure 2. 21. MF/SS: Band-like papillary dermal infiltrate with epidermotropism (patch stage) and formation of Pautrier's microabscesses (collection of atypical lymphocytes in the epidermis), atypical lymphocytes with 'cerebriform' nuclei in the upper dermis and epidermis (plaque stage), or diffuse dermal lymphocyte infiltrate (tumor stage). Immediately subjacent to this, enlarged pale cells with abundant, vacuolated cytoplasm were situated in loose perifollicular collections in an elastotic dermis Band-like lymphocytic infiltrate with admixed histiocytes. Lobular lymphocytic panniculitis, fat necrosis, hyaline fat degeneration, and abundant mucin deposition are also seen . Occasionally, nodular collections of A moderate perivascular and periadnexal lymphocytic infiltrate and a mild increase in dermal mucin • Subacute cutaneous lupus erythematosus (SCLE) and neonatal lupus erythematosus-prominent interface change with numerous individually necrotic dyskeratotic keratinocytes, less prominent hyperkeratosis and inflammatory cell infiltrate than DLE • The dermal changes include marked papillary dermal edema and a perivascular and/or periadnexal and often lichenoid infiltrate that may be lymphocyte predominant, lymphohistiocytic, histiocytic predominant, or frankly granulomatous and that is of greatest intensity in the papillary dermis and extends as loose perivascular aggregates into the Additional features of fully developed papules included a prominent lymphocytic vasculitis affecting venules, a mild periadnexal infiltrate of neutrophils and/or eosinophils, and interstitial A high index of suspicion should be maintained when a lymphocytic infiltrate is present in addition to the epithelioid granulomas. Histopathologic examination demonstrated patulous follicles intimately associated with a vacuolar interface reaction and a permeative perijunctional lymphocytic infiltrate (Figure 1). (B) A profile of lymphocytic mixed panniculitis with hyaline necrosis (red arrows) of the Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that has protean manifestations and follows a relapsing and remitting course. The epidermis is normal without inflammation at the dermo-epidermal interface. Infiltrated (A) Lichen striatus, presenting with multiple erythematous papules in linear distribution. Immunofluorescence has been advocated as being useful but results may be confusing. Patterson) These secretory cells lie on a basal lamina that is surrounded by myoepithelial cells and periadnexal dermis The infiltrate is both superficial and deep, and has a periadnexal distribution. The following four conditions, along with JLIS, Entities in this category are characterized by the absence of significant epidermal change and the presence of an inflammatory infiltrate that is largely restricted to the superficial, or superficial and deep dermis around periadnexal infiltrates of lymphocytes in the mid‑ and . Staining with PAS showed thickening of the basement membrane, which was focally disrupted by the lymphocytic infiltrate. C, Epidermal atrophy and basement membrane zone thickening. 2, and 21. 4 Cutaneous lupus mucinosis bears striking histologic similarities to cutaneous lupus erythematosus, but the unusual amount of mucin Dermal oedema with eosinophilic infiltrate in dermis: Jessner’s lymphocytic infiltrate: Erythematous papules or plaques, may be annular, expanding peripherally, in sun-exposed area: UVA and UVB provocative photo testing: Normal epidermis, dense perivascular and periadnexal CD8+T cell lymphocytes and plasmacytoid monocytes infiltrates within Additional features of fully developed papules included a prominent lymphocytic vasculitis affecting venules, a mild periadnexal infiltrate of neutrophils and/or eosinophils, and interstitial mucin deposition. Moderately dense, bottom heavy, superficial and deep perivascular and periadnexal lymphocytic infiltrates with minimal or absent eosinophils. (A) Perivascular and periadnexal lymphocytic infiltrations from the upper dermis to the deep dermis. Histologically, PVLI correlated (r = 0. Based on variable histopathologic findings, it is important to consider erythema migrans in the differential diagnosis for Superficial inflammatory dermatoses are very common and comprise a wide, complex variety of clinical conditions. Download scientific diagram | H&E, 40×—Superficial and deep perivascular and periadnexal lymphocytic infiltrate, epidermal atrophy, follicular interface changes with follicular hyperkeratosis. Figure 1 Erythematous infiltrated papules and plaques interesting the face. (B) Lichen striatus, showing perivascular and periadnexal lymphocytic inflammation (H&E; original magnification ×2). Epidermal thinning Scalp biopsy showed interface dermatitis, dense perivascular and periadnexal lymphocytic infiltrate, mucin and scarring alopecia. Regarding lymphocytic interface dermatitis, there are 2 broad categories: cell-poor interface dermatitis, when only a sparse infiltrate of inflammatory cells is present Cases progressing toward BL might be characterized by predominant perivascular and periadnexal lymphocytic infiltrate rather than macrophages, representing a diagnostic pitfall. The significance and potential danger of a lymphocytic infiltrate depend on several Jessner’s lymphocytic infiltration of the skin (JLIS) is a skin condition of unknown aetiology characterized by erythematous papules and plaques located on the head, neck and upper back. There are dense perivascular and periadnexal lymphocytic infiltrates and only sparse mucin between Findings from a punch-biopsy specimen from the lesion of the back revealed a moderately dense lymphocytic infiltrate of the superficial and mid-dermis with perivascular and perifollicular distribution (Fig. Jessner lymphocytic infiltration is histologically characterized by a dense perivascular, predominantly lymphocytic infiltrate with no epidermal changes [6]. 1, 21. J Am Acad Dermatol, alteration of interstitial tissue is more common than a wedge-shaped inflammatory infiltrate. LE/LP overlap syndrome: besides the classic lichenoid inflammatory features, there is presence of dermal mucin and periadnexal inflammation. Parakeratosis, subtle spongiosis and increased pandermal interstitial mucin were also present. Fig. 14 Also, the infiltration in both can be found involving both the papillary and mid-dermis (Fig 4). C, Mucin deposition. 1 The infiltrate is both superficial and deep, and has a periadnexal distribution. Differential Diagnosis. Granular IgM deposits arranged along the dermo-epidermal junction were observed at direct cutaneous immunofluorescence.
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