1. DISEASES OF SKIN
Dr. Umme Kulsum Munmun
Assistant Professor,
Department of Pathology,
Chandpur Medical College

8. Diseases of Skin
 Inflammatory dermatoses:
- Urticaria (hives)
- Eczematous dermatitis
- Erythema multiforme

9. Inflammatory Dermatoses
 Hives
 Urticaria (wheal)
 Generalized
 Allergic reaction
 Bee sting
 Medications
 IgE mediated
 Histamine release
 Vascular dilation
 Fluid in tissues

10. Eczema, ‘Boiling Over’
 Allergic contact dermatitis
 Atopic dermatitis
 Drug related atopic dermatitis
 Photoeczematous dermatitis
 Red, papulovesicular, oozing and crusted lesions
 Scaling plaque, if persistent

11. Chronic Inflammatory
Dermatoses
 Persistent, months to years
 Skin is roughened due to excessive or abnormal scale
formation and shedding
 Thickening
 Scaling
 Roughening
 Variable inflammation of dermis

12. Chronic Inflammatory
Dermatoses
 Seborrhoec dermatitis – regions with high density
of sebaceous glands, scalp etc

13. Psoriasis
 Ag/Ab reaction?
 Knees, elbows,
scalp, lumbosacral
areas, intergluteal
cleft, glans
 Whole body is
pretty bad
 At areas of trauma
 Pink to salmon –
colored plaque
covered by loosely
adherent silver
white scale

14. Lichen Planus
 Resolving spontaneously
1 to 2 years after onset
 Flat topped, pruritic,
pink-purple, polygonal
papule with white
lacelike patterns of lines
 Papules may coalesce to
form plaques

15. Lupus Eyrthematosis
 Autoimmune
 Two forms
 Systemic
 Discoid (skin only)
 Systemic problems
 Kidney failure
 Vasculitis and
 DVT with emboli
 Antibodies in serum
 Anti-DNA
 Other nuclear

16. Infections of Skin
 Bacterial
 Impetigo – Superficial bacterial infection
 Abscesses
 Acne – occlusion of sebaceous glands
 Fungal
 Ringworm
 Viruses
 Verurcae (warts), molluscum contagiosum, smallpox

17. Impetigo

18. Acne

19. Verrucae (Warts)
 Squamoproliferative disorders
 Caused by HPV
 Gray white to tan papules
 Verrucae vulgaris- most common, occur
anywhere, frequently on hands, periungual
areas
 Verrucae plana or fat wart- face, hands
 Verrucae plantaris- sole
 Verrucae palmaris- palm
 Condyloma acuminatum (veneral wart) –
genital region

20. Verrucae (Warts)

21. Disorders of Epidermal
Maturation
 Icthyosis

22. Epithelial tumours
 Benign:
- Seborrheic keratosis
- Acanthosis nigricans
- Keratoacanthoma
- Fibroepithelial polyp
- Epidermal cyst
Seborrheic Keratosis

23. Epithelial tumours
 Premalignant:
- Actinic Keratosis

24. Epithelial tumours
Malignant

25. Basal Cell
Carcinoma
 The most common malignancy
we suffer from.
 Solar exposed skin.
 Common site- above imaginary
line joining angle of mouth and
pinna
 Pearly papule
 Raised edges
 Maybe central ulceration

26. Basal Cell Carcinoma
 Slow growing tumors
 Do not metastasize usually
 Recognized at early stage
 Cured by local excision
 A small number (0.5%) of tumors are locally
aggressive
 Also called rodent ulcer

27. Squamous Cell Carcinoma
 Arises from
differentiated
squamous epithelium
 Sun exposed
 UV
 Metastasizes

28. Squamous Cell
Carcinoma
 Cells produce keratin
pearls
 Invade and spread
 High mitotic count

29. Squamous Cell Carcinoma
 Keratin Pearls

30. Disorders of Pigmentation

31. Vitiligo
 Autoimmune basis
 Hypopigmented/ white plaque
 pigment forming cells known as melanocytes
are injured

32. Vitiligo

33. Proliferative Melanocytic
Lesions
 Nevi
 Benign growths of young melanocytes.
 Many of them congenital.
 Dysplastic nevus
 Abnormal maturation.
 May become malignant
 Malignant melanoma

34. Dermal Nevus
 Clusters of young melanocytes.
 Confined to dermis.

35. Nevi

36. Dysplastic Nevus
 Abnormal maturation of nevus cells
 May proceed to malignant melanoma
 Sometimes part of a familial syndrome.

37. Malignant Melanoma
 Malignant melanocytic tumor
 Very unpredictable tumor
 Genetics
 Solar and UV exposure
 Ethnic
 Radial growth followed by
 Penetrating phase
 Metastasis

38. Malignant Melanoma
 Nodular or vertical
growth
 Depth >2 mm
 Bad development
 Sites
 Skin
 Conjunctiva
 Retina
 Iris
 Meninges

39. Dermal Tumors
 Fibroma

40. Xanthomas
 Histiocytes
containing lipid
 Around eyes
 Extensor surfaces
of extremities
 Diabetes
 Liver disease
 Hyperlipidemia

41. Blistering Conditions
 Pemphigus vulgaris
 Bullous pemphigoid
 Dermatitis herpetiformis

42. Cleft Position is Important
 Subcorneal: Impetigo
 Suprabasalar: Pemphigus vulgaris
 Subepidermal or basilar:
 Bullous pemphigoid
 Dermatitis herpatiformis

43. Pemphigus vulgaris
-

44. Bullous Pemphigoid
 Antibodies against hemidesmosomes.
 Hemidesomsomes anchor epidermis to
basement membrane

45. Skin Adnexal (Appendage) Tumour
 Eccrine poroma- sweat gland differentiation
 Cylindroma- Ductal (apocrine or eccrine differentiation)
 Syringoma- eccrine differentiation
 Sebaceous adenoma
 Pilomatricoma – hair follicular differentiation

46. Tumours of Cellular Migrants to
Skin
 Mycosis Fungoides (Cutaneous T-cell Lymphoma)

47. THANK YOU