Subspecialty of dermatology and pathology focused on performing and interpreting tests on human tissue samples to provide scientific data and consultative opinions to referring clinicians
subcorneal
intraepidermal
subepidermal
pemphigus
nikolski's sign
pemphigus foliaceous
pemphigus vulgaris
pseudonikolski's sign
revision notes for dermatology based on lecture notes and high yield topic
based on previous year question
Subspecialty of dermatology and pathology focused on performing and interpreting tests on human tissue samples to provide scientific data and consultative opinions to referring clinicians
subcorneal
intraepidermal
subepidermal
pemphigus
nikolski's sign
pemphigus foliaceous
pemphigus vulgaris
pseudonikolski's sign
revision notes for dermatology based on lecture notes and high yield topic
based on previous year question
1. Cutaneous T-cell pseudolymphomas
A) Primarily with stripe-like infiltration (the majority of cases)
Lymphomatoid drug eruption (most cases);
Lymphomatoid contact dermatitis;
Actinic reticuloid;
Nodular scabies (individual cases);
Idiopathic forms;
Clonal cutaneous T-cell pseudolymphomas.
B) Primarily with nodular infiltration (a small percentage
of the cases)
Drug-induced – mainly by anti-convulsive drugs
Persistent nodules after insect bites;
Nodular scabies (the majority of cases).
2. Cutaneous B-cell pseudolymphomas (with nodular infiltration)
Cutaneous lymphocytoma from Borrelia burgdorferi;
Cutaneous lymphocytoma after antigens injection;
Cutaneous lymphocytoma resulting from tattoo;
Cutaneous lymphocytoma after Herpes zoster;
Idiopathic forms;
Clonal cutaneous B-cell pseudolymphomas
various cutaneous lymphomas though having low incidence but need to be diagnosed accurately. they can be mimiced by many non neoplastic conditions of skin. so discussing both T and B cell lymphomas
history of TB,epidemiology, clinical features, lab diagnosis, treatment, MDR TB, XDR TB, TDR TB, and mechanism of drug resistant, methods of identification of resistant drugs
made as a part of residency programme in dermatology. includes latest classification.includes staining characteristics. good for revision. made from contents from Rooks and Bolognia
Merkel cells (MCs) constitute a very unique population of postmitotic cells scattered along the dermoepidermal
junction. These cells that have synaptic contacts with somatosensory afferents are regarded
to have a pivotal role in sensory discernment. Several concerns exist till date as to their origin,
multiplication, and relevance in skin biology.
DARIER’S DISEASE, Keratosis folliculiris, rare genetic disorder that is manifested predominantly by skin changes, due to ATP2A2 mutation, The histology is characteristic, known as focal acantholytic dyskeratosis associated with varying degrees of papillomatosis
Lichenoid Dermatoses, Characteristics of Lichenoid Dermatoses, What are the Major Lichenoid Dermatoses, Lichen planus (LP), Introduction of LP, Epidemiology of LP, Etiology of LP, Pathogenesis of LP, Clinical Features & Clinical variants of LP, Histopathology of LP, Immunohistochemistry of LP, Differential Diagnosis of LP, Treatment of LP
1. Cutaneous T-cell pseudolymphomas
A) Primarily with stripe-like infiltration (the majority of cases)
Lymphomatoid drug eruption (most cases);
Lymphomatoid contact dermatitis;
Actinic reticuloid;
Nodular scabies (individual cases);
Idiopathic forms;
Clonal cutaneous T-cell pseudolymphomas.
B) Primarily with nodular infiltration (a small percentage
of the cases)
Drug-induced – mainly by anti-convulsive drugs
Persistent nodules after insect bites;
Nodular scabies (the majority of cases).
2. Cutaneous B-cell pseudolymphomas (with nodular infiltration)
Cutaneous lymphocytoma from Borrelia burgdorferi;
Cutaneous lymphocytoma after antigens injection;
Cutaneous lymphocytoma resulting from tattoo;
Cutaneous lymphocytoma after Herpes zoster;
Idiopathic forms;
Clonal cutaneous B-cell pseudolymphomas
various cutaneous lymphomas though having low incidence but need to be diagnosed accurately. they can be mimiced by many non neoplastic conditions of skin. so discussing both T and B cell lymphomas
history of TB,epidemiology, clinical features, lab diagnosis, treatment, MDR TB, XDR TB, TDR TB, and mechanism of drug resistant, methods of identification of resistant drugs
made as a part of residency programme in dermatology. includes latest classification.includes staining characteristics. good for revision. made from contents from Rooks and Bolognia
Merkel cells (MCs) constitute a very unique population of postmitotic cells scattered along the dermoepidermal
junction. These cells that have synaptic contacts with somatosensory afferents are regarded
to have a pivotal role in sensory discernment. Several concerns exist till date as to their origin,
multiplication, and relevance in skin biology.
DARIER’S DISEASE, Keratosis folliculiris, rare genetic disorder that is manifested predominantly by skin changes, due to ATP2A2 mutation, The histology is characteristic, known as focal acantholytic dyskeratosis associated with varying degrees of papillomatosis
Lichenoid Dermatoses, Characteristics of Lichenoid Dermatoses, What are the Major Lichenoid Dermatoses, Lichen planus (LP), Introduction of LP, Epidemiology of LP, Etiology of LP, Pathogenesis of LP, Clinical Features & Clinical variants of LP, Histopathology of LP, Immunohistochemistry of LP, Differential Diagnosis of LP, Treatment of LP
Cutaneous manifestations of hiv infectiontashagarwal
Dermatological problems occur in more than 90% of patients with human immunodeficiency virus (HIV) infection. In some patients, skin is the first organ affected. Skin diseases have proved to be sensitive and useful measures by which HIV progression can be monitored.
Approach to a case of diffuse hair loss in females
. Anagen effluvium-
(a)Dystrophic
(b)Loose anagen hair
2. Telogen effluvium –
(a)acute telogen effluvium
(b)Chronic telogen effluvium
3. Female pattern hair loss
Primary CTE –represents a primary disorder and is a diagnosis of exclusion.
Secondary CTE- secondary to variety of systemic disorders.
Iron deficiency
Other deficiency –protein calorie malnutrition ,zinc deficiency
Thyroid diseases
Metabolic diseases-chronic liver or renal failure, advanced malignancy, pancreatic disease and upper GI disorder with malabsorption
SLE and other connective tissue disorders.
HIV infection
Drug induced
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
2. Introduction
• Primary pathology involves the "interface,“
• Pattern of inflammation in which lymphocytes aggregate around
the dermal-epidermal junction, obscuring the junction at
scanning magnification.
• T-cell-mediated cytokine damage is most likely mechanism
• -> cytotoxic damage, or apoptosis of keratinocytes
• -> become detached from their neighbors,
• -> become round,
• -> undergo a sequence of events,
– degradation of nuclear DNA,
– lysis of nuclei
– coagulation of proteins in cytoplasm, without spilling enzymes
• Termed as dyskeratotic cells,
• When they find their way into papillary dermis, termed as
colloid, cytoid or Civatte bodies
3. Morphological changes
1.Primary changes
A) Basal cell vacuolization
(Vacuolar alteration):
• Most prominent feature
• Partial or complete destruction
of basal cells and other
structures due to expansion of
cytoplasm produces tiny
vacuoles along dermoepidermal
junction,
• Total absence of basal cell with
spinous keratinocytes abutting
papillary dermis results in
squamatization of basal layer.
• Confluent basal cell damage
results in formation of clefts and
subepidermal vesicles.
Vacuolar changes of basal cells with
sparse perivascular lymphocytic
infiltrate. Morbilliform drug eruption (H
and E, ×100)
4. B) Apoptotic keratinocytes
(Colloid or Civatte bodies) :
• Seen as
small, rounded, eosinoph
ilic, hyaline, anucleate
structures,
• Are slightly smaller than
basal keratinocyte.
• May be seen in basal
layer, in upper papillary
dermis, individually or in
clumps, or in mid- and
upper spinous layers,
Colloid (Civatte) bodies at dermoepidermal junction with basal cell
vacuolization with melanophages in
the upper papillary dermis. Lupus
erythematosus (H and E, ×400)
5. C) Obscuring of dermoepidermal junction by
inflammatory cells :
• Lymphocytes are M/c
• Eosinophils, neutrophils
, mast cells, and
histiocytes may be
seen.
• Obliterates clear
distinction between
epidermis and papillary
dermis
• Density of inflammatory
infiltrate is variable
Several lymphocytes in basal cell layer
obscuring dermo-epidermal junction with
basal cell vacuolization and few apoptotic
keratinocytes in lower spinous zone.
Erythema multiforme (H and E, ×400)
6. 2. Secondary changes
A) Epidermal changes:
• Depend on disease, time of biopsy in course of
evolution or devolution of disease, and site of
biopsy.
• Acanthosis, hypergranulosis
• Thick compact orthokeratotic stratum corneum
• Thin and atrophic epidermis,
• Irregular epidermal hyperplasia
7. B) Papillary dermal changes:
• Secondary to basal cell damage.
• Papillary dermis undergoes
expansion to accommodate
inflammatory infiltrate,
• Fibrosis or sclerosis,
• "Incontinence" of melanin into
papillary dermis
• Melanophages in papillary dermis
C) Other changes
• Mucin deposits in reticular dermis
• Perivascular and periadnexal
infiltrates of lymphocytes in midand deep reticular dermis,
• lymphocytic lobular panniculitis
Thickened papillary dermis with sparse lymphocytic
infiltrate and numerous melanophages. persisting basal
cell vacuolization. Lichen planus pigmentosus
Sclerosis of thickened papillary dermis with
smudging of dermo-epidermal junction. Note
bluish-grey mucin in upper reticular dermis. LE
8. Classification of Interface Dermatitis
1. Histologically, classified as:
a) Prominent basal cell vacuolization
(Vacuolar-interface dermatitis):
•Basal cell vacuolization is most
prominent
•Variable perivascular and
interstitial infiltrates of
lymphocytes.
b) Prominent infiltrate in papillary
dermis aligned in lichenoid pattern
(Lichenoid-interface dermatitis):
•Dense band-like infiltrate in
papillary dermis
•Basal cell vacuolization may be
inconspicuous or absent.
9. 2. Le Boit’s classification depending on epidermal
changes
a) Acute cytotoxic type:
• Characterized by basal cell vacuolization with lymphocytes
infiltrating lower epidermis
• Scattered necrotic keratinocytes at various levels in epidermis.
• Entire process is rapid, Does not interfere with epidermal
keratinization,
• Horny layer is unaffected and maintains its normal basket
weave arrangement.
• EM is prototype.
• Few necrotic keratinocytes: Early EM, morbilliform drug and
viral eruptions,
• Numerous necrotic keratinocytes: Fully developed EM, acute
LE, TEN, radiation and chemotherapy-induced skin damage, FDE
(eosinophils, neutrophils, and melanophages), pityriasis
lichenoides (parakeratosis).
10. Numerous necrotic keratinocytes scattered in lower spinous zone with lymphocytes
obscuring dermo-epidermal junction. Note normal basket weave stratum corneum. EM
11. E M . 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, fullthickness epidermal necrosis (D). Note the preservation of the basket-weave horn.
Density of dermal inflammatory infiltrate is inversely proportionate to epidermal damage. Fairly
dense in EM, Very sparse or even absent in TEN. Eosinophils are not seen as a rule
12. 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).
13. b) Premature terminal differentiation:
• Refers to an early development of a thick granular layer and
compact stratum corneum
• A/w dense lichenoid infiltrates of lymphocytes.
• LP is prototype
• Dense lymphocytic infiltrates: LP, lichenoid
keratosis, lichenoid drug reaction especially
photolichenoid, acute GVHD, DLE, lichen striatus.
• Few lymphocytes: Dermatomyositis, lichenoid GVHD.
• Mixed infiltrates: Lichenoid drug reaction
(eosinophils), keratosis lichenoides chronica (plasma cells).
c) Irregular epidermal hyperplasia: variant of above
• Show marked irregular epidermal hyperplasia
• Seen in hypertrophic LP, verrucous DLE, and some longstanding lichenoid drug eruptions.
14. Lichen planus. There is compact orthokeratosis with no parakeratosis, wedgeshaped
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)
15. Lichenoid dermatitis involving contiguous
follicular infundibula. Hypertrophic lichen
planus
Wedge shaped hypergranulosis, lichenoid
lymphocytic infiltrate at base of
infundibulum, few colloid bodies at dermoepidermal junction
16. Clumps of numerous colloid bodies in upper papillary dermis with numerous
melanophages. Lichen planus pigmentosus
17. • 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).
18. • 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).
19. Lichen nitidus. There is a
•
lymphohistiocytic infiltrate filling
the papillary dermis with
"claw-like" hyperplasia of the
surrounding epidermis.
Lichen striatus. There is a superficial and deep
perivascular and periadnexal lymphohistiocytic
infiltrate with a band-like component that
obscures the dermoepidermal junction (A). Shows
psoriasiform hyperplasia of epidermis Foci of mild
to moderate spongiosis and may show exocytosis
of lymphocytes (B).
20. 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 is fibrotic (C).
21.
22. Superficial and deep perivascular and periadnexal lymphocytic
infiltrates. Note thin epidermis, basal cell vacuolization with
subepidermal clefts that involve follicular infundibular
epithelium, follicular plugging at one end of the sections. LE
Pools of bluish-grey
mucin between
bundles of collagen in
reticular dermis. LE
23. 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
24. 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)
25. d) Interface dermatitis with psoriasiform hyperplasia:
•
•
•
•
•
Show interface changes as a secondary pathological feature
Not classified as primary interface dermatitis.
Lymphocytes and siderophages: Lichenoid purpura.
Eosinophils predominant: Urticarial pemphigoid, some drug eruptions.
Lymphocytes mostly: Mycosis fungoides, lichen striatus, pityriasis
lichenoides, lichen sclerosus, center of porokeratosis.
• Plasma cells: Secondary syphilis, early acrodermatitis chronica
atrophicans.
e) Interface dermatitis with epidermal atrophy:
• Represents late atrophic phase of several dermatoses
• Plasma cells: Late stage of acrodermatitis chronica atrophicans.
• Band of melanophages: Regressing malignant melanoma, late
pigmented patches of FDE.
• Lymphocytic infiltrate: Atrophic LP, long-standing lesions of LE,
dermatomyositis, poikiloderma, atrophic lesions of lichen sclerosus,
center of porokeratosis.
26. Lichen sclerosus et atrophicus (LS et A), atrophy, follicular plugging, papillary dermal
edema, and sclerosis with a patchy, band-like predominantly
lymphocytic infiltrate interposed between the altered collagen of the upper dermis and
normal collagen of lower dermis (A and B).
Fully developed LS et A. There is effacement of rete ridge pattern of epidermis with
vacuolar alteration of basal keratinocytes and sclerosis of dermis (C)
27. Pityriasis lichenoides et varioliformis acuta (PLEVA).
There is a superficial and deep perivascular
lymphocytic infiltrate that obscures dermoepidermal
junction (A). Neutrophils are in stratum corneum
admixed with degenerated necrotic keratinocytes and
parakeratotic corneocytes (B). Necrotic keratinocytes
are scattered throughout epidermis and erythrocytes
are interposed between keratinocytes (C).
28. Superficial perivascular lymphocytic infiltrate, SUBTLE VACUOLAR ALTERATIONS,
+/- EXTRAVASTED RBC . Note the thick wafer-like scale containing flat parakeratosis and flecks
of melanin. Pityriasis lichenoides chronica