Derm Path Pics

Front 1

Back 1

Psoriasis

Multiple small red plaques are visible on the elbows.

Front 2

Back 2

Psoriasis

Multiple red scaley areas are present over the lower back. The white scaley areas correspond to the microscopic finding of parakeratosis.

Front 3

Back 3

Psoriasis

Close-up view of a cutaneous plaque. Redness reflects vascularity. White indicates parakaratosis.

Front 4

Back 4

Acanthosis in psoriasis.

Microscopically, psoriasis is characterized by hyperplasia of the epidermis, downward elongation of the rete ridges with thinning of overlying stratum granulosum, with parakeratosis above this. Capillaries within dermal papillae are brought close to the surface. In some biopsies, neutrophils are visible in the stratum corneum or epidermis.

Front 5

Back 5

This is contact dermatitis, a form of type IV hypersensitivity reaction that is localized. This person contacted a plant in a tropical jungle to which he was already sensitized. A couple of days later, the skin is red from inflammation and slightly raised from local edema.

Front 6

Back 6

This shows a poison-ivy-like lesion of contact dermatitis in a linear distribution. An edematous oozing eruption of vesicles (small collections of fluid), which forms where the leaf brushes the skin. Pruritis may be pronounced.

Front 7

Back 7

Spongiosis is intercellular edema in the epidermis, (visualized as the clear spaces between the epidermal cells).

Front 8

Back 8

A blister

This is an epidermal vesicle, which has formed due to marked spongiosis.

Front 9

Back 9

Dermatophyte "ring"

Front 10

Back 10

The skin of the face, neck, and chest is affected with sloughing of the epidermal layer due to a drug reaction. There are few dermatologic emergencies. This is one of them.

Front 11

Back 11

Bullous pemphigoid

Clear, tense bullae on an erythematous base.

Front 12

Back 12

Bullous pemphigoid

Clear, tense bullae on an erythematous base.

Front 13

Back 13

Bullous pemphigoid

Immunofluorescence studies can be performed on skin biopsies. Seen here is a bright green band of staining with antibody to IgG. The localization at the dermal-epidermal junction is typical, for immune complexes tend to be trapped along basement membranes. Diseases with this pattern may include systemic lupus erythematosus, discoid lupus erythematosus, and bullous pemphigoid.

Front 14

Back 14

Nodular basal cell carcinoma

Front 15

Back 15

Nodular BCC

Pearly, opalescent.

Front 16

Back 16

BCC w/ telangiectasia

Front 17

Back 17

Palisading in BCC

The neoplastic masses of epithelial cells show palisading of the peripheral rim of cells, i.e the elongate cells are oriented perpendicular to the basement membrane. This characteristic helps pathologists recognize BCC.

Front 18

Back 18

Invasive SCC



This is a nodular ulcerated lesion on the arm.

Front 19

Back 19

Invasive SCC



The lower lip has high exposure to the sun and is a frequent site for SCC.

Front 20

Back 20

Squamous cell carcinoma



The lesion on the left appears to be ulcerated and covered by a dark crust. The lesion on the right appears to have a hyperkeratotic scale on the surface.

Front 21

Back 21

Squamous cell carcinoma



This shows the invasive protion of a well differentiated SCC. The keratinization of nests of cells is prominent (“keratin pearls”).

Front 22

ommon epidermal lesions, especially in the elderly. Wart-like keratotic growths, often pigmented, predominantly growing above the level of the surrounding skin - imparting a "stuck on" appearance. They may be composed of basaloid cells, which often contain melanin, or basaloid keratinocytes which show keratin production with formation of keratin-filled channels ("horn pseudocysts").

Back 22

Seborrheic keratoses

Front 23

Back 23

Seborrheic keratoses, skin



Seen here are examples of a very common lesion of older adults--a seborrheic keratosis (SK). They are rough-surfaced and brown coin-like plaques that vary from a few millimeters in size to several centimeters.

Front 24

Back 24

Pigmented Seborrheic Keratosis



This lesion is pigmented

Front 25

Back 25

Seborrheic Keratosis



This resected seborrheic keratosis has been cut perpendicular to the skin surface. You can see that the lesion sits on top of the dermis and that it is pigmented.

Front 26

Back 26

Superficial spreading melanoma

Front 27

Back 27

Superficial spreading melanoma

Front 28

Back 28

Superficial spreading melanoma



This skin lesion has an irregular border and variable pigmentation with nearly complete loss of brown color on the upper left margin and near the center.

Front 29

Back 29

Pigmented nodular melanoma

Front 30

Back 30

Pigmented nodular melanoma

Front 31

Back 31

Lentigo Maligna Melanoma



Lentigo maligna occurs in the setting of sun damaged skin, usually on the face of elderly patients. However, with increased sun exposure, even early middle age patients develop lentigo maligna melanoma.

Front 32

Back 32

Acral-Lentiginous Melanoma

Front 33

Back 33

Congenital melanocytic nevus on the neck, face and ear of a child.

Precursor of malignant melanoma

Front 34

Back 34

Dysplastic Nevi

Precursor to malignant melanoma

Front 35

Back 35

Dysplastic nevi

Precursor to malignant melanoma