By Ronald Marks, Arthur Knight, P. Laidler (auth.)
Dermatopathology is either intriguing and exasperating. tum corneum cells. this happens in issues of keratiniza pores and skin has a sublime simplicity in its features but a tion as the means of desquamation is disturbed (Figure 1. 1). ferocious complexity in its constitution. this is often one of many paradoxes that underly the pathology of pores and skin illness Parakeratosis. The presence of nucleated horn cells in and will cross a way in explaining the multitudinous the stratum corneum. ordinarily the horn cells (corneocy issues to which the surface is topic. The prepared visibility tes) are skinny lamellae of lower than 1 f. lm thickness. They of the outside may help clarify why easy include no detectable cytoplasmic contents as those are histological exam can't consistently offer an misplaced within the granular cellphone layer. Parakeratosis happens while resolution to a clinicians's query. particularly dramatic seem the method of keratinization is disturbed reminiscent of whilst ances might be as a result of adjustments of the relative charges of the speed of epidermal phone construction is elevated (as in blood move, without or with oedema, within the varied psoriasis) in order that nuclei are usually not damaged down earlier than the vascular plexuses or round assorted buildings within the stratum corneum is reached and whilst harm happens horizontal measurement, neither of which can lead to to the higher pores and skin (Figure 1. 2). 'much to determine' histologically. The inherent sampling errors Porokeratosis.
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H & E (8) 51 52 papillary capillaries may be thick walled and the sebaceous glands tend to shrink. In nodular prurigo the epidermal hyperplasia is exaggerated 3 and there are superimposed changes due to mechanical injury. Differential Diagnosis of Eczema These include psoriasis, dermatophyte infection, pityriasis rosea, pityriasis lichenoides chronica and premycosis fungoides. Chronic psoriasis may appear similar to lichenified eczema particularly if the typical Munro abscess of neutrophils in the stratum corneum is absent4.
Reynolds, D. , Marks, R. and Dykes, P. J. (1978) . The epidermis in Refsum's disease (Heredopathia atactic polyneuritiformis). In Marks, R and Dykes P. J. ) The Ichthyoses. pp. 51-64. (Lancaster: MTP) 44 DISORDERS OF KERATINIZATION 4. Davies, M. , Dykes, P. J. and Reynolds, D. (1977). Epidermal abnormalities in Refsum's disease. Br. J. , 97, 401 kinetic discriminants between lamellar ichthyosis and nonbullous congenital icthyosiform erythroderma. Arch. , 121, 489 5. , Puissant, A. and Schnyder, U.
1). A similar but less common disorder is X-linked ichthyosis. This is inherited as a sex-linked characteristic so that it is manifest in boys only, but carried by the female. This resembles autosomal dominant ichthyosis but is more severe, involving the flexures and the sides ofthe neck. 2). In recent years it has been found that patients with sex-linked ichthyosis have steroid sulphatase deficiency and a consequent accumulation of cholesterol sulphate in the stratum corneum. Although abnormalities in lipid metabolism have been identified in autosomal dominant ichthyosis these are non-specific and do not inform concerning the underlying fault 1 .