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Experimental Stomatology
Published in Samuel Dreizen, Barnet M. Levy, Handbook of Experimental Stomatology, 2020
Samuel Dreizen, Barnet M. Levy
Microscopically, the relatively smooth dorsal epithelial surface was composed of a basal cell layer, greatly thickened spinous cell layer, and very thin corneum. Rete pegs were widened, and the lamina propria was diffusely infiltrated with chronic inflammatory cells. Surface continuity was disrupted by microbially infected superficial and deep necrotizing ulcers. Both types were marginated by an infiltrate of polymorphonuclear and mononuclear inflammatory cells. Gingivitis was manifested by reddening, swelling, ulceration, and exudation of the interdental papillae capped by a blood-tinged necrotic slough, with extension of the lesions into the attached gingiva. Histologically, there was partial to complete necrosis of the epithelial and connective tissue components of the free gingiva, which often extended into the attached gingiva and coronal aspects of the periodontal ligaments. The necrotic interdental papillae were surfaced by a pyogenous exudate comprised of fibrin, bacteria, pus cells, erythrocytes, and tissue debris. Subjacent surviving soft tissue was diffusely infiltrated with lymphocytes, macrophages, and neutrophils.
Benign tumors
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
The acral pseudolymphomatous angiokeratoma of children (APACHE) lesion is mainly observed in children and is characterized by multiple small hyperkeratotic angiomatoid lesions on the tips of several digits with striking clinical similarity with angiokeratoma of Mibelli.189 Single digit plus nail involvement is very rare.190 Histopathology exhibits marked hyperkeratosis, thinning of the epidermis over the lesion itself with elongated rete pegs at the margin of the lesion. A well-circumscribed, dense infiltrate of mature T and B lymphocytes is present around dilated vessels that extend from the papillary dermis down to the subcutaneous tissue. The epidermis is not invaded. The multiple lesions rule out angiokeratoma of Mibelli.
Skin
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Zbigniew W. Wojcinski, Lydia Andrews-Jones, Daher Ibrahim Aibo, Rie Kikkawa, Robert Dunstan
The epidermis is separated from the dermis by a basement membrane consisting of type IV collagen, laminin, entactin, fibrillin, and perlecan. The junction between the epidermis and dermis is typically smooth in areas protected by a dense hair coat; however, in areas where the skin is subjected to mechanical stress (e.g., footpads, lips), interdigitation of epidermal projections with dermal papillae and ridges is very prominent. These interdigitations form rete pegs in larger mammalian species. The epidermis is bound to the dermis by anchoring fibers composed of type IV collagen.
Punctal pseudoepitheliomatous hyperplasia mimicking a mass lesion
Published in Orbit, 2021
Nandini Bothra, Mohammad Javed Ali
A 46-year-old lady presented to us with a growth on the right upper eyelid (Figure 1, Panel A), which was gradual, progressive and painless over the last 6 months and associated with a foreign body sensation. On examination, there was an elevated pinkish lesion with surface vessels in the punctal area, measuring about 2 × 3 mm, engulfing the punctal opening (medial to *, Panel B). The differential diagnosis at this stage was either a punctal granuloma or papilloma. The punctal opening could be clinically still negotiable (Panel C). Anterior segment optical coherence tomography (AS-OCT) showed the punctal opening and the vertical canaliculus on the surface of the lesion (arrow, Panel D). Dacryoendoscopy did not show any extension of the lesion into the proximal canaliculus (Panel E). The lesion was confined to the punctal area of the upper punctum of the right eye. While placing a Bowman’s lacrimal probe in the upper lacrimal passage (Panel C), excision biopsy of the mass lesion was taken. Placement of a lacrimal stent was avoided based on our differential diagnosis. Histopathology revealed hyperplastic stratified squamous epithelium with saw-tooth like rete pegs. Underlying stroma showed proliferating blood vessels and few chronic inflammatory cells, thus, giving the diagnosis of PEH with mild reactive atypia (Panel F).
Lichen sclerosus associated with Nd:YAG laser therapy
Published in Journal of Cosmetic and Laser Therapy, 2019
Seher Bostanci, Bengu Nisa Akay, Pelin Ertop, Seçil Vural, Aylin Okcu Heper
A 43-years-old woman with color change in genital area was admitted to our clinic. Medical history revealed type II diabetes mellitus (DM) and Hashimoto thyroiditis. The patient had six sessions of whole body laser assisted hair removal with long pulsed 1064 nm Nd:YAG laser in last 2 years. Lesions had developed 2 weeks after the last session. Dermatological examination revealed perifollicular atrophic depigmented macules on perineum and mons pubis. Figure 1a The shape, size, and location of the lesions correlated with the width of laser probe and treatment area. Patient was Fitzpatrick phototype IV. White clods on multiple white structureless areas and perifollicular hypopigmentation were observed on dermatoscopic examination. Figure 1b Histopathological examination of incisional biopsy specimens from mons pubis revealed acanthosis, hyperkeratosis, and loss of rete pegs in epidermis. In upper dermis there was hyalinized zone with increased connective tissue. Mononuclear cell infiltration dispread from upper dermis to middle dermis was observed. Figure 1c With these findings patient was diagnosed with LS. Borrelia burgdorferi antibodies were negative. Antinuclear antibody and nuclear antibody immunoblot tests were also negative. Treatment choice for this patient was tacrolimus monohydrate 0.1 ointment twice daily for 3 months and mometasone furoate cream usp 0.1 once daily for 1 month; 90% clinical response was achieved with this treatment.
Lichen sclerosus of the oral mucosa: clinical and histopathological findings. Review of the literature and a case report
Published in Acta Odontologica Scandinavica, 2018
Anna-Maija Matela, Jaana Hagström, Hellevi Ruokonen
Discoid lupus erythematosus consists of usually atrophic, round lesions with white keratotic striae. Ulcerations are common and erythematous areas are usually seen. Histopathologically, the same features exist in oral LS such as hyperkeratosis, atrophy of rete pegs, liquefaction degeneration of basal cells, lamina propria oedema and deep diffuse inflammatory infiltration. Direct immunofluorescence is positive and IgA, IgG, IgM and complement components are found at the basement membrane [39].