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. 2019 Dec 18:6:2374289519892559.
doi: 10.1177/2374289519892559. eCollection 2019 Jan-Dec.

Educational Case: Granulomatous Dermatitis

Anne M Stowman  1   2
Affiliations

Educational Case: Granulomatous Dermatitis

Anne M Stowman. Acad Pathol. .

Abstract

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040.1.

Keywords: exogenous antigens; granulomatous dermatitis; noncaseating granulomatous dermatitis; organ system pathology; pathology competencies; skin; tattoo-related disorder.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A punch biopsy of the patient’s skin showing a noncaseating granulomatous dermatitis. There are well-formed clusters of histiocytes, some with surrounding lymphocytic inflammation, extending from the papillary dermis into the reticular dermis. The epidermis shows mild reactive change and orthokeratosis (hematoxylin and eosin, ×4).
Figure 2.
Figure 2.
A medium-power view from the punch biopsy of skin highlighting the clusters of histiocytes with scattered giant cells (arrow). The histiocytes are identified by their abundant eosinophilic cytoplasm and ovoid nuclei. Red pigment is appreciated at this power, both within the granuloma and within the interstitium (hematoxylin and eosin, ×10).
Figure 3.
Figure 3.
A high-power image of a granuloma from the punch biopsy of skin. The histiocytes are arranged in a tight cluster, with focal rimming of lymphocytes. Cytologically, the histiocytes contain ovoid to reniform nuclei and abundant eosinophilic and vacuolated cytoplasm. Exogenous red pigment is seen within the granuloma (hematoxylin and eosin, ×20).
Figure 4.
Figure 4.
A high-power view of histiocytes containing exogenous red pigment. The pigment is coarse, and at this power, individual granules are visible. The histiocytes are notable for their variably prominent nucleoli, reniform nuclei, and abundant cytoplasm. Scattered lymphocytes can also be seen (hematoxylin and eosin, ×40).
See this image and copyright information in PMC

References

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