Dermatopathology Dirk Elston

Visit to download the full and correct content document:

https://textbookfull.com/product/dermatopathology-dirk-elston/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...

Nonneoplastic Dermatopathology 2nd Edition Brian J.

Hall

https://textbookfull.com/product/nonneoplastic-
dermatopathology-2nd-edition-brian-j-hall/

Dermatopathology A Z A Comprehensive Guide Vladimir

Vincek

https://textbookfull.com/product/dermatopathology-a-z-a-
comprehensive-guide-vladimir-vincek/

Hospital based Dermatopathology 1st Edition Mai P.

Hoang

https://textbookfull.com/product/hospital-based-
dermatopathology-1st-edition-mai-p-hoang/

Fate s Attraction 1st Edition Dirk Greyson Greyson Dirk

https://textbookfull.com/product/fate-s-attraction-1st-edition-
dirk-greyson-greyson-dirk/
Next Civilization Dirk Helbing

https://textbookfull.com/product/next-civilization-dirk-helbing/

Women's Writing in Colombia: An Alternative History 1st

Edition Cherilyn Elston (Auth.)

https://textbookfull.com/product/womens-writing-in-colombia-an-
alternative-history-1st-edition-cherilyn-elston-auth/

Statistical Human Genetics Methods and Protocols 2nd

Edition Robert C. Elston (Eds.)

https://textbookfull.com/product/statistical-human-genetics-
methods-and-protocols-2nd-edition-robert-c-elston-eds/

Strategic Retail Management Dirk Morschett

https://textbookfull.com/product/strategic-retail-management-
dirk-morschett/

Innovation and the Entrepreneurial University Dirk

Meissner

https://textbookfull.com/product/innovation-and-the-
entrepreneurial-university-dirk-meissner/
Dermatopathology

THIRD EDITION

Edited by

Dirk M. Elston, MD
Professor and Chairman
Department of Dermatology and Dermatologic Surgery
Medical University of South Carolina
Charleston, SC, USA

Tammie Ferringer, MD
Section Head and Fellowship Director of Dermatopathology
Departments of Dermatology and Laboratory Medicine
Geisinger Medical Center
Danville, PA, USA
with

Christine J. Ko, MD

Steven Peckham, MD

Whitney A. High, MD, JD, MEng

David J. DiCaudo, MD

Sunita Bhuta, MD

2
3
Table of Contents

Instructions for online access

Cover image

Title Page

Copyright

Online Lectures and Atlas Materials

Preface

List of Contributors

Acknowledgments

Dedications

Chapter 1 The basics

Glossary of terms

Normal skin anatomy

Other “special” stains

Further reading

Chapter 2 Benign tumors and cysts of the epidermis

Benign acanthomas

Cysts

Further reading

Chapter 3 Malignant tumors of the epidermis

Actinic keratosis

Bowen disease

Squamous cell carcinoma

Keratoacanthoma

Basal cell carcinoma (BCC)

Paget disease

4
 Lymphoepithelioma-like carcinoma

Further reading

Chapter 4 Pilar and sebaceous neoplasms

Pilar neoplasms

Sebaceous neoplasms

Further reading

Chapter 5 Sweat gland neoplasms

Cylindroma (turban tumor)

Spiradenoma

Spiradenocarcinoma

Syringocystadenoma papilliferum

Hidradenoma papilliferum

Papillary digital carcinoma (aggressive digital papillary adenocarcinoma)

Mucinous carcinoma

Syringoma

Microcystic adnexal carcinoma

Hidrocystoma

Endocrine mucin-producing sweat duct carcinoma of the eyelid

Mixed tumor (chondroid syringoma)

Cutaneous myoepithelioma

Malignant mixed tumor (malignant chondroid syringoma)

Acrospiromas

Malignant acrospiroma (porocarcinoma, malignant poroma)

Syringofibroadenoma of Mascaro

Papillary “eccrine” adenoma (tubular apocrine adenoma)

Adenoid cystic carcinoma

Eccrine angiomatous hamartoma

Benign intraductal adenoma of the nipple

Supernumerary nipple (polythelia)

Further reading

Chapter 6 Melanocytic neoplasms

Solar lentigo

Melanotic macule

Benign melanocytic nevus

Nevus of Ota/nevus of Ito

Mongolian spot

Malignant melanoma

Further reading

5
Chapter 7 Interface dermatitis
Lichenoid interface dermatitis

Vacuolar interface dermatitis

Still's disease

Further reading

Chapter 8 Psoriasiform and spongiotic dermatitis

Psoriasis

Inflammatory linear verrucous epidermal nevus (ILVEN)

Mycosis fungoides

Syphilis

Necrolytic erythemas/nutritional deficiency dermatitis

Granular parakeratosis

Porokeratosis

Acute spongiotic dermatitis

Seborrheic dermatitis

Subacute spongiotic dermatitis

Chronic dermatitis (lichen simplex chronicus)

Pityriasis rosea

Spongiotic pigmented purpuric eruption (PPE)

Stasis dermatitis

Spongiotic dermatitis with intraepidermal eosinophils

Zoon balanitis

Pityriasis rubra pilaris

Toxic shock syndrome

Further reading

Chapter 9 Blistering diseases

Subcorneal vesiculobullous disorders

Intraepidermal vesiculobullous disorders

Subepidermal vesiculobullous disorders: pauciinflammatory subepidermal conditions

Inflammatory subepidermal conditions

Friction blisters

Further reading

Chapter 10 Granulomatous and histiocytic diseases

Granuloma annulare

Actinic granuloma

Necrobiosis lipoidica

Rheumatoid nodule

Lupus miliaris disseminatus faciei (LMDF: acne agminata)

Sarcoidosis

6
 Necrobiotic xanthogranuloma (NXG)

Xanthogranuloma

Reticulohistiocytic granuloma (solitary reticulohistiocytoma)

Rosai–Dorfman disease (sinus histiocytosis with massive lymphadenopathy)

Langerhans cell histiocytosis (histiocytosis X)

Xanthomas

Gout

Foreign-body granuloma

Further reading

Chapter 11 Inflammatory vascular diseases

Leukocytoclastic vasculitis (LCV)

Neutrophilic dermatoses

Perivascular lymphoid infiltrates

Lymphoid vasculitis

Insect bite

Perniosis

Occlusive vascular diseases

Noninflammatory purpura

Further reading

Chapter 12 Genodermatoses
Pseudoxanthoma elasticum

Ichthyosis vulgaris

Incontinentia pigmenti (Bloch–Sulzberger syndrome)

Mastocytosis

Epidermolytic ichthyosis (bullous congenital ichthyosiform erythroderma)

Lipoid proteinosis (hyalinosis cutis et mucosae, Urbach–Wiethe disease)

Goltz syndrome (focal dermal hypoplasia, Goltz–Gorlin syndrome)

Dowling–Degos disease (reticulated pigmented anomaly of the flexures)

Galli–Galli disease

Further reading

Chapter 13 Alterations in collagen and elastin

Lichen sclerosus (et atrophicus)

Chronic radiation dermatitis

Morphea/scleroderma

Sclerodermoid graft-versus-host disease

Eosinophilic fasciitis (Shulman syndrome)

Elastosis perforans serpiginosa

Reactive perforating collagenosis

Scar and keloid

7
 Chondrodermatitis nodularis helicis

Acrodermatitis chronica atrophicans

Ochronosis

Colloid milium

Anetoderma

Atrophoderma

Connective tissue nevus

Aplasia cutis congenita

Further reading

Chapter 14 Metabolic disorders

Mucinoses

Amyloidosis

Cutaneous calcification

Gout

Erythropoietic protoporphyria (EPP)

Colloid milium

Mucocele

Oxalosis

Further reading

Chapter 15 Disorders of skin appendages

Noninflammatory alopecia

Inflammatory nonscarring alopecia

Cicatricial alopecia

Acute Langerhans cell histiocytosis (histiocytosis X)

Miliaria

Neutrophilic eccrine hidradenitis

Hidradenitis suppurativa

Pseudocyst of the auricle

Relapsing polychondritis

Further reading

Chapter 16 Panniculitis
Septal panniculitis

Lobular panniculitis

Subcutaneous fat necrosis of the newborn

Traumatic fat necrosis (“mobile encapsulated lipoma”)

Subcutaneous panniculitis-like lymphoma

Further reading

Chapter 17 Bacterial, spirochete, and protozoan infections

8
 Bacterial diseases

Spirochete-mediated diseases

Protozoan diseases

Further reading

Chapter 18 Fungal infections

Tinea

Tinea versicolor

Candidiasis

Coccidioidomycosis

Cryptococcosis

Blastomycosis

Paracoccidioides infection (South American “blastomycosis”)

Histoplasmosis

Lobomycosis (keloidal blastomycosis)

Sporotrichosis

Mycetomas

Tinea nigra

Phaeohyphomycosis

Chromomycosis (chromoblastomycosis)

Zygomycosis

Hyalohyphomycosis (including aspergillosis and fusariosis)

Protothecosis

Rhinosporidiosis

Further reading

Chapter 19 Viral infections, helminths, and arthropods

Viral infections

Flukes, tapeworms, and roundworms

Arthropods

Further reading

Chapter 20 Fibrous tumors

Dermatofibroma

Multinucleate cell angiohistiocytoma

Adult myofibroma

Juvenile myofibroma

Dermatomyofibroma

Fibromatosis

Infantile myofibromatosis

Juvenile hyaline fibromatosis

Scar

9
 Keloid

Metaplastic synovial cyst

Fibrous hamartoma of infancy

Infantile digital fibroma (inclusion body fibroma)

Giant cell tumor of the tendon sheath

Giant cell tumor of the soft tissue

Elastofibroma dorsi

Sclerotic fibroma

Pleomorphic fibroma

Collagenous fibroma (desmoplastic fibroblastoma)

Nuchal-type fibroma (collagenosis nuchae)

Angiofibromas

Nodular fasciitis

Intravascular fasciitis

Ischemic fasciitis (atypical decubital fibroplasia)

Calcifying aponeurotic fibroma

Ossifying fibromyxoid tumor of soft parts

Borderline tumors

Malignant tumors

Further reading

Chapter 21 Tumors of fat, muscle, cartilage, and bone

Fat

Muscle

Cartilage and Bone

Further reading

Chapter 22 Neural tumors

Neurofibroma

Schwannoma (neurilemmoma)

Neuromas

Supernumerary digit (rudimentary polydactyly)

Merkel cell carcinoma (primary neuroendocrine carcinoma of the skin, trabecular carcinoma)

Granular cell tumor

Neurothekeoma

Malignant peripheral nerve sheath tumor (MPNST) (neurofibrosarcoma, malignant schwannoma)

Cutaneous ganglioneuroma

Perineurioma

Glial heterotopia (nasal glioma)

Meningeal heterotopia (rudimentary meningocele)

Meningioma

Neuroblastoma

10
 Further reading

Chapter 23 Vascular tumors

Angiokeratoma

Lymphangioma

Nevus flammeus

Angioma serpiginosum

Venous lake

Glomus tumor

Pyogenic granuloma

Bacillary angiomatosis

Cherry angioma

Infantile hemangioma

Angiolymphoid hyperplasia with eosinophilia

Kimura disease

Intravascular papillary endothelial hyperplasia of Masson (IPEH)

Arteriovenous malformation (arteriovenous hemangioma)

Targetoid hemosiderotic hemangioma (hobnail hemangioma)

Eccrine angiomatous hamartoma

Glomeruloid hemangioma

Microvenular hemangioma

Tufted angioma (angioblastoma)

Myopericytoma (perivascular myoid tumor)

PEComa (perivascular epithelioid cell tumor)

Kaposiform hemangioendothelioma

Pleomorphic hyalinizing angiectatic tumor (PHAT)

Hemangiopericytoma

Spindle cell hemangioma (spindle cell hemangioendothelioma)

Epithelioid hemangioendothelioma

Retiform hemangioendothelioma

Angiosarcoma

Atypical vascular lesion (AVL)

Kaposi sarcoma

Further reading

Chapter 24 Cutaneous T-cell lymphoma, NK-cell lymphoma, and myeloid leukemia

Cutaneous T-cell lymphoma and NK-cell lymphoma

Further reading

Chapter 25 B-cell lymphoma and lymphocytic leukemia

Cutaneous B-cell lymphoproliferative disorders

Lymphomatoid granulomatosis

11
 Further reading

Chapter 26 Metastatic tumors and simulators

Breast carcinoma

Lung carcinoma

Renal carcinoma

Colon carcinoma

Ovarian carcinoma

Signet-ring carcinoma

Thyroid carcinoma

Prostate carcinoma

Metastatic squamous cell carcinoma

Meningioma

Lesions that mimic metastatic carcinoma

Further reading

Appendix 1 Dermatopathology mnemonics

Appendix 2 Skin ultrastructure

1 Desmosome

2 Langerhans cell (with Birbeck granules)

3 Premelanosome

4 Tonofibrils

5 Eosinophil

6 Mast cell

7 Merkel cell

Appendix 3 External agents and artifacts

1 Electrocautery

2 Gelfoam

3 Aluminum chloride

4 Monsel's solution (ferric subsulfate)

5 Triamcinolone

6 Splinter

7 Suture

8 Amalgam

9 Calcium hydroxylapatite

10 Hyaluronic acid

11 Poly-L-lactic acid

12 Silicone granuloma

13 Argyria

Further reading

12
Index

13
Copyright

© 2019, Elsevier Limited. All rights reserved.

First edition 2009

Second edition 2014

The right of Dirk M. Elston, Tammie Ferringer, Christine J. Ko, Steven Peckham, Whitney A. High,
David J. DiCaudo to be identified as authors of this work has been asserted by them in accordance
with the Copyright, Designs and Patents Act 1988.

No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and
retrieval system, without permission in writing from the publisher. Details on how to seek
permission, further information about the Publisher's permissions policies and our arrangements
with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency,
can be found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).

Copyright for all original illustrations and online material is retained by the authors.

Portions of the text and images were produced while the authors were government employees are
in the public domain.

Notices
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds or experiments described herein.
Because of rapid advances in the medical sciences, in particular, independent verification of
diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is
assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or
property as a matter of products liability, negligence or otherwise, or from any use or operation of
any methods, products, instructions, or ideas contained in the material herein.

ISBN: 978-0-7020-7280-2
E-ISBN: 978-0-7020-7281-9

Content Strategist: Charlotta Kryhl

Content Development Specialists: Joanne Scott, Kim Benson
Project Manager: Joanna Souch
Design: Ashley Miner
Illustration Manager: Muthukumaran Thangaraj
Marketing Manager: Michele Milano

14
Printed in China

Last digit is the print number: 9 8 7 6 5 4 3 2 1

15
Online Lectures and Atlas Materials
1. Author-narrated lectures – 27 presentations with approximately 2000 slides and over 8
hours running time
2. Clinical image atlas – with approximately 600 images
3. Histopathology atlas – with approximately 400 images
4. Infectious disease atlas – with approximately 2500 histopathologic images
5. Soft tissue tumor atlas – with approximately 300 histopathologic images
6. Lymphoma atlas – with 111 images

16
Preface
This text is designed to cover the essentials of dermatopathology in a style that is enjoyable and
easily understood. Please note that you are holding only a portion of the book in your hands!
Much of it is online in the form of online lectures and extensive digital image atlases. Online
material also includes a high-quality clinical image atlas, an extensive infectious disease atlas, a
soft tissue tumor atlas, a lymphoma atlas, and more. Be sure to check out all the online features
at http://www.expertconsult.com. For students of dermatopathology, we hope the book and
lectures make your way a little easier. For those in practice, we hope the book becomes one of your
favorite references and one that you reach for often.
Dirk M. Elston

17
List of Contributors
With contributions by Patricia Malerich, MD; Lindsay Sewell, MD; Nektarios Lountzis, MD; David
Adams, MD; Martie Jewell, MD; Chad Thomas, MD; Sasha Kramer, MD; Eric Hossler, MD; Morgan
Wilson, MD; Puja Puri, MD; Michael Conroy, MD; Seth Forman, MD, and Carly Elston.
Monkey pox slides courtesy of Erik Stratman, MD.
Chancroid and granuloma inguinale slides courtesy of Brooke Army Medical Center teaching file.
Lucio phenomenon slide courtesy of David M. Scollard, MD.
Kimura disease slide courtesy of Jim Fitzpatrick, MD.
Peppered moth image courtesy of David Tomlinson, Professor Emeritus Faculty of Life Sciences,
University of Manchester.
Sparganum proliferum images courtesy of Richard Bernert, MD.
Contributing authors

Sunita Bhuta MD
Chief, Head and Neck Pathology
Professor, Pathology and Laboratory Medicine
Director, Transmission Electron Microscopy Laboratory
David Geffen School of Medicine, UCLA
Los Angeles, CA, USA

David J. DiCaudo MD
Chair, Dermatopathology Division
Associate Professor, Dermatology and Laboratory Medicine/Pathology
Department of Dermatology
Mayo Clinic College of Medicine
Scottsdale, AZ, USA

Dirk M. Elston MD
Professor and Chairman
Department of Dermatology and Dermatologic Surgery Medical University of South Carolina
Charleston, SC, USA

Tammie Ferringer MD
Section Head and Fellowship Director of Dermatopathology
Departments of Dermatology and Laboratory Medicine
Geisinger Medical Center
Danville, PA, USA

Whitney A. High MD, JD, MEng

Professor, Dermatology and Pathology
Director, Dermatopathology Laboratory (Dermatology)
University of Colorado School of Medicine
Denver, CO, USA

Christine J. Ko MD
Professor of Dermatology and Pathology
Departments of Dermatology and Pathology
Yale University

18
New Haven, CT, USA

Steven Peckham MD
Pathologist/Dermatopathologist
Precision Pathology Services
San Antonio, TX, USA

19
Acknowledgments
I would like to thank my fellow authors as well as the faculty residents and fellows of the Medical
University of South Carolina, the Ackerman Academy of Dermatopathology, the Robert Wood
Johnson School of Medicine, Saint Lukes-Roosevelt /Mount Sinai, Palisades Medical Center, China
Medical University, Central South University, Peking University, Geisinger Medical Center, Brooke
Army Medical Center, and Wilford Hall Medical Center. This book would not have been possible
without their support. I would also like to thank my first teachers in dermatopathology: Dean
Pearson, Tim Berger, Jim Graham, George Lupton, and Wilma Bergfeld.
John Metcalf and John Maize deserve recognition as true gentlemen and scholars. Special thanks
to those who collaborated on projects and made my years at the Ackerman Academy a pleasure. Ed
Heilman: You are the ultimate gentleman. Mike Kramer: Your generosity of spirit and commitment
to do right are always appreciated. Pat Heller: You are the best of New York wrapped up in one
person. Jakki Hopkins: I could not have survived the AAD year without you. Raj Singh: Your work
ethic and commitment to education are an example to us all. Jisun Cha and Eun Ji Kwon: The
dynamic duo of New Jersey. Ying Guo: Graceful and brilliant. Joan Mones: Passionately devoted to
DO education and the Ackerman Academy core team: Elaine Waldo, Elen Blochin, Sau Wong,
Jonathan Truong, Geffie Figueroa, and Amy Spizuoco. Mark Jacobsen and Paul Chu were always
generous with resources at Port Chester. I would like to thank all of those who contributed to
research projects and discussions, especially Viktoryia Kazlouskaya, Alexandra Flamm, Cheng
Zhou, Amira Elbendary, Manuel Valdebran, Kruti Parikh, Nathan Cleaver, Filamer Kabigting,
Khanh Thieu, Jeffrey Shackelton, Mara Dacso, John R. Griffin, Erick Jacobson-Dunlop, Qiang Xie,
Dave Hall, Mary Mcgonagle, Tatyana Groysman, Steve Hammond, Jennifer Lambe, Kalpana
Reddy, Sean Stephenson, Elgida Volpicelli, Karen Wu, Munir Idriss, Shengli Chen, Caihong Sun,
Liping Zhao, Sherihan Allam, Yanping Bai, Lubna Rizwan, Xiaoqin Wang, Nausheen Yaqoob,
Mebratu Ketema Tabor, Raissa Couto, Ying Zhou, Xueling Mei, Lei Zhang, Ying Sun, Shijun Shan,
Johanna Sales, Chao Ji, Zhancai Zheng, Yue Zhang, Seniz Ergin, Ruzeng Xue, Shaoshan Cui, Jing
Zhang, Kara Melissa Torres, Sarah Velasquez, Yan Yu, Christian Andres, Ciara Maguire, Philip
Muller, Carlos Morais, Marc Bodendorf, and Anja Miesel.
The editors and authors would like to thank the editorial and publication team at Elsevier,
without whom this work would not have been possible.
Dirk M. Elston

20
Dedications

This book is dedicated to my wife and best friend Kathy, my children Carly and Nate
who make me so proud, and to all of those students of dermatopathology, young and
old, who make it such a pleasure to teach.
Dirk M. Elston

This work is dedicated to my daughter Emily who has filled holes in my life that I did
not know I had; my husband Jim and mother Judy for their patience, understanding, and
support; and to the memory of my father Elzie. None of this would be possible without
the incredible guidance and tutelage of Dirk M. Elston and would lack purpose without
the curiosity and eagerness of the residents and fellows that go on to become my
colleagues and friends.
Tammie Ferringer

To Peter, Dylan, and Owen.

Christine J. Ko

To my Ms, old and new …

Whitney A. High

To my parents, James and Hilda, who have always encouraged me to do my best.

Steven Peckham

To my wife Valerie, our children Matthew and Gianna, and all the dermatology
residents, past and present, whom I have had the pleasure to teach.
David J. DiCaudo

21
22
CHAPTER 1

23
The basics

Diagnostic terms, skin anatomy, and stains

Tammie Ferringer, Christine J. Ko

24
Glossary of terms
Acantholysis

• Loss of cell–cell adhesion

FIG. 1.1 Acantholysis, pemphigus vulgaris

Acanthosis

• Increase in thickness of the epidermis

• Regular (all rete pegs descend to the same level) or irregular
(rete pegs descend to different levels in the papillary dermis)

FIG. 1.2 Acanthosis, psoriasis

25
Anaplasia

• Atypical nuclei (abnormal size, shape, staining) and

pleomorphism (variation in nuclear characteristics)

FIG. 1.3 Anaplasia, Bowen disease

Apoptosis (pronounced apohtosis)

• “Programmed cell death”

• “Dead red” keratinocytes with pyknotic nuclei
• Although the term is often applied to any necrotic or
dyskeratotic keratinocyte, it is best reserved for physiologic
programmed cell death or pathologic processes that produce death
through a similar pathway

26
 FIG. 1.4 Apoptosis, outer root sheath, catagen follicle

Arborizing

• Branching, often refers to rete or vasculature

Asteroid body

• Collections of eosinophilic material seen in sporotrichosis

• Also refers to star-shaped intracytoplasmic inclusions seen in
giant cells of sarcoidosis or berylliosis or other granulomatous
processes

27
 FIG. 1.5 Asteroid body, sarcoidosis

Atrophy

• Decrease in thickness of epidermis

Ballooning degeneration

• Destruction of epidermis by dissolution of cell attachments and

intracellular edema

FIG. 1.6 Ballooning degeneration, herpes simplex

28
Caterpillar body

• Pale pink linear basement membrane material within epidermis,

seen in porphyria cutanea tarda
• Represents degenerated type IV collagen

Civatte/colloid bodies

• Pink, globular remnants of keratinocytes

FIG. 1.7 Civatte bodies, lichen planus

Collagen entrapment

• Collagen fibers surrounded by histiocytes/spindle cells (collagen

balls)

FIG. 1.8 Collagen entrapment, dermatofibroma

29
Another random document with
no related content on Scribd:
 copies of the works possessed in a physical medium and
discontinue all use of and all access to other copies of Project
Gutenberg™ works.

• You provide, in accordance with paragraph 1.F.3, a full refund of

any money paid for a work or a replacement copy, if a defect in
the electronic work is discovered and reported to you within 90
days of receipt of the work.

• You comply with all other terms of this agreement for free
distribution of Project Gutenberg™ works.

1.E.9. If you wish to charge a fee or distribute a Project Gutenberg™

electronic work or group of works on different terms than are set
forth in this agreement, you must obtain permission in writing from
the Project Gutenberg Literary Archive Foundation, the manager of
the Project Gutenberg™ trademark. Contact the Foundation as set
forth in Section 3 below.

1.F.

1.F.1. Project Gutenberg volunteers and employees expend

considerable effort to identify, do copyright research on, transcribe
and proofread works not protected by U.S. copyright law in creating
the Project Gutenberg™ collection. Despite these efforts, Project
Gutenberg™ electronic works, and the medium on which they may
be stored, may contain “Defects,” such as, but not limited to,
incomplete, inaccurate or corrupt data, transcription errors, a
copyright or other intellectual property infringement, a defective or
damaged disk or other medium, a computer virus, or computer
codes that damage or cannot be read by your equipment.

1.F.2. LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except

for the “Right of Replacement or Refund” described in paragraph
1.F.3, the Project Gutenberg Literary Archive Foundation, the owner
of the Project Gutenberg™ trademark, and any other party
distributing a Project Gutenberg™ electronic work under this
agreement, disclaim all liability to you for damages, costs and
expenses, including legal fees. YOU AGREE THAT YOU HAVE NO
REMEDIES FOR NEGLIGENCE, STRICT LIABILITY, BREACH OF
WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
PROVIDED IN PARAGRAPH 1.F.3. YOU AGREE THAT THE
FOUNDATION, THE TRADEMARK OWNER, AND ANY
DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE LIABLE
TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL,
PUNITIVE OR INCIDENTAL DAMAGES EVEN IF YOU GIVE
NOTICE OF THE POSSIBILITY OF SUCH DAMAGE.

1.F.3. LIMITED RIGHT OF REPLACEMENT OR REFUND - If you

discover a defect in this electronic work within 90 days of receiving it,
you can receive a refund of the money (if any) you paid for it by
sending a written explanation to the person you received the work
from. If you received the work on a physical medium, you must
return the medium with your written explanation. The person or entity
that provided you with the defective work may elect to provide a
replacement copy in lieu of a refund. If you received the work
electronically, the person or entity providing it to you may choose to
give you a second opportunity to receive the work electronically in
lieu of a refund. If the second copy is also defective, you may
demand a refund in writing without further opportunities to fix the
problem.

1.F.4. Except for the limited right of replacement or refund set forth in
paragraph 1.F.3, this work is provided to you ‘AS-IS’, WITH NO
OTHER WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED,
INCLUDING BUT NOT LIMITED TO WARRANTIES OF
MERCHANTABILITY OR FITNESS FOR ANY PURPOSE.

1.F.5. Some states do not allow disclaimers of certain implied

warranties or the exclusion or limitation of certain types of damages.
If any disclaimer or limitation set forth in this agreement violates the
law of the state applicable to this agreement, the agreement shall be
interpreted to make the maximum disclaimer or limitation permitted
by the applicable state law. The invalidity or unenforceability of any
provision of this agreement shall not void the remaining provisions.
1.F.6. INDEMNITY - You agree to indemnify and hold the
Foundation, the trademark owner, any agent or employee of the
Foundation, anyone providing copies of Project Gutenberg™
electronic works in accordance with this agreement, and any
volunteers associated with the production, promotion and distribution
of Project Gutenberg™ electronic works, harmless from all liability,
costs and expenses, including legal fees, that arise directly or
indirectly from any of the following which you do or cause to occur:
(a) distribution of this or any Project Gutenberg™ work, (b)
alteration, modification, or additions or deletions to any Project
Gutenberg™ work, and (c) any Defect you cause.

Section 2. Information about the Mission of

Project Gutenberg™
Project Gutenberg™ is synonymous with the free distribution of
electronic works in formats readable by the widest variety of
computers including obsolete, old, middle-aged and new computers.
It exists because of the efforts of hundreds of volunteers and
donations from people in all walks of life.

Volunteers and financial support to provide volunteers with the

assistance they need are critical to reaching Project Gutenberg™’s
goals and ensuring that the Project Gutenberg™ collection will
remain freely available for generations to come. In 2001, the Project
Gutenberg Literary Archive Foundation was created to provide a
secure and permanent future for Project Gutenberg™ and future
generations. To learn more about the Project Gutenberg Literary
Archive Foundation and how your efforts and donations can help,
see Sections 3 and 4 and the Foundation information page at
www.gutenberg.org.

Section 3. Information about the Project

Gutenberg Literary Archive Foundation
The Project Gutenberg Literary Archive Foundation is a non-profit
501(c)(3) educational corporation organized under the laws of the
state of Mississippi and granted tax exempt status by the Internal
Revenue Service. The Foundation’s EIN or federal tax identification
number is 64-6221541. Contributions to the Project Gutenberg
Literary Archive Foundation are tax deductible to the full extent
permitted by U.S. federal laws and your state’s laws.

The Foundation’s business office is located at 809 North 1500 West,

Salt Lake City, UT 84116, (801) 596-1887. Email contact links and up
to date contact information can be found at the Foundation’s website
and official page at www.gutenberg.org/contact

Section 4. Information about Donations to

the Project Gutenberg Literary Archive
Foundation
Project Gutenberg™ depends upon and cannot survive without
widespread public support and donations to carry out its mission of
increasing the number of public domain and licensed works that can
be freely distributed in machine-readable form accessible by the
widest array of equipment including outdated equipment. Many small
donations ($1 to $5,000) are particularly important to maintaining tax
exempt status with the IRS.

The Foundation is committed to complying with the laws regulating

charities and charitable donations in all 50 states of the United
States. Compliance requirements are not uniform and it takes a
considerable effort, much paperwork and many fees to meet and
keep up with these requirements. We do not solicit donations in
locations where we have not received written confirmation of
compliance. To SEND DONATIONS or determine the status of
compliance for any particular state visit www.gutenberg.org/donate.

While we cannot and do not solicit contributions from states where

we have not met the solicitation requirements, we know of no
prohibition against accepting unsolicited donations from donors in
such states who approach us with offers to donate.

International donations are gratefully accepted, but we cannot make

any statements concerning tax treatment of donations received from
outside the United States. U.S. laws alone swamp our small staff.

Please check the Project Gutenberg web pages for current donation
methods and addresses. Donations are accepted in a number of
other ways including checks, online payments and credit card
donations. To donate, please visit: www.gutenberg.org/donate.

Section 5. General Information About Project

Gutenberg™ electronic works
Professor Michael S. Hart was the originator of the Project
Gutenberg™ concept of a library of electronic works that could be
freely shared with anyone. For forty years, he produced and
distributed Project Gutenberg™ eBooks with only a loose network of
volunteer support.

Project Gutenberg™ eBooks are often created from several printed

editions, all of which are confirmed as not protected by copyright in
the U.S. unless a copyright notice is included. Thus, we do not
necessarily keep eBooks in compliance with any particular paper
edition.

Most people start at our website which has the main PG search
facility: www.gutenberg.org.

This website includes information about Project Gutenberg™,

including how to make donations to the Project Gutenberg Literary
Archive Foundation, how to help produce our new eBooks, and how
to subscribe to our email newsletter to hear about new eBooks.