Dermato-Pathology

Muhammad Takbir
Departemen Patologi Anatomik FK UNKHAIR
2019
 Layers of the Skin

Epidermis

Dermis

Subcutis
 Skin Pathology
• Pigmentation
• Epidermal tumor
• Dermal tumor
• Maturation disorder
• Dermatoses (inflammation)
• Blister/ bulla
• Adnexal disorder
• Panniculitis
• Infection
 Pigmentation
Vitiligo
Freckle (Ephelis)
Melasma
Lentigo
Nevus
“Dysplastic” Nevus
Malignant Melanoma
 Vitiligo
• Loss of
melanocytes
• Acquired
disorder
 Freckles
• Melanocytes
overproduce
melanin granules
• Melanocyte
hyperplasia
 Melasma
• Stimulation of
melanocyte to
produce melanin
• Estrogen n
Progesteron
 Lentigo
• Melanocyte
hyperplasia

Robbins Basic Pathology 9ed, 2015

 Nevus
• Common, benign neoplasm
• Main things  differentiate with melanoma
• Junctional: more pigmented, closely
associated with melanoma
• Intradermal
• Compound: Both
Junctional Nevus

Robbins Basic Pathology 9ed, 2015

Compound Nevus

Robbins Basic Pathology 9ed, 2015

 Melanoma
1. Incidence rising, VERY much
2. Related to SUN
3. QUICKLY METASTASIZES
4. Has both VERTICAL and HORIZONTAL growth
phase but prognosis is 100% related to the
VERTICAL
5. DIFFICULT to differentiate from NEVUS
clinically and often microscopically
 Melanoma
• Asymetry
• Border
• Color
• Diameter
Melanoma

Robbins Basic Pathology 9ed, 2015

 Benign Epidermal Tumor
Seborrheic Keratosis
Acanthosis Nigricans
Fibroepithelial Polyp (skin tag)
Epidermal (inclusion) Cyst
Adnexal tumors : Eccrine, Apocrine
Keratoacanthoma
 Seborrheic Keratosis
• Middle-older
individual
• Head and neck,
trunk
 Acanthosis Nigricans
• Signs from
underlying
diseases
• Obesity, diabetes,
adenoCa
 Fibroepithelial Polyp (skin tag)
• Papilloma
• Skin polyp lesion
Epidermal (inclusion) Cyst
 Premalignant - Malignant
• Actinic (solar)Keratosis  precursor
SCC
• Squamous Cell Carcinoma
• Basal Cell Carcinoma
 Actinic Keratosis
• Premalignant
• Sun-damaged skin
• Hyperkeratosis – dysplasia
• Local eradication: excision, chemotheurapetic
agent topical
Actinic Keratosis
 Squamous Cell Carcinoma
• 2nd most common, sun exposed site, older
people.
• DNA damaged induced by exposure to UV
light
• Others risk factor: industrial carcinogens,
chronic ulcers, draining osteomyelitis
• HPV infection with immunosupresion
• TP53 mutation  tumor suppressor gene
SCC
 Basal Cell Carcinoma
• Locally aggressive cutaneus tumor
• Sun exposed sites
• Slow growing – rarely metastasize
• Mutation that activate Hedgehog signaling
• Local excision with free surgical margin
BCC

https://en.wikipedia.org/wiki/Basal-cell_carcinoma
BCC
 Tumors of the Dermis
• Mesenchymal elements:
– Smooth muscle
– Vascular (endothelium)
– Fibroblast
– Neural tissue
• Dermatofibroma, Hemangioma
 Dermatoses
• Acute inflammatory dermatoses
– Days-weeks
– urticaria, eczema
• Chronic inflammatory dermatosis
– Months-years
– Psoriasis
 Urticaria
• Dermal edema
• Dilatation vascular
spaces
• Perivascular
inflammatory cells
 Psoriasis
• Elbows, knees
• Autoimmun
• Parakeratosis, hyperplasia, elongation of
rete ridges (achantosis), microabscess
intraepidermal
Psoriasis
 Infection
• Verrucae/ warts  HPV
• Moluscum contagiosum: viral
• Impetigo: S. aureus
• Fungi: Tinea
• Arthropod
Verrucae
TERIMA KASIH..