Aproximación al diagnóstico dermatopatológico de las lesiones figuradas

Abstract

Both clinical and pathologic findings must be considered when diagnosing figurate skin lesions, which are often seen in routine practice. Although a skin biopsy may sometimes be diagnostic, more often the information provided is nonspecific. In an attempt to offer an approach to diagnosing these dermatoses, we have classified annular lesions according to the presence of lymphocytic, neutrophilic-eosinophilic, or granulomatous infiltrates, and infiltrates containing plasma cells. Neoplastic annular lesions are included in a separate group. Lesions containing lymphocytic infiltrates include superficial and deep erythema annulare centrifugum and the differential diagnosis includes a large number of conditions. In the neutrophilic-eosinophilic class, we include annular psoriasis, vasculitis, linear immunoglobulin A dermatosis, eosinophilic dermatitis, erythema marginatum rheumatica, and annular erythema of infancy. Sarcoidosis and granuloma annulare are the prototypical annular lesions containing granulomas. Secondary syphilis is typical of lesions containing plasma cells. Mycosis fungoides is the principal skin tumor that may initially manifest with annular lesions.

Eosinophilic annular erythema in childhood - Case report

“…The latest case involved a 4-year-old boy, described by Kunz et al Since 2000, when the first case of eosinophilic annular erythema was reported in an adult woman, no further cases involving children have been described. 1-4 Histopathology is quite characteristic, revealing a superficial, deep, perivascular, inflammatory infiltrate composed of lymphocytes and abundant eosinophils. ¨Flame figures¨ are unusual and were first described by Rongioletti et al in two out of four adult patients, and later by El-Khalawany et al in seven out of ten adult patients with well-developed, long-standing lesions.…”

“…¨Flame figures¨ are unusual and were first described by Rongioletti et al in two out of four adult patients, and later by El-Khalawany et al in seven out of ten adult patients with well-developed, long-standing lesions. 1-4 One important differential diagnosis is annular erythema in childhood, a rare entity that differs from eosinophilic annular erythema due to the presence of lesions that feature predominantly in children aged under 1, entailing spontaneous resolution and eosinophilic infiltration. 3 The main differential histopathological diagnosis is Wells' syndrome, also known as eosinophilic cellulitis, where tissue eosinophilia and the presence of "flame figures" are characteristic.…”

A case of tinea incognita and differential diagnosis of figurate erythema

“…the interstitial granulomatous reaction that is most often due to antihypertensives or lipid-lowering agents but can also be associated with certain forms of autoimmune diseases. It is characterized by palisading granulomas surrounding small collagenous deposits [1].…”

“…In the histology of psoriasis, neutrophil infiltrates in epidermis and parakeratosis are typically observed. Ichthyosis linearis circumflexa in Netherton syndrome is associated with atopic diathesis, highly elevated serum IgE and its erythematous plaques are bordered by double-edged scales [1].…”

“…The differential diagnosis (Fig. 1) can be broad and sometimes challenging, and include more than 30 conditions [1].

Fig. 1Differentials and patients’ lesion.

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