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2009
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Publié par
Date de parution
30 octobre 2009
Nombre de lectures
2
EAN13
9780702047749
Langue
English
Poids de l'ouvrage
9 Mo
Publié par
Date de parution
30 octobre 2009
Nombre de lectures
2
EAN13
9780702047749
Langue
English
Poids de l'ouvrage
9 Mo
Table of Contents
Cover Image
COPYRIGHT
PREFACE
1. An approach to the interpretation of skin biopsies
2. Diagnostic clues
3. The lichenoid reaction pattern (‘interface dermatitis’)
4. The psoriasiform reaction pattern
5. The spongiotic reaction pattern
6. The vesiculobullous reaction pattern
7. The granulomatous reaction pattern
8. The vasculopathic reaction pattern
9. Disorders of epidermal maturation and keratinization
10. Disorders of pigmentation
11. Disorders of collagen
12. Disorders of elastic tissue
13. Cutaneous mucinoses
14. Cutaneous deposits
15. Diseases of cutaneous appendages
16. Cysts, sinuses, and pits
17. Panniculitis
18. Metabolic and storage diseases
19. Miscellaneous conditions
20. Cutaneous drug reactions
21. Reactions to physical agents
22. Cutaneous infections and infestations – histological patterns
23. Bacterial and rickettsial infections
24. Spirochetal infections
25. Mycoses and algal infections
26. Viral diseases
27. Protozoal infections
28. Marine injuries
29. Helminth infestations
30. Arthropod-induced diseases
31. Tumors of the epidermis
32. Lentigines, nevi, and melanomas
33. Tumors of cutaneous appendages
34. Tumors and tumor-like proliferations of fibrous and related tissues
35. Tumors of fat
36. Tumors of muscle, cartilage, and bone
37. Neural and neuroendocrine tumors
38. Vascular tumors
39. Cutaneous metastases
40. Cutaneous infiltrates – non-lymphoid
41. Cutaneous infiltrates – lymphomatous and leukemic
Index
COPYRIGHT
© 2010, Elsevier Limited All rights reserved.
First Edition 1997
Second Edition 2002
The right of David Weedon to be identified as author of this work has been asserted by him 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. Permissions may be sought directly from Elsevier's Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com . You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions .
ISBN: 978-0-7020-3485-5
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Notice
Medical knowledge is constantly changing. Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Neither the Publisher nor the author assumes any liability for any injury and/or damage to persons or property arising from this publication.
The Publisher
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
For Elsevier
Commissioning Editor: Michael Houston
Development Editor: Ben Davie
Editorial Assistant: Kirsten Lowsen
Project Manager: Joannah Duncan
Design: Stewart Larking
Illustration Manager: Bruce Hogarth
Marketing Manager(s) (UK/USA): John Canelon/Radha Mawrie
PREFACE
Completing the third edition of this book has been a Herculean task, not made any easier by a high reporting load, another myocardial infarct in July 2008, and my computer illiteracy in an era when competency in this skill is almost essential for proper functioning as a dermatopathologist and author. I must thank my colleagues, particularly Dr Richard Williamson and Dr Nick Mellick who commenced work at midnight during my absences. They also did some reference and OMIM hunting for me.
This new era is not without its shortcomings. Some of the medical graduates seem to lack the breadth and depth of knowledge that characterized earlier generations, but this reduced knowledge does not seem to interfere with the ability of recent graduates to practice medicine. One recent graduate proudly told me that she had ‘Googled her way through medical school’, something that I could never achieve. Many pathologists are now ‘PubMed-ing’ their way through the daily sign-out. As a consequence, the need for a comprehensive textbook in any field has probably lessened. Notwithstanding this view, the last edition of this book contained a valuable collection of references, and as this is likely to be the last edition of this book by the current author, it seemed appropriate to build on, rather than purge, this bank of references. PubMed-ing one's way to a diagnosis is seemingly not without its problems. To use an analogy from the old days of warfare: ‘if one feeds in the wrong coordinates, one hits the wrong target’. Hopefully, this comment does not sound like ‘sour grapes’ from an acknowledged troglodyte, unable to do the same. In a similar vein, the undersigned marvels at the reliance placed on immunoperoxidase markers to reach a presumptively-correct diagnosis. Automation of these tests appears to have lessened rather than strengthened their specificity. It is often forgotten that the specificity of an antibody for a particular tumor is only as specific as the last paper to be published. I watch with interest as D2-40, one of the newer markers, goes the same way as vimentin, CD34, and CD10 before it.
Since the last edition of this book, Professor W. St C. (Bill) Symmers, who was instrumental in getting me to write the precursor volume to this book, has ‘passed on’. He was truly inspirational, and from the old school of language perfection. I still recall vividly his hand-written comments on some proofs admonishing me for my use of the word ‘prominent’ to describe the magnitude of an inflammatory infiltrate. Hopefully not too many ‘prominents’ have crept into this edition. The recent death of A. Bernard (Bernie) Ackerman has been described as the ‘end of an era’. Few others contributed so much to dermatopathology. Other mentors of mine have now retired, some more fully than others, such as John Sullivan, John Kerr, Robin Cooke, and Alistair Burry. Hopefully I am wiser for their counsel, and for their interest in my career. The work of Professor Kerr in establishing apoptosis as a concept was monumental, as evidenced by its basic role in many aspects of carcinogenesis. As a consequence of my interest in this concept since the 1970s, I still cringe when I hear the term ‘necrotic keratinocytes’ used for apoptotic cells.
Medical writing style has also changed enormously in the last 20 years. No longer are the titles of articles short and succinct. Some are mini-abstracts. Everyone seems to be a co-author these days; 17 authors for a letter to the Editor seems somewhat excessive, but I have heard many times the justification for this event. Also, the possessive apostrophe is going the way of the dodo. There seems little point in retaining eponymous designations without one, although I appreciate the reasoning that the person does not own the disease. The possessive apostrophe has been with us since the 17th century, so it will be retained here for syndromes that have traditionally been named in this style. This edition has sections on treatment. As I am not a dermatologist, doses of drugs have not been given. These sections are intended to highlight recent treatment trials and guidelines as well as some successful treatments of an anecdotal nature.
I would like to thank and acknowledge the assistance once again of Dr Geoffrey Strutton, and for this edition, the help of Dr Adam Rubin for some of the photomicrographs. I also thank Alyson Coxon and Cleo Wilkinson for their assistance. Michael Houston, Executive Publisher at Elsevier Ltd, and Ben Davie, the Development Editor, provided sound advice. Their patience during the long gestation period of this volume was amazing. Finally, once again my secretary and friend Pam Kent typed every word of the text and all the references and tables, not to mention her role as my proxy computer operator.
David Weedon
Brisbane, Australia
1. An approach to the interpretation of skin biopsies
Introduction 4
Major tissue reaction patterns 4
The lichenoid reaction pattern (‘interface dermatitis’) 4
The psoriasiform reaction pattern 5
The spongiotic reaction pattern 6
The vesiculobullous reaction pattern 7
The granulomatous reaction pattern 7
The vasculopathic reaction pattern 11
Combined reaction patterns 12
Minor tissue reaction patterns 12
Epidermolytic hyperkeratosis 12
Acantholytic dyskeratosis 12
Cornoid lamellation 12
Papillomatosis (‘church-spiring’) 15
Acral angiofibromas 15
Eosinophilic cellulitis with ‘flame figures’ 15
Transepithelial elimination 15
Patterns of inflammation 16
Superficial perivascular inflammatio