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Keloid (852)
hyalinized collagen
bundles
Normal epidermis
Thick connective
tissue deposition
Histopathology:
keloidal collagen bundles
absence of vertically orientated blood
vessels
keloidal collagen:
markedly eosinophilic
thickened
haphazardly arranged and
hyalinized
relatively normal epidermis
whorls of thick, hyalinized collagen
bundles and keloidal collagen
(prominent keloidal collagen) with an
infiltrative advancing lateral edge
refers to a type of scar that extends beyond skin adjacent
to the wound. A simple hypertrophic scar as distinct from
a keloid does not extend beyond the wound.
Benign, non-contagious
fibrous tissue and collagen
more common in African-Americans and Asians
In Turner syndrome, formation frequency is higher.
Clinical presentation:
most occur within a year after injury
painful (needle-like), pruritic nodular scar that grow
beyond the area of original injury
earlobe, upper arm, shoulder, upper back , anterior
chest
recurrence ~50% to 80% at site after attempt to
remove by surgical excision
does not regress with time.
Keloids are firm, rubbery lesions or shiny fibrous
nodules, can vary from pink to flesh-colored or red to
dark brown in color.
Nodular scar that extends beyond the area of injury
irregular shaped
characteristic keloidal collagen bundles that are
thickened, brightly eosinophilic
Keratoacanthoma (854)
Male predominance
Grows within 4 to 6 weeks
Develops usually on sun-exposed skin of more elderly
adults
Regresses spontaneously with scarring usually within 6
months
Excision is recommended
Rapidly growing, benign crateriform tumor
Endophytic papillary proliferations of keratinocytes
Clinical presentation:
exo-endophytic architecture
the lesion is cup-shaped, with a central, keratin-filled
plug (keratin debris in the center) and overhanging
edges
pink to light red
This symmetric crater-like nodule has a prominent
central keratin plug.
The crater-like architecture: the dermis is red, epithelial
elements are gray, and the central keratin plug is yellow
Ghost cells
Normal looking
loose stroma
Palisading nuclei at
edge of nests
The melanocytic nevi are classified according to their location and cytologic features
junctional nevus intraepidermal nests of nevus cells are found along the dermal junction
compound nevus nests of nevus cells are found intraepidermally along the dermoepidermal
junction and in the underlying dermis
dermal nevus nests of nevus cells only in the dermis
Melanocytic nevi are tan to brown, uniformly pigmented, small (usually <6 mm across), solid
regions of relatively flat (macules) to elevated skin (papules) with well-defined, rounded borders.
They may become more prominent during pregnancy, indicating a degree of hormone sensitivity
Histopathology:
nests of melanoma cells invade
various layers of epidermis and
dermis
characteristic:
binucleated tumor cells
eccentric nuclei
melanin in cytoplasm
irregular nests and sing-cell growth
of melanoma cells within the
epidermis and an underlying
inflammatory response within the
dermis
malignant melanoma often produce
pigment. Not all malignant melanomas
produce pigment, and tumor must always
be considered in diagnosis of
malignancies with large pleomorphic
cells and prominent nucleoli.
Nuclei show features of malignancy:
polymorphism, large nucleoli with
irregular contours