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1．INTRODUCTION1

Technic for Biopsy1

Limitations of Histologic Diagnosis2

2．EMBRYOLOGY OF THE SKIN3

The Epidermis3

The Dermis5

3．HISTOLOGY OF THE SKIN8

The Epidermis8

The Epidermal Appendages16

The Dermis23

4．LABORATORY METHODS34

Fixation,Processing and Staining34

Histochemical Staining36

Polariscopic Examination37

5．MORPHOLOGY OF THE MESODERMAL CELLS39

Myeloid Group39

Lymphoid Group40

Reticulohistiocytic Group41

Plasma Cells43

Mast Cells44

6．CONGENITAL DISEASES(GENODERMATOSES)48

Ichthyosis48

Ichthyosis Vulgaris48

Ichthyosis Congenita48

Congenital Ichthyosiform Erythroderma49

Keratosis Palmaris et Plantaris51

Keratosis Punctata Palmaris et Plantaris51

Pachyonychia Congenita51

Dyskeratosis Congenita52

Porokeratosis Mibelli52

Xeroderma Pigmentosum53

Congenital Ectodermal Defect54

Rothmund＇s Syndrome(Poikiloderma Congenitale),Werner＇s Syndrome(Progeria of Adults)and progeria of Children55

Epidermolysis Bullosa56

Darier＇s Disease(Keratosis Follicularis)58

Familial Benign Chronic Pemphigus61

Acrokeratosis Verruciformis63

Pseudoxanthoma Elasticum64

Juvenile Elastoma(Nevus Elasticus)66

Cutis Hyperelastica(Ehlers-Danlos Syndrome)67

Urticaria Pigmentosa68

Incontinentia Pigmenti71

7．NONINFECTIOUS VESICULAR AND BULLOUS DISEASES79

Dermatitis-Eczema81

Dermatopathic Lymphadenitis90

Miliaria91

Pompholyx(Dyshidrotic Eruption)92

Erythema Toxicum Neonatorum93

Pemphigus94

Pemphigus Vulgaris94

Pemphigus Vegetans97

Pemphigus Foliaceus99

Pemphigus Erythematosus101

Bullous Pemphigoid102

Benign Mucous-Membrane Pemphigoid(Cicatricial Pemphigoid,Pemphigus Conjunctivae)105

Erythema Multiforme105

Dermatitis Herpetiformis106

Subcorneal Pustular Dermatosis107

Burn109

8．NONINFECTIOUS INFLAMMATORY DISEASES114

Urticaria114

Erythema Annulare Centrifugum114

Prurigo Nodularis115

Erythema Nodosum116

Nodular Vasculitis119

Psoriasis119

Pustular Psoriasis,Acrodermatitis Continua,Impetigo Herpetiformis122

Reiter＇s Disease125

Pustulosis Palmaris et Plantaris(Pustular Bacterid)127

Parapsoriasis128

Pityriasis Varioliformis Acuta129

Pityriasis Rosea130

Lichen Planus131

Lichen Nitidus135

Lichen Striatus136

Pityriasis Rubra Pilaris137

Granuloma Faciale137

Erythema Elevatum Diutinum140

Granuloma Annulare140

Subcutaneous Nodules of Rheumatic Fever and Rheumatoid Arthritis143

Acrodermatitis Chronica Atrophicans145

Radiodermatitis146

Polymorphous Light Eruption(Solar Dermatitis)149

Acne Vulgaris152

Acne Varioliformis(Acne Necrotica Miliaris)152

Acne Rosacea153

Fox-Fordyce Disease154

Hidrocystoma155

Alopecia Areata156

Alopecia Cicatrisata(Pseudopelade Brocq)156

Alopecia Mucinosa157

Purpura159

Noninflammatory Purpura159

Inflammatory Purpura(Vasculitis)160

Purpura Pigmentosa Chronica(Majocchi-Schamberg)164

Relapsing Febrile Nodular Nonsuppurative Panniculitis(Weber-Christian Disease)166

Sclerema Neonatorum168

Hereditary Edema of the Legs(Milroy＇s Disease)170

Chondrodermatitis Helicis and Anthelicis170

Scabies172

Arthropod Bites174

Lichen Urticatus(Papular Urticaria)174

Foreign-Body Granulomas175

Lipid Granuloma(Paraffinoma)176

Tattoo Granuloma177

Silica Granuloma177

Zirconium Granuloma178

Beryllium Granuloma179

Swimming-Pool Granuloma180

9．ERUPTIONS DUE TO DRUGS192

Fixed Drug Eruption192

Quinacrine Hydrochloride(Atabrine)Dermatitis192

Exfoliative Dermatitis Due to Drugs193

Hydralazine(Apresoline)Eruption193

Bromoderma193

Iododerma195

Argyria195

Chrysiasis197

Arsenical Keratosis and Carcinoma197

10．DEGENERATIVE DISEASES200

Senile Degeneration200

Elastosis Perforans Serpiginosa(Miescher)202

Hyperkeratosis Follicularis in Cutem Penetrans(Kyrle)205

Lichen Sclerosus et Atrophicus205

Kraurosis Vulvae207

Balanitis Xerotica Obliterans209

Striae Distensae210

Macular Atrophy(Anetoderma)210

Atrophia Alba(Milian)210

Atrophoderma Reticulatum(Folliculitis Ulerythematosa Reticulata)211

Colloid Milium(Colloid Degeneration of the Skin)211

11．BACTERIAL DISEASES217

Impetigo217

Erysipelas218

Folliculitis(Impetigo Bockhart,Furuncle,Folliculitis Barbae)218

Folliculitis Keloidalis(Dermatitis Papillaris Capillitii)219

Hidradenitis Suppurativa219

Pyoderma Gangrenosum(Chronic Undermining Burrowing Ulcer)220

Aphthosis221

Meningococcemia(Waterhouse-Friderichsen Syndrome)221

Tuberculosis222

Primary Tuberculosis224

Reinfection Tuberculosis225

Sarcoidosis234

Cheilitis Granulomatosa240

Leprosy241

Diphtheria of the Skin245

Anthrax246

Tularemia246

Chancroid247

Granuloma Inguinale248

Rhinoscleroma250

12．SPIROCHETAL DISEASES257

Syphilis257

Yaws(Frambesia Tropica)265

Pinta266

13．FUNGAL DISEASES269

Dermatophytosis(Tinea)269

Moniliasis273

North American Blastomycosis(Gilchrist＇s Disease)275

South American Blastomycosis(Paracoccidioidomycosis)278

Chromoblastomycosis279

Cryptococcosis(Torulosis)281

Coccidioidomycosis(San Joaquin Valley Fever)282

Actinomycosis,Nocardiosis285

Sporotrichosis287

Histoplasmosis289

14．DISEASES CAUSED BY PROTOZOA294

Cutaneous Leishmaniasis294

Mucocutaneous Leishmaniasis296

15．DISEASES CAUSED BY VIRUSES298

Variola,Varicella,Herpes Zoster,Herpes Simplex298

Eczema Vaccinatum and Eczema Herpeticum(Kaposi＇s Varicelliform Eruption)304

Molluscum Contagiosum305

Verruca308

Verruca Vulgaris308

Verruca Plana311

Verruca Plantaris312

Condyloma Acuminatum312

Lymphogranuloma Venereum(Lymphogranuloma Inguinale,Lymphopathia Venerea)314

Milkers＇ Nodules315

Ecthyma Contagiosum(Orf)316

16．METABOLIC DISEASES320

Lipoidoses320

Systemic Lipoidoses with Increased Serum Lipids320

Systemic Lipoidoses with Normal Serum Lipids326

Purely Cutaneous Lipoidoses with Normal Blood Lipids336

Amyloidosis343

Primary Systemic Amyloidosis344

Lichen Amyloidosus347

Localized Nodular Amyloidosis347

Calcinosis Cutis348

Metastatic Calcification348

Dystrophic Calcification349

Gout350

Porphyria351

Myxedema352

Generalized Myxedema353

Circumscribed Myxedema353

Lichen Myxedematosus354

Scleredema Adultorum(Buschke)355

Addison＇s Disease356

Acanthosis Nigricans357

Riehl＇s Melanosis,Melanodermatitis Toxica358

Vitiligo360

Hemochromatosis(Bronze Diabetes)360

Ochronosis361

Vitamin A Deficiency(Phrynoderma)362

Pellagra362

Vitamin C Deficiency(Scurvy)363

17．SYSTEMIC DISEASES OF UNKNOWN CAUSE372

Lupus Erythematosus372

Chronic Discoid Lupus Erythematosus373

Subacute Disseminated Lupus Erythematosus376

Acute Systemic Lupus Erythematosus377

Lupus Erythematosus Profundus383

Lymphocytic Infiltration of the Skin(Jessner)384

Dermatomyositis385

Poikiloderma Atrophicans Vasculare388

Scleroderma390

Circumscribed Scleroderma(Morphea)390

Systemic Scleroderma392

Periarteritis Nodosa394

Wegener＇s Respiratory Granulomatosis397

Lethal Mid-line granuloma of the Face398

Malignant Atrophic Papulosis(Degos)399

18．EPIDERMAL TUMORS406

Histogenesis and Classification of Epidermal Tumors406

1．Tumors of the Surface Epidermis410

Nevus Verrucosus410

Seborrheic Keratosis(Verruca Senilis,Basal Cell Papilloma)412

Epidermal Cyst,Sebaceous Cyst,Milium,Dermoid Cyst415

Keratosis Senilis419

Leukoplakia423

Squamous Cell Carcinoma(Epidermoid Carcinoma)425

Keratoacanthoma433

Bowen＇s Disease436

Erythroplasia of Queyrat439

Paget＇s Disease439

2．Tumors of the Epidermal Appendages444

Nevus Sebaceus(Jadassohn)444

Adenoma Sebaceum(Pringle)(Tuberous Sclerosis)446

Senile Sebaceous Nevus(Senile Sebaceous Hyperplasia)447

Fordyce＇s Disease448

Apocrine-Gland Nevus448

Hair Nevus449

Sebaceous Adenoma449

Syringocystadenoma Papilliferum(Nevus Syringocyst-adenomatosus Papilliferus)450

Hidradenoma Papilliferum454

Folliculoma(Hair-Follicle Tumor)456

Sebaceous Epithelioma457

Syringoma458

Cylindroma460

Apocrine Myo-epithelioma463

Mixed Tumor of the Skin466

Trichoepithelioma(Epithelioma Adenoides Cysticum,Multiple Benign Cystic Epithelioma)467

Calcifying Epithelioma471

Basal Cell Epithelioma474

Eccrine Spiradenoma489

Eccrine Poroma491

Carcinoma of Sebaceous Glands493

Carcinoma of Eccrine Sweat Glands494

Carcinoma of Apocrine Glands495

3．Metastatic Carcinoma of the Skin496

Cutaneous Metastasis from Carcinoma of the Breast496

Cutaneous Metastasis from Carcinomas Other Than Breast Carcinoma498

19．MESODERMAL TUMORS514

1．Tumors of Fibrous Tissue514

Dermatofibroma,Histiocytoma(Sclerosing Hemangioma,Nodular Subepidermal Fibrosis)514

Giant-Cell Reticulohistiocytoma519

Giant-Cell Epulis521

Keloid521

Fibrosarcoma522

Subcutaneous Fibrosarcoma522

Dermatofibrosarcoma Protuberans524

2．Tumors of Mucoid Tissue525

Myxoma525

Myxosarcoma526

Mucous Cyst of the Skin527

3．Tumors of Fatty Tissue527

Nevus Lipomatosus Superficialis527

Lipoma528

Hibernoma528

Liposarcoma530

Malignant Hibernoma531

4．Tumors of Nerve Tissue532

Neuroma532

Neurofibromatosis(von Recklinghausen＇s Disease)533

Neurilemmoma537

Cutaneous Meningioma538

5．Tumors of Vascular Tissue539

Hemangioma539

Granuloma Pyogenicum542

Senile Hemangioma543

Angiokeratoma Mibelli544

Angiokeratoma Corporis Diffusum544

Nevus Araneus546

Osler＇s Disease(Familial Hemorrhagic Telangiectasia)546

Lymphangioma547

Glomus Tumor548

Hemangiopericytoma550

Kaposi＇s Sarcoma(Multiple Idiopathic Hemorrhagic Sarcoma)551

Hemangio-endothelioma555

Postmastectomy Lymphangiosarcoma557

6．Tumors of Muscular Tissue558

Leiomyoma558

Leiomyosarcoma560

Granular Cell Myoblastoma561

Malignant Granular Cell Myoblastoma564

7．Tumors of Osseus Tissue564

Osteoma Cutis564

20．PIGMENTED NEVI AND MALIGNANT MELANOMA575

Pigmented Nevus575

Malignant Melanoma582

Juvenile Melanoma589

Lentigo591

Mongolian Spot592

Blue Nevus593

21．LYMPHOMA AND MYELOSIS600

Lymphoma600

Stem-Cell Lymphoma604

Reticulum-Cell Lymphoma605

Lymphoblastic Lymphoma606

Lymphocytic Lymphoma608

Follicular Lymphoma(Brill-Symmers)611

Hodgkin＇s Disease612

Mycosis Fungoides615

Generalized Exfoliative Dermatitis in Lymphoma621

Herpes Zoster in Lymphoma622

Lymphocytoma Cutis(Lymphadenosis Benigna Cutis;Spiegler-Fendt Sarcoid)622

Myelosis625

Plasmacytoma(Multiple Myeloma)626

Erythremic Myelosis627

GLOSSARY631

INDEX635