Elastosis perforans serpiginosa pathology

Histology of elastosis perforans serpiginosa

The low power of histology of the serpeginous perforating elastosis demonstrates a column of keratotic debris forming a focal intussusception through hyperplastic epidermis (Figure 1). A closer inspection identifies the material in process transepidermal elimination (figure 2). Brightly eosinophilic Fibers are seen within the extruded material, mixed with keratinous debris and a mixture inflammatory cell infiltrate (Figures 3, 4).

Special spots in sergynous perforating elastosis

Elastic-Van Gieson (EVG) staining highlights elastic fibersTherefore, in this condition, black fibers will appear transgressing through the transepidermal elimination focus (Figures 5, 6).

Differential diagnosis from elastosis perforans serginosa

Traumatic collagen drilling: after traumatic erosion of the epidermis, altered collagen fibers on the surface dermis It may appear to pierce the residual epidermis. This is a secondary phenomenon that is not infrequently found in lesions of the prurigo nodularis Wide areas of epidermal erosion with adjacent epidermal hyperplasia and oriented vertically dermal fibrosis indicating chronic Prurigo are clues to the underlying cause. Also, the extruded fibers are collagen and will be negative with EVG staining.

Kyrle's disease: In this condition, the material that is "perforated" is a strictly inflammatory residue of the dermis and not collagen or elastic tissue. It overlaps with reactive perforating collagenosis.

Perforating reactive collagenosis: the extruded fibers are collagen and will be negative with EVG staining.