S11C20P15-Fungus

S11C20P15-1: The patterns are both psoriasiform and spongiotic. There is a sub-corneal defect. In the region of the defect, the patterns somewhat resemble those of pemphigus foliaceus. The papillary dermis is edematous (superficial fungus infection).

S11C20P15-2: With a PAS stain and at higher magnification, there are a few hyphae in the keratin layer and in the defect (red arrows) (superficial fungus infection).

S11C20P15-3: This portion of acral (palmar) skin is basically free of inflammation. There is some degree of acanthosis with elongation of rete ridges. A stratum lucidum is represented. There is some degree of hyperkeratosis; the keratinized cells are not flattened. When faced with a biopsy specimen in which there are few clues as to why the clinician may have taken the biopsy, a careful examination of the keratin layer, in search of organisms, is indicated.

S11C20P15-4:At higher magnification, green arrows identify pigmented, branching hyphae in defects in the keratin layer (tinea nigra).

 

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