S11C26P21Herpes

S11C26P21-1: In this lesion of herpes simplex virus infection, the cytopathic changes, especially ballooning degeneration, are well developed; there are lytic defects. Many of the nuclei contain inclusions (blue arrows). Some of the keratinocytes are multinucleated (red arrows). Neutrophils are prominent in the epidermal infiltrates. In the dermis, in lesions of this type, the infiltrates usually are composed of histiocytes and lymphocytes.

S11C26P21-2: In this field from a lesion of herpes simplex virus infection, green arrows identify intra-nuclear inclusions. A blue arrow points to a dyskeratotic cell. Red arrows point to a binucleated keratinocyte; each nucleus contains an inclusion.

S11C26P21-3: Red arrows point to intra-nuclear inclusions. Blue arrows point to cells showing prominent ballooning degeneration. There is an infected, multinucleated keratinocyte near the top of the field ( herpes simplex virus infection).

S11C26P21-4: This lesion of epidermolytic hyperkeratosis might seem out of place in a discussion of inflammatory changes in viral diseases but, to the uninitiated, the patterns might easily be confused with those of herpes virus infection. Organization is better preserved than in a lesion of herpes simplex. The lesion shows a prominent granular layer with compact hyperkeratosis. There is marked intra-cellular edema with dyskeratosis. Intranuclear inclusions are not a feature. Inflammation generally is not a feature.

S11C26P21-5: This is another example of epidermolytic hyperkeratosis (linear nevus). In this example, the intra-cellular edema has disrupted some of the keratinocytes to produce lytic defects in reticulated patterns.

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