S11C29P24-Vibrio

S11C29P24-1: In this field, the epidermis and the dermis are necrotic. Extravasated red blood cells contribute the intense red to the right of the center of the field; the lesion is purpuric. The zone of basophilia to the right at the bottom of the field represents an area of suppuration and necrosis (wet gangrene - vibrio vulnificus infection). On viewing these patterns, Ed Beckman comes to mind.

S11C29P24-2: Ghost outlines, including those of epidermis, collagen bundles of the reticular dermis, skin appendages, and thrombosed vessels, are preserved in this area of necrosis. The few scattered nuclei are pyknotic and fragmented; they probably represent the altered nuclei of inflammatory cells. The lesion is gangrenous (Vibrio infection).

S11C29P24-3: In this area of suppuration and necrosis, a vessel, cut in cross-section, shows fibrinoid necrosis.

S11C29P24-4: The adipose tissue is necrotic; it contains interstitial infiltrates of neutrophils. A vessels to the right is inflamed and thrombosed (Vibrio infection).

S11C29P24-5: The patterns in this example of a lesion of varicella are lichenoid and vesicular. The defects are sub-, and intra-epidermal. The roof of the vesicle is partially necrotic. The defect contain numerous, dead, condensed, acidophilic keratinocytes (cellular debris loosely spaced in acantholytic patterns - green arrows). At the margins of the vesicular component, the patterns, at the dermal-epidermal interface, have lichenoid qualities (varicella).

S11C29P24-6: The epidermal defect contains the debris of necrotic (dyskeratotic) keratinocytes and scattered, viable, but infected, keratinocytes. There are collections of extravasated red blood cells in the epidermal defect and at the dermal-epidermal interface.

S11C29P24-7:Many of the altered, but viable, acantholytic cells in the defect (the cells that show intact nuclei) also show intra-nuclear inclusions. There are numerous necrotic, condensed cells. The infiltrates along the floor of the defect are rich in histiocytes.

S11C29P24-8: Blue arrows identify two of the nuclei which contain intra-nuclear inclusions. The inclusion is a pale, homogeneous pink; the nuclear chromatin is pushed to the periphery of the nucleus by the inclusion. A classic Cowdry type A inclusion generally is not a feature of formalin fixed tissue. Ballooning degeneration, dyskeratosis, and cytolysis are prominent features.

 

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