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S2C12P6-1: This example of psoriasiform chronic dermatitis is hypertrophic. The papillary qualities along the surface are contributed in part by the widened ostia of hair follicles. The widened papillary dermis shows lamellar fibrosis; lichen simplex chronicus should be considered in the differential diagnosis.

S2C12P6-2: In this example of spongiotic and psoriasiform dermatitis, the papillary dermis shows some evidence of lamelllar fibrosis.

S2C12P6-3: Prurigo nodularis is an extreme response of the skin to chronic external trauma. This lesion is nodular at the surface of the skin; it has a central stalk composed of dense fibrous tissue. The epidermal patterns have a psoriasiform quality. Perivascular infiltrates of lymphoid cells are more prominent in the dermis, adjacent to the lesion, than in the stalk, or in the dermis beneath the lesion. The lesion has fibrokeratomatous qualities. Hyperplasia of peripheral nerves is sometimes mentioned as a requisite for the diagnosis of prurigo nodularis.

S2C12P6-4: In this example of lichen simplex chronicus, lamellar fibrosis is a prominent feature (Reed RJ & Ackerman AB: Pathology of the adventitial dermis. Hum Pathol 1973;4:207-217)). Lamellar fibrosis of the papillary dermis in this pattern has a relationship to chronic external trauma, such as scratching.

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