S5C18bP12b-1: In this example of graft vs host reaction, the patterns are those of a cell-poor lichenoid reaction at the dermal-epidermal interface, especially to the right of the center of the field. The papillary dermis and the neighboring portion of the reticular dermis are edematous. In this area, collagen bundles are thin; they are widely spaced in a clear matrix. Atrophy may also account for the pattern of collagen bundles in the reticular dermis. Vessels are ectatic. There are minimal perivascular infiltrates of lymphoid cells. The cell-poor lichenoid reaction affects a sweat duct, above and to the left of the center of the field. It also affects a follicle near the lower margin of the field.

S5C18bP12b-2: Rete patterns are effaced. Centrally, there are vacuolar changes at the dermal-epidermal interface. Melanophages are loosely spaced in the edematous, and atrophic, papillary and reticular dermis.

S5C18bP12b-3: The epidermis shows hyperplasia of the superficial unit with hyperkeratosis  and a prominent granular layer. The basal unit is atrophic; the basal layer shows vacuolar changes. At least one “apoptotic” cell is represented in the basal layer. Melanophages are present in the underlying dermis. The patterns have a LE-like quality.

S5C18bP12b-4: This sweat duct shows epithelial hyperplasia; the epithelial cells have keratinizing qualities. The lumen contains inflammatory cells. There are vacuolar changes at the interface between the epithelium and the dermis. There are mild, loose periductal infiltrates of lymphocytes.

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