S8C26aP12a-Dermatolysis



S8C26aP12a-1: The reticular dermis shows severe actinic damage with solar elastosis. In the altered dermis, near the interface between the papillary dermis and the reticular dermis, an irregular and angulated cleft contains a blood clot. There also are clusters of extravasated red blood cells in the interstitium of the neighboring dermis. The cleft is real; it is a defect easily produced in the altered connective tissue of aged, sun-damaged skin by the shearing forces of daily life; the process is closely related to “senile purpura;” I use the designation, senile or actinic dermatolysis, for lesions of this type.

S8C26aP12a-2: The defects may be encountered in histologic preparations long after the markers for trauma (i.e., red blood cells) have disappeared. The defects generally are ignored by pathologists; they are dismissed as technical artefacts. In some examples, the defects are inlaid with a delicate fibrous matrix that is devoid of the elastotic material (senile dermatolysis).


S8C26aP12a-3: The defects tear into the sun-damaged dermis; they are unlined.

S8C26aP12a-4: This is another example of senile dermatolysis; the defect appears to be mid-dermal, but is within the zone of actinically damaged connective tissue (zone of solar elastosis). The pale, acidophilic fibrous tissue, interspersed among islands of solar elastosis, beneath the cleft, is interpreted as a pattern of repair in an earlier defect. There are scattered deposits of condensed fibrin along the surface of the cleft.

S8C26aP12a-5: In this field, the defect is represented; it is partially outlined by condensed fibrin. A follicle has been interrupted by the cleft; follicular epithelium has regenerated along the floor of the defect.

S8C26aP12a-6: Multiple jagged defects are present in the zone of solar elastosis and senile dermal atrophy. Some are lined by deposits of condensed fibrin; some (i.e., to the left above the center of the field) are filled with a loose meshwork of fibrin.

S8C26aP12a-7: The defects of senile dermatolysis may persist as such; in some lesions, as in this example, a delicate, fibrous matrix is inlaid in the defects.

S8C26aP12a-8: A loose, delicate fibrous matrix in outlined by blue arrows. This matrix is interpreted as an inlay in a defect of senile dermatolysis.

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