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Dr. Mona Abdel-Halim

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Understanding dermatopathology related terminology is the basic step in learning dermatopathology. Sometimes residents get confused in these two words;" spongiosis" and "spongiform[b]"[/b]

From the medical dictionary (www.medical-dictionary.com), spongiosis was defined as an inflammatory intercellular edema of the epidermis, while spongiform was given 3 descriptions: 1) Soft, and full of cavities; of an open, loose, pliable texture as, a spongy excrescence; spongy earth; spongy cake; spongy bones. 2) Wet; drenched; soaked and soft, like sponge; rainy "Spongy April". 3) Having the quality of imbibing fluids, like a sponge.

Spongiform pustules in dermatopathology textbooks are defined as collections of neutrophils within degenerated and reticulated keratinocytes in which the cell walls of the keratinocytes persist as a sponge like network. Looking at them, you can clearly feel you are looking at a sponge that has imbibed neutrophils. It is a peculiar form of neutrophil exocytosis. Not any neutrophils within a spongiotic epidermis are spongiform pustules!!! You have to see a sponge filled with neutrophils to describe spongiform pustules!!

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