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Dermatopathology is all around you!


Dr. Mona Abdel-Halim

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Dermatopathology is an interesting branch with which one develops a special passion! A passion that make you live with cells running in front of your eyes, tissue reaction patterns puzzling you day and night, lovely adnexal tumors dancing in your visual memory, scary yet pretty looking malignant tumors popping in front of you every now and then. When you love dermatopathology, you take it with you wherever you go! Just see:

• You enjoy a cup of tea with your best friends, you look at the lovely China tea pot, and you remember the tilted focal parakeratosis of pityriasis rosea (Tea Pot Lid Sign).

• You feel hungry, you go to the nearby Italian restaurant, you order spaghetti and meat balls, you start to eat, suddenly, you see in your plate the hyphae and spores of tinea versicolor (Spaghetti and Meat Ball Sign).

• When you crave for a sandwich and while you are stuffing it you remember the hyphae of dermatophytes sandwiched between an upper normal basket weave stratum corneum and a lower recently produced abnormal stratum corneum (parakeratosis or compact orthokeratosis) (Sandwich Sign).
• You go to the market to buy beans, a bag of beans, you see in front of you the large hungry histiocytes that has engulfed many erythrocytes and cellular debris in histiocytic cytophagic panniculitis, hemophagocytosis (Been Bag Cells).

• You eat ripe bananas; you remember the ocher colored crescentic banana shaped collagen fibres seen in Ochronosis.

• Sometimes it is somehow disgusting, you fry nuggets for your kids, you forget them in the pan, they get brown, and oh that is awful, scybala, Sarcoptes scabii excreta in the stratum corneum (Brown Nuggets Sign).

• Your daughter asks you to brush her hair and make her a small pig tail; you remember the egg fragments or casings of the Sarcoptes scabii mite after it hatches when they remain connected to the stratum corneum (Pink Pig Tails Sign).
• You walk in the field, you watch the bees flying around the comb, here comes the image of the lymphocytes surrounding and attacking the bulb of the hair follicle in alopecia areata (Swarm of Bees Sign).
• You play a game of chess with your friend, you start to arrange your army, and you remember the alternating parakeratosis and orthokeratosis in both vertical and horizontal directions seen in pityriasis rubra pilaris (Checker Board Sign).

• You watch a beautiful lady wearing a short top and exposing her belly button, you remember the lymphocytes present on the upper (epidermal) side of the superficial vascular plexus with few, if any, on the under surface reflecting their directed migration to the epidermis in MF (Bare Underbelly Sign).

• You watch coal miners in a TV documentary, you remember the large hyperchromatic atypical lymphocytes seen in lymphomatoid papulosis like chunks of coal among the infiltrate (Chunks of Coal Sign).

• You watch the news and you hear about protestors in Egypt being attacked by buck-shots that scatter in their eyes and bodies, you remember the atypical melanocytes spreading singly in a pagetoid manner in the epidermis of superficial spreading melanoma (Buck-shot Scatter Sign).

• Finally, you relax in the weekend and think about what you have achieved last week, you remember (The Last Week Sign) when you see parakeratosis overlying basket weave orthokeratin indicating a no longer active dermatosis, a dermatosis that is playing itself out.

Told you, Dermatopathology is everywhere around you!
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Dr. Phillip McKee

Posted

You are a true and perfect dermatopathologist, Mona. Mind you I am not sure that I would want to dine with you. I eat pretty much nothing but beef, either roasted or as steaks. I have an awful feeling that somehow you would be able to make me put my knife and fork away and reach for a glass of water although some many critters live in water that perhaps it is off limits too!! Perhaps we should get our day's calories in tablet form.
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Dr. Hafeez Diwan

Posted

A wonderful post! I am reminded of William Blake, who wrote, "To see a world in a grain of sand/And a heaven in a wild flower/Hold infinity in the palm of your hand/And eternity in an hour." I think you are saying something like (with apologies to the late William Blake), "To see Tinea versicolor in a plate of spaghetti/And ochronosis in a ripe banana/See mycosis fungoides in a beach bare underbelly/And nuggets remind you of scybala."
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Dr. Mona Abdel-Halim

Posted

I am glad to receive such lovely comments from such experts,,, Dermatopathology is my passion,,,
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