Discover and read the best of Twitter Threads about #DermPath
Most recents (24)
A 44-yo♂️, HIV +, CD4 cell count of 86/mL, viral load of 35,900 copies/mL: a 1-month history of fevers and pruritic blackish-brown lamellated plaques on the limbs and scalp.
¼
👇
DOI: 10.1056/NEJMicm2213894
#IDtwitter #dermatology
¼
👇
DOI: 10.1056/NEJMicm2213894
#IDtwitter #dermatology
A RPR titer of 1:32.
A Treponema pallidum particle agglutination: ➕.
A skin-biopsy of the left forearm 🔬: diffuse dermal lymphocytes and histiocytes admixed with a plasma-cell infiltrate.
MALIGNANT SYPHILIS
2/4
#microbiology #dermpath #RareInfection
A Treponema pallidum particle agglutination: ➕.
A skin-biopsy of the left forearm 🔬: diffuse dermal lymphocytes and histiocytes admixed with a plasma-cell infiltrate.
MALIGNANT SYPHILIS
2/4
#microbiology #dermpath #RareInfection
Malignant #syphilis:
- uncommon form of secondary syphilis
- primarily affects immunocompromised persons.
-skin manifestations are varied, ranging from ulceronodular lesions to oyster shell–like crusts
3/4
#primarycare #MedTwitter #Awareness
- uncommon form of secondary syphilis
- primarily affects immunocompromised persons.
-skin manifestations are varied, ranging from ulceronodular lesions to oyster shell–like crusts
3/4
#primarycare #MedTwitter #Awareness
FINALLY clinician’s have figured that the PSEUDOSCIENTIFIC term “squamoproliferative lesion” means nothing more than a proliferating squamous lesion 🤣
#dermpath #dermtwitter #pathtwitter #dermatologia #dermatology #dermatologist #histopathology #dermatopathology
#dermpath #dermtwitter #pathtwitter #dermatologia #dermatology #dermatologist #histopathology #dermatopathology
Squamoproliferative lesion was invented by some hotshot pathologist pretending its a diagnostic entity, but it actually means nothing more than an unspecified and unqualified proliferating squamous “lesion”.
#dermpath #dermtwitter #pathtwitter #dermatology #dermatopathology
#dermpath #dermtwitter #pathtwitter #dermatology #dermatopathology
Viral warts, seborrhoeic keratosis, actinic keratosis, keratoacanthomas, in situ and invasive squamous carcinomas are ALL either benign, atypical or malignant “squamoproliferative lesions”
🤣🤣🤣
#dermpath #dermtwitter #pathtwitter #dermatologia #dermatology #histopathology
🤣🤣🤣
#dermpath #dermtwitter #pathtwitter #dermatologia #dermatology #histopathology
Finally a quiet moment😓.
This is an interesting case that came through this week:
76 F Rt Forehead.
SCC vs NUB #skin #dermpath #dermatology #dermatopathology #pathology #pathtwitter
low power 1st:
This is an interesting case that came through this week:
76 F Rt Forehead.
SCC vs NUB #skin #dermpath #dermatology #dermatopathology #pathology #pathtwitter
low power 1st:
Next is higher power at 100x
And now 200x
50+ Female, painful “end” nodule middle finger after trauma ?Neuroma
A rare Pacinian Corpuscle Neuroma 🤩
#dermpath #dermtwitter #pathtwitter #pathresident #dermatologia #dermatology #dermatologist #pathologist #histopathology #surgpath #dermatopathologia #dermatopathology
A rare Pacinian Corpuscle Neuroma 🤩
#dermpath #dermtwitter #pathtwitter #pathresident #dermatologia #dermatology #dermatologist #pathologist #histopathology #surgpath #dermatopathologia #dermatopathology
And tagging my icons to say “thank you” for your valued contributions and teaching 🙏
@DiegoMoralesN @melanopath @mccalmo @et565 @JacobSmalberger @alegru18 @CarlosMonteag20 @atman_ci @PIorfino @HENRYY_MD @kis_lorand @AlomariDermpath @CArnold_Coach @DKalodimou @ChristineJKoMD
@DiegoMoralesN @melanopath @mccalmo @et565 @JacobSmalberger @alegru18 @CarlosMonteag20 @atman_ci @PIorfino @HENRYY_MD @kis_lorand @AlomariDermpath @CArnold_Coach @DKalodimou @ChristineJKoMD
A short commentary of some interesting facts.
15yr Female, long standing slow growing pigmented lesion on buttock. DBN?
What of diffuse strong nuclear cyclin D1?
#dermpath
@DiegoMoralesN @melanopath @mccalmo @et565 @JacobSmalberger @alegru18 @CarlosMonteag20 @atman_ci @PIorfino @HENRYY_MD @kis_lorand @AlomariDermpath
What of diffuse strong nuclear cyclin D1?
#dermpath
@DiegoMoralesN @melanopath @mccalmo @et565 @JacobSmalberger @alegru18 @CarlosMonteag20 @atman_ci @PIorfino @HENRYY_MD @kis_lorand @AlomariDermpath
Immunos
And in case Henry asks if i STILL did a p16 the answer is …
An 85-YO in rural Mississippi: months of tender, erythematous plaques & edema on bilateral hands extending to the elbows & on feet extending below the knees with significant pain
🔬skin granulomatous inflammation & numerous AFB
Mycobacterial🧫:➖
1/19
#IDtwitter #dermatology
🔬skin granulomatous inflammation & numerous AFB
Mycobacterial🧫:➖
1/19
#IDtwitter #dermatology
A repeat skin extensive granulomatous inflammation (A), with Ziehl-Neelsen stain clusters of acid-fast bacilli throughout the dermis (B).
Kinyoun stain >9 AFB/high-power field (C & D).
2/19
DOI: doi.org/10.1128/jcm.00…
#dermpath #microbiology
Kinyoun stain >9 AFB/high-power field (C & D).
2/19
DOI: doi.org/10.1128/jcm.00…
#dermpath #microbiology
Molecular identification: 100% identity to multiple Mycobacterium leprae
BORDERLINE LEPROMATOUS LEPROSY WITH REVERSAL REACTION
3/19
#MedTwitter #MolBiol
BORDERLINE LEPROMATOUS LEPROSY WITH REVERSAL REACTION
3/19
#MedTwitter #MolBiol
Feeling lucky 🎰?
🍑vs 🍓.
These 2 lesions are similar but not the same. Let’s take a closer 👀 look…
#skin #dermpath #dermatology #dermatopathology #pathology #dermresident #dermboards #dermboardsstudying #pathologist #surgicalpathology #surgpath #pathtwitter #pathresident
🍑vs 🍓.
These 2 lesions are similar but not the same. Let’s take a closer 👀 look…
#skin #dermpath #dermatology #dermatopathology #pathology #dermresident #dermboards #dermboardsstudying #pathologist #surgicalpathology #surgpath #pathtwitter #pathresident
Let’s look closer at peach 🍑
Now closer at strawberry 🍓
A pathologist’s first words:
“red is dead, blue is bad.”
This picture of a slide encapsulates both in one image.
#skin #dermpath #dermatology #dermatopathology #pathology #pathologist #surgicalpathology #surgpath #pathtwitter #pathresident #trishtorial
“red is dead, blue is bad.”
This picture of a slide encapsulates both in one image.
#skin #dermpath #dermatology #dermatopathology #pathology #pathologist #surgicalpathology #surgpath #pathtwitter #pathresident #trishtorial
Only 53…leg. Didn’t suspect it. Only hx of prior nevi removed.
I suppose it’s obvious where the diagnosis is headed…
I suppose it’s obvious where the diagnosis is headed…
I only did 3 stains, probably could have used just 1, but with the lack of history I guess it felt right to super-prove it .
A 50-YO ♀️ bitten by her pet rat: fever, myalgia, sore throat, headaches a nonpruritic rash on extremities including palms & soles, arthralgias, knees arthritis.
A punctate wound with central necrosis on L palm, & her R thumb.
1/9
#rheumatology #internalmedicine #dermatology
A punctate wound with central necrosis on L palm, & her R thumb.
1/9
#rheumatology #internalmedicine #dermatology
Leukocytosis with neutrophilia
ESR & PCR:⬆️
Purulent R knee synovial fluid:
✔️46 000 cells/mL (88% neutrophils).
✔️Gram stain: scant pleomorphic gram-negative bacilli in chains with lateral bulbar swellings
2/9
doi.org/10.1093/cid/ci…
#microbiology #rheumatologist
ESR & PCR:⬆️
Purulent R knee synovial fluid:
✔️46 000 cells/mL (88% neutrophils).
✔️Gram stain: scant pleomorphic gram-negative bacilli in chains with lateral bulbar swellings
2/9
doi.org/10.1093/cid/ci…
#microbiology #rheumatologist
Synovial fluid 🧫culture: Streptobacillus moniliformis identified by biochemical testing & confirmed by MALDI-TOF.
RAT BITE FEVER (RBF) WITH SEPTIC ARTHRITIS DUE STREPTOBACILLUS MONILIFORMIS
3/9
#bacteriology #IDtwitter #microbiología
RAT BITE FEVER (RBF) WITH SEPTIC ARTHRITIS DUE STREPTOBACILLUS MONILIFORMIS
3/9
#bacteriology #IDtwitter #microbiología
13 años ♂️: lesiones verrugosas en mucosa oral de 2 años de evolución, con progresivo aumento en tamaño y número.
1/7
🖊️Alonso P, Vázquez A, Santos JL.
continuum.aeped.es/screens/play/1…
@ContinuumAEP @aepediatria
#pediatria #dentista #AtencionPrimaria
1/7
🖊️Alonso P, Vázquez A, Santos JL.
continuum.aeped.es/screens/play/1…
@ContinuumAEP @aepediatria
#pediatria #dentista #AtencionPrimaria
@ContinuumAEP @aepediatria HIPERPLASIA EPITELIAS FOCAL o ENFERMEDAD DE HECK:
📌infección viral rara de la mucosa oral
📌causada por el virus del papiloma humano, especialmente los subtipos 13 o 32.
2/7
#infecciosas #microbiología #MIR
📌infección viral rara de la mucosa oral
📌causada por el virus del papiloma humano, especialmente los subtipos 13 o 32.
2/7
#infecciosas #microbiología #MIR
@ContinuumAEP @aepediatria ✔️Es una proliferación epitelial benigna, ✔️asintomática,
✔️ múltiples pápulas de 3 a 10 mm con color de mucosa oral normal.
La frecuencia de esta enfermedad varía ampliamente de una región geográfica y grupo étnico a otro.
3/7
#healthcare #MedicinaInterna
✔️ múltiples pápulas de 3 a 10 mm con color de mucosa oral normal.
La frecuencia de esta enfermedad varía ampliamente de una región geográfica y grupo étnico a otro.
3/7
#healthcare #MedicinaInterna
A 46-YO ♂️: oropharyngeal lesions, cervical lymphadenopathy, intermittent fever, hepatosplenomegaly, and deteriorating general health.
Needle aspiration from submandibular lymph node: intra- and extracellular yeasts
1/4
DOI:
doi.org/10.4269/ajtmh.…
#dermpath #mycology
Needle aspiration from submandibular lymph node: intra- and extracellular yeasts
1/4
DOI:
doi.org/10.4269/ajtmh.…
#dermpath #mycology
The histopathology of oral lesion showed features of HISTOPLASMOSIS confirmed later from culture of Histoplasma capsulatum on culture
2/4
#IDtwitter #microbiology #MedTwitter
2/4
#IDtwitter #microbiology #MedTwitter
In immunocompetent hosts, when chronic disseminated histoplasmosis occurs from pulmonary infection, oral ulcers, nodules, and vegetative plaques are common and dissemination to liver, spleen, bone marrow, and other organs is frequent.
3/4
#Doctor #MedStudentTwitter #resident
3/4
#Doctor #MedStudentTwitter #resident
A 37-YO, farmer in India, #HIV+ immunecompromised ♂️, treatment for suspected pulmonary tuberculosis: papulonodular lesions of 3-month duration over the face, neck, trunk, limbs, palms & soles, & oropharynx; fever & generalized lymphadenopathy
🔬: ?
1/7
#IDTwitter #microbiology
🔬: ?
1/7
#IDTwitter #microbiology
🔬: Blastoconidias within the macrophages.
🧫: Histoplama capsulatum: characteristic colony, conversion to yeast form, characteristic🔬appearance.
PROGRESSIVE DISSEMINATED HISTOPLASMOSIS
2/7
doi: 10.4269/ajtmh.17-0432
#dermpath #mycology #internalmedicine
🧫: Histoplama capsulatum: characteristic colony, conversion to yeast form, characteristic🔬appearance.
PROGRESSIVE DISSEMINATED HISTOPLASMOSIS
2/7
doi: 10.4269/ajtmh.17-0432
#dermpath #mycology #internalmedicine
Diagnosis is usually suspected on visualization of characteristic intracellular yeast (blastoconidias), the pathogenic or tisular form, with a clear rim and garnulomatous cellular infiltrate in tissue specimen or lymph node aspirate
3/7
#MedTwitter #Doctor
3/7
#MedTwitter #Doctor
An 86-YO ♂️, injury on his L leg 47 years prior, several debridements, skin grafts, & vein stripping procedures: chronic bilateral leg progressive ulcers.
Superficial🧫: multiple organisms including E. coli & coagulase➖Staphylococcus.
1/6
#internalmedicine #IDtwitter
Superficial🧫: multiple organisms including E. coli & coagulase➖Staphylococcus.
1/6
#internalmedicine #IDtwitter
Skin biopsy🔬: bilateral invasive squamous cell carcinomas.
BILATERAL INVASIVE SQUAMOUS CELL CARCINOMAS (MARJOLIN ULCERS)
2/6
#dermatology #dermpath
doi.org/10.1093/cid/ci…
BILATERAL INVASIVE SQUAMOUS CELL CARCINOMAS (MARJOLIN ULCERS)
2/6
#dermatology #dermpath
doi.org/10.1093/cid/ci…
The mean time period between development of a wound to malignancy is 30–35 years.
The most common malignancies seen in Marjolin ulcers are squamous cell carcinomas, but basal cell carcinomas and melanomas have been reported.
3/6
#Doctor #healthcare #MedStudentTwitter
The most common malignancies seen in Marjolin ulcers are squamous cell carcinomas, but basal cell carcinomas and melanomas have been reported.
3/6
#Doctor #healthcare #MedStudentTwitter
This little lesion was a cute surprise. It came in from the finger (radial nail fold) of a 46 yo male, clinically described as either a wart or callus.
Let’s take a little look 👀see🫣shall we?#dermpath #trishtorial #pathtwitter@
Let’s take a little look 👀see🫣shall we?#dermpath #trishtorial #pathtwitter@
Things you can notice at low power:
🔺acral skin with nail☑️,
🔺no epidermal collarette around area of lesion (which appears dermal)☑️,
🔺something looks bluish☑️
🔺acral skin with nail☑️,
🔺no epidermal collarette around area of lesion (which appears dermal)☑️,
🔺something looks bluish☑️
So let’s start figuring this out, yes 🙌? Is this a:
Based on the above images, what is your first impression?
* Dermatofibrosarcoma protuberans
^Pleomorphic dermal sarcoma
* Dermatofibrosarcoma protuberans
^Pleomorphic dermal sarcoma
S100 and SOX10
Skin.
Two images to think about in this diagnosis.
What tips can we list in these two images?
What did I sign?
Next step?
#dermpath #pathology
Two images to think about in this diagnosis.
What tips can we list in these two images?
What did I sign?
Next step?
#dermpath #pathology
1- In these images, I want to draw attention to two tips. First, that there is a combination of patterns (Lichenoid + psoriasiform). A combination of different reaction patterns should always make you think of syphilis.
2- Another tip is what I drew: Rete ridges. Dr Elston's famous quote for them is sexy ridges. Very characteristic of syphilis.
Next step: Thinking about syphilis, look for plasma cells.
Next step: Thinking about syphilis, look for plasma cells.
Paciente de 70 años,natural de Pakistan.Presenta la siguientes lesiones a nivel cervical.
¿En qué entidad pensarías?
#dermatology #dermatología #2MIR23 #2MIR24 #ENARM2023 #dermtwitter #dermpath #MedTwitter #medicina
¿En qué entidad pensarías?
#dermatology #dermatología #2MIR23 #2MIR24 #ENARM2023 #dermtwitter #dermpath #MedTwitter #medicina
Elige la respuesta correcta:
En este caso,para llegar al diagnóstico, ¿cuál de las siguientes opciones es la más correcta?
Classic and common dual pathology. 70 Male curetted “Seborrhoeic keratosis” …..which its not 🤣🤣🤣
#dermpath #dermtwitter #pathtwitter #dermatology #dermatologist #pathologist #dermatopathologia #dermatopathology
#dermpath #dermtwitter #pathtwitter #dermatology #dermatologist #pathologist #dermatopathologia #dermatopathology
Morphology: basal cell carcinoma with an unusually diffuse and dense infiltrate of monotonous small inactive lymphocytes.
Immunohistochemistry:
Another case to discuss, Cylindroma on 91yo female abdomen. it’s multiple in dermatomal distribution with extreme pain. There is this nerve entrapment at the base of the section. Histology seems benign but somewhat infiltrated nodules at the base. Q below #dermpath #derm
It is challenging to treat, and also a concern if this is malignant based on clinical behavior. I am suggesting to excise the prominent nodules with local radiation for the rest of small nodules in the region. Any other thoughts ?
This patient has no history of syndromic features, but she had to remove 2 ft intestines in the past(I couldn’t get the detail but assume obstruction or diverticulitis).
Sept challenge! recently taught @yalederm, trying to channel thinking, fast and slow:thru 9/30, 1 #dermpath/day, 10 AM EST (please retweet!) - can you mentally match each posted WSI (not all rep'ed here) with these clinical? in other words, what'd be the #histopath? @kikofordocs
Around September 30th, there will be "review" and an index of these cases on KiKo (credit to @forthejon for a great platform!) - please share with anyone interested in a case/day @JMGardnerMD @RoxanaDaneshjou @michi_shinohara @MishaRosenbach @DrStevenTChen @sunpungi
Dome shaped papule with central ulcer and massive necrosis, prominent cytoplasmic ballooning degeneration of epithelial cells noted in peripheral edges of the papule.
The ballooning degeneration mainly occurred in the lower part of the epidermis, underlying dermis is necrotic with vascular occlusion and dense inflammation.
It's overdue. Time for a #dermtwitter #tweetorial on...
SEZARY SYNDROME!
We're going to focus on presentation and work up!
#sezary #ctcl #medtwitter #onctwitter #meded #FOAMEd
1/
SEZARY SYNDROME!
We're going to focus on presentation and work up!
#sezary #ctcl #medtwitter #onctwitter #meded #FOAMEd
1/
Just a few years ago, Sezary Syndrome (SS) was thought to be the leukemic variant of Mycosis Fungoides (MF). We basically thought people had MF, it would keep getting worse, and then it would turn into SS.
Check out my old #tweetorial on MF here👇
2/
Check out my old #tweetorial on MF here👇
2/
But patients often present with either the classic SS exam (red all over, super itchy), or with MF. Some patients would progress from MF--> SS, but it's the minority. So it became clear these are two different processes.
For that reason, we've changed how we think about it...
3/
For that reason, we've changed how we think about it...
3/
Areas of hyperpigmentation on bilateral cheeks, what is your diagnosis? #dermpath #pathology #dermatology
Final diagnosis: Ochronosis 🔬 Banana/crescentic shaped, ochre-colored fibers that can be free in the dermis or within macrophages #dermpath #pathology #dermatology
Can occur in
(1) Alkaptonuria-Dark blue pigmentation of head/neck, sclera, ears & palmoplantar
(2) Hydroquinone induced (skin bleaching agent)-Usually face/neck
(3) Anti-malarial drug-induced–Subungual, pretibial & facial pigmentation #dermpath #pathology #dermatology
(1) Alkaptonuria-Dark blue pigmentation of head/neck, sclera, ears & palmoplantar
(2) Hydroquinone induced (skin bleaching agent)-Usually face/neck
(3) Anti-malarial drug-induced–Subungual, pretibial & facial pigmentation #dermpath #pathology #dermatology
Due to the current outbreak of monkeypox in Western countries, I thought it would be good to review the clinical and pathology of this rare disease. More below.
#monkeypox #pathology #dermpath #dermatology
#monkeypox #pathology #dermpath #dermatology
Previously, monkeypox outbreaks were zoonotic from monkeys or rodents. The current outbreak is human-to-human. Currently, most cases are homosexual males with genital skin lesions.
Incubation period of 1-2 wks, followed by fever, headache, backache, and vomiting. Skin lesions start as macules, then vesicles, papules, pustules, and crusts.
Source of photo: ncbi.nlm.nih.gov/pmc/articles/P…
Source of photo: ncbi.nlm.nih.gov/pmc/articles/P…
