Cintra M L, de Souza E M
Department of Pathology and Dermatology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, UNICAMP, São Paulo, Brasil.
Rev Paul Med. 1992 Sep-Oct;110(5):237-40.
Two specimens containing clinically inapparent histologic features of acantholytic dyskeratosis (on the base of a fibrous papule of the nose and overlying a psoriatic lesion) are presented. The authors discuss the conduct to be followed by the pathologist in similar cases. The general pathologist should be well trained in dermatopathology since cutaneous biopsies account for 10 to 25% of the specimens submitted for histologic diagnosis or, even, form the major part of the workload (Berry). There is a wall between the physician who submits the skin biopsies (who may be or not a dermatologist) and the pathologist. The clinical information provided by dermatologists is scant and incomplete and physicians who are not dermatologists seldom submit any information. The histological pictures found in skin biopsies are, often, common to several nosological entities and an adequate understanding of their meaning is desirable for a thorough evaluation. We ought to assess it with the maximum scientific severity, searching to solve the puzzle without depreciating the information received. In this report the authors analyse the histopathological approach to the cutaneous lesions of two patients. They displayed the association between acantholytic dyskeratosis (AD) and another cutaneous pathology. Findings like these may obstruct the final diagnosis to be issued by the pathologist.(ABSTRACT TRUNCATED AT 250 WORDS)
本文展示了两份标本，其具有棘层松解性角化不良的临床隐匿性组织学特征（一份位于鼻部纤维性丘疹基底，另一份覆盖于银屑病皮损之上）。作者讨论了病理学家在类似病例中应遵循的做法。由于皮肤活检标本占送检组织学诊断标本的10%至25%，甚至构成工作量的主要部分（贝里），普通病理学家应接受良好的皮肤病理学培训。提交皮肤活检标本的医生（可能是也可能不是皮肤科医生）与病理学家之间存在隔阂。皮肤科医生提供的临床信息稀少且不完整，而非皮肤科医生很少提交任何信息。皮肤活检中发现的组织学图像通常在几种疾病实体中较为常见，为了进行全面评估，需要充分理解其意义。我们应该以最大的科学严谨性来评估它，力求在不贬低所获信息的情况下解开谜团。在本报告中，作者分析了两名患者皮肤病变的组织病理学研究方法。他们展示了棘层松解性角化不良（AD）与另一种皮肤病理学之间的关联。这样的发现可能会妨碍病理学家做出最终诊断。（摘要截取自250词）
