Inflammatory Dermpath 101 (A Beginner's Guide to Diagnosing Skin Rashes for Non-Dermatopathologists)

A basic algorithmic approach to the microscopic diagnoses of inflammatory skin disease aimed at medical students, residents, general surgical pathologists, and other non-dermatopathologists. Presented virtually as the 2021 Bouldin Lectureship Grand Rounds lecture at the University of North Carolina Department of Pathology & Laboratory Medicine, April 8, 2021. All images in the video are from my Survival Guide to Dermatopathology textbook (available here: bit.ly/2Te2haB). ‬
A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
Topics discussed and timestamps:
**HUGE thanks to viewer Tonia Syrnioti for typing these up for me! Thank you!!!**
Intro 0:00
How to approach an inflammatory skin biopsy 5:56
Spongiotic pattern 9:16
List of diseases 11:04
Presence of eosinophils 11:46
Langerhans microabscesses 12:46
Subcorneal pustule 13:58 (spongiosis + eosinophils + subcorneal pustule: AGEP)
Do a PAS stain - think of dermatophyte infection
Scale (parakeratosis) crust (pink serum) 16:10
Psoriasiform pattern 16:58
List of diseases 19:20
Munro's microabscess 19:58
Guttate psoriasis 20:08
Psoriasiform + lichenoid + plasma cells - Do spirochete stain for secondary syphilis!
Vacuolar & Lichenoid interface pattern 20:40
Vacuolar interface pattern 20:48
List of diseases 22:38
Lichenoid interface pattern 23:38
List of diseases 23:52
Lichen planus 24:48
Hypertrophic lichen planus 26:50
Lichen sclerosus et atrophicus 28:25
Lichen simplex chronicus 32:46
Prurigo nodularis 34:36
Stevens- Johnson's syndrome/TEN 36:08 (can look identical to Erythema multiforme)
Lupus erythematosus 37:26
Discoid lupus erythematosus 38:06 (can look like AK/SCC)
Superficial perivascular pattern 38:49
List of diseases 38:58
Urticaria 39:08
Superficial & deep perivascular pattern 39:21
List of diseases 39:39
Arthropod bite reaction 40:01 (can look like bullous pemphigoid)
Wells syndrome 40:29
Perniosis (chilblains) 41:02
Granulomatous pattern 41:19
List of diseases 41:45
Remember to look for fungi & foreign material
Sarcoidosis - diagnosis of exclusion
Palisading necrobiotic granulomatous pattern 42:15
List of diseases 42:49
Granuloma annulare 43:25
Elastophagocytosis 43:35
Rheumatoid nodule 43:55
Mimic: epithelioid sarcoma 44:45
Necrobiosis lipoidica 45:38
Necrobiotic xanthogranuloma 46:00
Leukocytoclastic vasculitis pattern 46:22
List of diseases 47:58
Polyarteritis nodosa 48:05
Thrombotic vasculopathy pattern 48:34
List of diseases (often medical emergencies!!) 49:20
This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.
Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.
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Twitter: @JMGardnerMD
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Kiko: kikoxp.com/profile/jerad_gard...
Facebook: / jmgardnermd

[@JMGardnerMD]

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@lucianabattipiede4425]

thank you so much!!!

[@deeptisukheeja905]

How to open this library?

[@SunilSahu-vl4it]

Sir how to do crash course i want to knows about atopic dermatitis and eczema

[@SunilSahu-vl4it]

Plz suggest

[@toniasyrnioti9389]

Intro 0:00 How to approach an inflammatory skin biopsy 5:56 Spongiotic pattern 9:16 List of diseases 11:04 Presence of eosinophils 11:46 Langerhans microabscesses 12:46 Subcorneal pustule 13:58 (spongiosis + eosinophils + subcorneal pustule: AGEP) Do a PAS stain - think of dermatophyte infection Scale (parakeratosis) crust (pink serum) 16:10 Psoriasiform pattern 16:58 List of diseases 19:20 Do a spirochete immunostain (esp if there are plasma cells) - think of secondary syphilis Munro's microabscess 19:58 Guttate psoriasis 20:08 Vacuolar & Lichenoid interface pattern 20:40 Vacuolar interface pattern 20:48 List of diseases 22:38 Lichenoid interface pattern 23:38 List of diseases 23:52 Lichen planus 24:48 Hypertrophic lichen planus 26:50 Lichen sclerosus et atrophicus 28:25 Lichen simplex chronicus 32:46 Prurigo nodularis 34:36 Stevens- Johnson's syndrome/TEN 36:08 (can lood identical to Erythema multiforme) Lupus erythematosus 37:26 Discoid lupus erythematosus 38:06 (can look like AK/SCC) Superficial perivascular pattern 38:49 List of diseases 38:58 Urticaria 39:08 Superficial & deep perivascular pattern 39:21 List of diseases 39:39 Arthropod bite reaction 40:01 (can look like bullous pemphigoid) Wells syndrome 40:29 Perniosis (chilblains) 41:02 Granulomatous pattern 41:19 List of diseases 41:45 Remember to look for fungi & foreign material Sarcoidosis - diagnosis of exclusion Palisading necrobiotic granulomatous pattern 42:15 List of diseases 42:49 Granuloma annulare 43:25 Elastophagocytosis 43:35 Rheumatoid nodule 43:55 Mimic: epithelioid sarcoma 44:45 Necrobiosis lipoidica 45:38 Necrobiotic xanthogranuloma 46:00 Leukocytoclastic vasculitis pattern 46:22 List of diseases 47:58 Polyarteritis nodosa 48:05 Thrombotic vasculopathy pattern 48:34 List of diseases (often medical emergencies!!) 49:20

[@JMGardnerMD]

Thank you!!!! You’re a rockstar!!! I’ll copy paste this into video description and give you name credit for typing it up! Do you have a Twitter or Instagram profile or website link I can promote for you? If so I’ll copy it there also. Thank you again!

[@ryaddjaghri861]

I don't know how to thank you for all you are doing, you are a very good teacher, and you are a human and generous person... I hope you can continue in what you are doing... Thank you so much... God bleds you

[@sameeraansar1343]

Thank you so much. This is the most time-consuming and difficult topic for beginners like me. Thank you very much for your time and effort. You make our life better!!

[@dermatologie-quist]

Dear Jared, thanks a lot for your fantastic videos and for putting them together in a database. This is outstanding work!!

[@Hemepath]

Congratulations on approaching to 40K subscribers!

[@jabrowski_]

Hey Doc. I'm a security guard and they sent me to help out at a dermapatholoic diagnostic company. KZbind and found u. Liked and subbed bro. Thanks for the info

[@JMGardnerMD]

Wow that’s awesome. Thanks for the work you do!

[@madhudewan8207]

Fantastic presentation. After finishing my fellowship and bringing four projects to completion in 1999, with Bernie Ackerman as my program Director , I missed him at times. You made my day. This is awesome.

[@firdauszakaria7794]

Thank you for your videos Dr Gardner. You're very inspirational and I pray for your success 🤲 InsyaAllah - 1st year clinical derm fellow from Malaysia

[@dr.parneetkd1940]

Such a great video on such a difficult topic!!!

[@gerikn20]

Thank you so much for your detailed and really useful work!

[@user-ec2df9cy7l]

Thank you for your precious lecture, and your ambition

[@aminasalman318]

Thankyou for this great learning opportunity .

[@mohammednatiq1139]

thank you for your great effort to make skin, soft tissue and bone pathology entertaining. I"ve watched almost all your videos. it help me a lot and I wish you the best in your life.

[@JMGardnerMD]

Thank you! A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@mohammednatiq1139]

@@JMGardnerMD thank you sir

[@roselynmakaza1363]

Thank you. This is fantastic and priceless!

[@shamoliyasmin699]

such a nice lecture, thank you so much!

[@alejandroalvarez6075]

Thanks for your time and all your videos. Im just start my dermpath rotation in Seville.

[@JMGardnerMD]

Good luck on your rotation! Me encanta Sevilla!

[@younesaljohmani5560]

Thank you so much!

[@waelibrahim1961]

Thanks a bunch!

[@samiransari2944]

Dear Dr ... u r superb 👏 ...

[@pathologieradeberg9429]

fellowship forever unknown friend.. berni for everyone!

[@JMGardnerMD]

🙏🏻

[@yasirmohammedali]

Hi ... Thank you very much

[@woloabel]

Dermatitides or Dermatoses are just the beginning of a medical concern diagnostically or patient morbidity (pathogenesis of martyrdom). If the patient/subject is not congenitally pathological, it is an inflitrative disease process (Infectious inflammatory disease; Epidemiology shows this clearly). MD Jared M. Gardner et al, this is a good start (From Houston to Pennsylvania)....Most correct, the Internet is a massive beast, but can be a window into vital subjects and the dissemination thereof. I just wished this tool was better utilized. Cheers. Die Kenntniss immer sehr gut geht ist! Aufwiedersehen.

[@lusshie3098]

Thank you 🌺🌺

[@darioahangari8301]

Hello Dr Gardner, do you have any notion at all about eosinophils in lupus tumidus or lupus in general? Thank you!

[@JMGardnerMD]

Eosinophils are usually rare or absent in lupus. I’ve seen exceptions, but as a general rule, if I see eosinophils, I don’t usually call it lupus.

[@JMGardnerMD]

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@dr.rameshbabu5191]

Thanks a lot. Your vedios are really useful and I enjoy a lot lisening to the vedios. I have a question for you. How to differentiated Reumaoid nodule Vs Gouty tophus, since both shows palisaded necrobiotic granulomas with central pink material ?

[@JMGardnerMD]

The granulomas in gout are not as palisaded as rheumatoid nodule and they tend to have more multinucleated giant cells. But the big difference is the material in the center of the granuloma... It looks very different between those two diseases. In rheumatoid nodule it is a dense dark red fibrinoid necrosis. In gout it is light fluffy pale pink. Here’s a video about gout: kikoxp.com/posts/3799. Also, A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@dr.rameshbabu5191]

@@JMGardnerMD Thank you dear Dr. Jerad

[@JMGardnerMD]

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@wonder7798]

Often times dermatologist do not take the time to investigate and listen to patients. Like scalp inflammation, autoimmune disorder related. I personally was dismissed. I have suffered for 4 yrs, I had to shave my head because of the extreme scalp pain at tension points, including suture lines of the skull, but on surface level. Not once have they listened. It has changed my nails, mucous membranes, gums, lips. I can explain exactly what it is if someone would just listen.

[@Swelandet92]

God bless you Jerad for putting in all the time and effort sharing your knowledge! I bought your book and read it folder to folder. Is there anyway I can repay you except like and subscribe which I already did 😁?

[@JMGardnerMD]

Thank you! Can I ask a small favor? If you liked my #dermpath survival guide book, could you please rate it & write a short honest review on Amazon? Thank you! 🙏🏻 buff.ly/366R7va

[@JMGardnerMD]

Also FYI A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@Swelandet92]

@@JMGardnerMD thanks! I can’t give you write a review on Amazon cause I bought it directly from innovative science press as soon as it got released. Haven’t bought anything else on Amazon either so I’m not allowed to make a review apparently 😞😞

[@amaliyadipita6906]

👍🏾👍🏾👍🏾👍🏾👍🏾❤❤❤❤❤

[@ryaddjaghri861]

I don't know how to thank you for all you are doing, you are a very good teacher, and you are a human and generous person... I hope you can continue in what you are doing... Thank you so much... God bleds you