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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Subtle Vacuolar Interface Dermatitis With Extravasated RBC Mean?

I would like an interpretation of a biopsy that reads: Gross Description: A) Submitted in fixative, the specimen consists of a tan-yellow skin punch, measuring 0.4 x 0.4 x 0.3 cm. The specimen was placed into one cassette. MICROSCOPIC DESCRIPTION: A) Multiple deeper cuts are reviewed. Sections show an irregular hyperplasia of the epidermis with hyperkeratosis. A subtle vacuolar change of the basal layer is evident. There is a mild superficial perivascular and interstitial lymphocytic infiltrate with rare neutrophils. The lymphocytes are small without overt cytologic atypia. Extravasated red blood cells are noted. The small vessels are relatively unremarkable. The findings are not diagnostic for erythema multiforme. DIAGNOSIS: A) Subtle vacuolar interface dermatitis with extravasated red blood cells (see micro and comment) COMMENT: A) Subtle bacuolar alteration, extravasated red blood cells and rare neutrophils favor a drug eruption. Similar histomorphology many be seen with viral exanthem. The findings are not those of erythema multiforme. Clinical correlation is advised.
Mon, 17 Nov 2014
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,
The histopathological examination of the skin biopsy shows features which are not characteristic of any disease.
Instead the histopathological features are indicative of viral infection.
A clinical correlation is required to final diagnosis.
The disorder is not erhthema multiforme as suspected by your dermatologist.
Treament can be planned after correlating the biopsy report with histopathological features.


Thanks and take care
Dr Shailja P Wahal
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What Does Subtle Vacuolar Interface Dermatitis With Extravasated RBC Mean?

Hello and welcome to HCM, The histopathological examination of the skin biopsy shows features which are not characteristic of any disease. Instead the histopathological features are indicative of viral infection. A clinical correlation is required to final diagnosis. The disorder is not erhthema multiforme as suspected by your dermatologist. Treament can be planned after correlating the biopsy report with histopathological features. Thanks and take care Dr Shailja P Wahal