Differential Diagnosis > Morphology > Reaction Patterns > Dermal

Dermal

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The dermal reaction pattern mainly consists of disease with no epidermal change: lumps and bumps more or less.  It is often a biopsy diagnosis, but you should run down the five dermal groups granulomatous, the 5 L's, deposition, purple plums, and tumors in your head to come up with a differential.

 

 

some other "classic" dermal differential diagnoses:

 

•ddx 1:  collagenoma vs. plexiform neurofibroma vs. nevus lipomatosis superficialis

 

•ddx 2: JXG vs. Spitz nevus vs. mastocytoma

 

 

hmtoggle_plus1ddx 3:  Dermal Papules on the Elbows or Knees:
•Granuloma Annulare
•Erythema Elevatum Diutinum
•Multicentric Reticulohistiocytosis
•Rheumatoid Nodules
•Rheumatoid Papules (palisaded and neutrophilic granulomatous dermatitis)
•Gottron's papules
•Xanthomas

 

 

 

 

and some not-so "classic" dermal differential diagnsoses:

 

hmtoggle_plus1ddx 4:  "Waxy"
•nodular amyloid
•mucinosis
•lipoid proteinosis (?)
•colloid milium
•multicentric reticulohistiocytosis (?)
•Waldenstrom's macroglobulinemia (?)

 

 

ddx 5:   Smooth pink “nub” molluscum vs. NF vs. cylindroma ( ???)