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

Published 2021-04-14
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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All Comments (21)
  • 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!!
  • 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
  • Dear Jared, thanks a lot for your fantastic videos and for putting them together in a database. This is outstanding work!!
  • 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
  • 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.
  • @jabrowski_
    Hey Doc. I'm a security guard and they sent me to help out at a dermapatholoic diagnostic company. YouTubed and found u. Liked and subbed bro. Thanks for the info
  • @gerikn20
    Thank you so much for your detailed and really useful work!
  • 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
  • @Hemepath
    Congratulations on approaching to 40K subscribers!
  • 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.
  • Thanks for your time and all your videos. Im just start my dermpath rotation in Seville.