There are occasional dyskeratotic
cells, while koilocytes are absent (hematoxylin-eosin, original magnifications X10 [A] and X400 [B]).
Histologically, malignant PTTs show severe nuclear atypia, marked cellular pleomorphism with atypical mitoses, dyskeratotic
cells and infiltrating margins.
Human polyomavirus 6 and 7 are associated with pruritic and dyskeratotic
High power showed additional features of dyskeratotic
hydropic degeneration of the basal cell layer, papillary dermal oedema, and superficial perivascular lymphoid cell infiltrate containing neutrophils and nuclear dust in patient 1, patient 2, and patient 3 (b, d, and f, resp.).
Skin punch biopsy revealed an ulcerative lesion with a fibrinous cap and spongiotic vesicles (Figure 4) with marked eosinophilic exocytosis associated with dyskeratotic
keratinocytes and eosinophilic intraepidermal microabscess formation (Figure 5).
Inset: Squamous cell carcinoma with pleomorphic neoplastic epidermal cells with marked nuclear atypia and individual dyskeratotic
cells or clusters.
epithelial cells, apoptosis, and an inflammatory infiltrate of lichenoid appearance under the basement membrane, consisting of CD3+ and CD68+ T cells, can be seen.
Vacuolated and dyskeratotic
keratinocytes are also typically present within the epidermal invagination.
cells and basal vacuolization are also seen .
Two cases showed both cytoplasmic and nuclear HIPK2 expression in the minority of well-differentiated, dyskeratotic
Tzanck smear is an easily performed, sensitive, specific, cost-effective and rapid test that is useful in clinical settings in dermatologist's daily practice.3,4 Arnault Tzanck first used this method for the diagnosis of cutaneous disorders in 1947.5 It can also be performed at the bedside with minimal patient discomfort.6,7 In this method, scrapings from the floor of the vesicles are transferred to a glass slide, stained with various dyes, and then examined under the light microscope, that reveals multinucleated giant cells in herpetic infection, acantholytic cells in pemphigus, dyskeratotic
acantholytic cells and cocci in bullous impetigo, pseudohyphae in candidiasis and necrotic basal cells in toxic epidermal necrolysis.7
The histopathologic hallmark of PNP is a predominant interface reaction pattern, characterized by basal cell vacuolar degeneration, dyskeratotic
and necrotic keratinocytes, and lymphocytic inflammation characterized by lymphocytic exocytosis with either as sprinkling of lymphocytes at the basement membrane zone or a band-like infiltrate in the upper dermis.[sup] However, sometimes acantholysis might be minimal or absent.