Patterson - Practical Skin Pathology: A Diagnostic Approach
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James W. Patterson, MD
Professor of Pathology and Dermatology, Director of Dermatopathology, University of Virginia Health System, Charlottesville, Virginia
Pattern Recognition Series
Series editors: Kevin O. Leslie and Mark R. Wick
Practical Breast Pathology
Edited by Kristen A. Atkins and Christina S. Kong
Practical Cytopathology
Edited by Matthew Zarka and Barbara Centeno
Practical Skin Pathology
Written by James W. Patterson
Practical Hepatic Pathology
Edited by Romil Saxena
Practical Orthopedic Pathology
Edited by Andrea T. Deyrup and Gene P. Siegal
Practical Pulmonary Pathology, Second Edition
Edited by Kevin O. Leslie and Mark R. Wick
Practical Renal Pathology
Edited by Donna J. Lager and Neil A. Abrahams
Practical Soft Tissue Pathology
Edited by Jason L. Hornick
Practical Surgical Neuropathology
Edited by Arie Perry and Daniel J. Brat
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
PRACTICAL SKIN PATHOLOGY: A DIAGNOSTIC APPROACH ISBN 978-1-4377-1996-3
Copyright 2013 by Saunders, an imprint of Elsevier Inc.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publishers permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
Library of Congress Cataloging-in-Publication Data
Practical skin pathology : a diagnostic approach / James W. Patterson.
p. ; cm.(Pattern recognition series)
Includes bibliographical references and index.
ISBN 978-1-4377-1996-3 (hardcover : alk. paper)
I. Title.II. Series: Pattern recognition series.
[DNLM:1.Skinpathology.2.Skin Diseasesdiagnosis.3.Skin Diseasespathology. WR 105]
616.5071dc23
2012045987
Acquisitions Editor: William R. Schmitt
Publishing Services Manager: Pat Joiner
Designer: Lou Forgione
Printed in China
Last digit is the print number:987654321
This book is dedicated to my wife, Julie, and our son, Wyatt, who fully support my efforts and show great tolerance when I try to finish just one more page on the computer while at home and officially off duty. I also wish to express my gratitude to a wonderful mentor and friend, the late Dr. James H. Graham.
Smitha S. Kuppalli, MD , Chief Resident
Department of Dermatology
University of Virginia School of Medicine
Charlottesville, Virginia
Michael Marchetti, MD , Chief Resident
Department of Dermatology
University of Virginia School of Medicine
Charlottesville, Virginia
Mark R. Wick, MD , Professor of Pathology
Division of Surgical Pathology
University of Virginia Medical Center
Charlottesville, Virginia
It is often stated that anatomic pathologists come in two forms: Gestalt-based individuals, who recognize visual scenes as a whole, matching them unconsciously with memorialized archives; and criterion-oriented people, who work through images systematically in segments, tabulating the resultsinternally, mentally, and quicklyas they go along in examining a visual target. These approaches can be equally effective, and they are probably not as dissimilar as their descriptions would suggest. In reality, even Gestaltists subliminally examine details of an image, and, if asked specifically about particular features of it, they are able to say whether one characteristic or another is important diagnostically.
In accordance with these concepts, in 2004 we published a textbook entitled Practical Pulmonary Pathology: A Diagnostic Approach (PPPDA). That monograph was designed around a pattern-based method, wherein diseases of the lung were divided into six categories on the basis of their general image profiles. Using that technique, one can successfully segregate pathologic conditions into diagnostically and clinically useful groupings.
The merits of such a procedure have been validated empirically by the enthusiastic feedback we have received from users of our book. In addition, following the old adage that imitation is the sincerest form of flattery, since our book came out other publications and presentations have appeared in our specialty with the same approach.
After publication of the PPPDA text, representatives at Elsevier, most notably William Schmitt, were enthusiastic about building a series of texts around pattern-based diagnosis in pathology. To this end we have recruited a distinguished group of authors and editors to accomplish that task. Because a panoply of patterns is difficult to approach mentally from a practical perspective, we have asked our contributors to be complete and yet to discuss only principal interpretative images. Our goal is eventually to provide a series of monographs which, in combination with one another, will allow trainees and practitioners in pathology to use salient morphological patterns to reach with confidence final diagnoses in all organ systems.
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