Skin crusts and scale crusts comprise a very common category of skin diseases seen by both the patient and physician. One classification is to organize by the mechanism of formation.SECONDARY TO INTRAEPIDERMAL VESICLES
Spongiotic Allergic contact, nummular, and dyshidrotic dermatitis Dermatophytosis Response to the bite of an insect Crust upon an epidermis with vesiculation above a wedge-shaped infiltrate Seborrheic dermatitis At lips of follicular ostia Acantholytic Infection by herpesvirus Blister beetle (cantharidin) dermatitis Ballooning Infection by herpesvirus
SECONDARY TO PUSTULES
Follicular Acne vulgaris Crust filled with neutrophils above an infundibulum with suppuration and perifollicular infiltrate of neutrophils, histiocytes, or both Impetigo Majocchi's granuloma With suppurative granulomatous perifolliculitis Intraepidermal Pustular psoriasis Intraepidermal pustule Fungal Dermatophytosis Candidiasis
SECONDARY TO LOSS OF SURFACE TISSUE SUCH AS ULCER OR EROSION
Loss of the cornified layer Bullous impetigo Crust with neutrophils above an epidermis with acantholytic cells in the upper portion Pemphigus foliaceus Loss of the cornified layer and part of the spinous layer Pemphigus vulgaris Hailey-Hailey disease Loss of the entire epidermis Bullous pemphigoid Dermatitis herpetiformis Loss of part of the reticular dermis Pyoderma gangrenosum Ulcer of venous stasis
Dermatopathology, Practical and Conceptual 1999;5:126-129.
Last Updated 1/23/2001
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