Pathology outlines4/28/2023 Acute eczemaĪcute spongiosis is typified by massive intercellular oedema of the epidermis with a widening of the intercellular spaces, disruption of desmosomes and formation of microvesicles. An eczematous disease may start at any stage and evolve into another. Histologically, there are three stages of eczema: acute, subacute, and chronic. Histologically, it is more useful to classify eczema based on chronicity. Three stages of eczemaĬlinically, eczema is grouped according to aetiology. Dermal changes include varying degrees of oedema and a superficial perivascular infiltrate with lymphocytes, histiocytes and occasional neutrophils and eosinophils. Droplets of plasma accumulate in the mounds of parakeratosis. Parakeratosis forms above areas of spongiosis, probably as a result of an acceleration in the movement of keratinocytes towards the surface. Infiltration of the epidermis with lymphocytes ( exocytosis) is common. Spongiotic dermatitis is a dynamic pathological process vesicles come and go and can be situated at different levels of the epidermis. Further accumulation of fluid leads to the formation of intraepidermal vesicles. Initially, there is a widening of intercellular spaces between keratinocytes and elongation of the intercellular bridges. The spongiotic tissue reaction pattern is characterised by intercellular oedema within the epidermis ( spongiosis). The consensus among most dermatopathologists is that the expression 'eczema' should be replaced with the term 'spongiotic dermatitis' to reflect the histopathologic changes that underlie the so-called 'eczemas'. However, 'dermatitis' means inflammation of the skin and is not synonymous with eczematous processes. The terms eczema and dermatitis are often used interchangeably to denote a polymorphic inflammatory reaction pattern involving the epidermis and dermis. Eczema is a common skin condition with multiple clinical patterns, characterised histologically by a spongiotic tissue reaction pattern.
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