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A vase-like shape characterizes the epidermal-mononuclear cell collections seen in spongiotic dermatitis

P E LeBoit1, B A Epstein

  • 1Department of Pathology, University of California, San Francisco 94143-0506.

Insights

Vase-shaped mononuclear cell collections in the epidermis can mimic Pautrier microabscesses. These collections are markers of spongiosis, not definitively diagnostic of spongiotic dermatitis in mycosis fungoides.

Area of Science:

  • Dermatopathology
  • Histopathology

Background:

  • Mononuclear cell collections in the epidermis occur in both mycosis fungoides and spongiotic dermatitis.
  • Distinguishing between Pautrier microabscesses and spongiotic mimics is clinically important.

Purpose of the Study:

  • To evaluate the diagnostic utility of vase-shaped epidermal collections in differentiating spongiotic dermatitis from mycosis fungoides.
  • To identify specific histological features that aid in differential diagnosis.

Main Methods:

  • Retrospective analysis of 49 biopsy specimens of spongiotic dermatitis and 50 of mycosis fungoides.
  • Histological examination focusing on epidermal mononuclear cell collections and their morphology.

Main Results:

  • Vase-shaped collections were observed in 5 of 49 (10.2%) spongiotic dermatitis cases.
  • No vase-shaped collections were found in 50 mycosis fungoides specimens.
  • Vase-shaped collections can be present in mycosis fungoides with significant spongiosis.

Conclusions:

  • Vase-shaped epidermal collections are a potential marker of spongiosis.
  • These collections are not exclusive to spongiotic dermatitis and can be seen in mycosis fungoides.
  • Their presence should prompt consideration of spongiosis rather than being solely diagnostic of spongiotic dermatitis.

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