title: Disorders characterized by predominant or exclusive dermal inflammation.
abstract: Some cutaneous inflammatory disorders are typified by a predominant or exclusive localization in the dermis. They can be further subdivided by the principal cell types into lymphocytic, neutrophilic, and eosinophilic infiltrates, and mixtures of them are also seen in a proportion of cases. This review considers such conditions. Included among the lymphoid lesions are viral exanthems, pigmented purpuras, gyrate erythemas, polymorphous light eruption, lupus tumidus, and cutaneous lymphoid hyperplasia. Neutrophilic infiltrates are represented by infections, Sweet syndrome, pyoderma gangrenosum, and hidradenitis suppurativa, as well as a group of so-called "autoinflammatory" dermatitides comprising polymorphonuclear leukocytes. Eosinophil-dominated lesions include arthropod bite reactions, cutaneous parasitic infestations, the urticarial phase of bullous pemphigoid, Wells syndrome (eosinophilic cellulitis), hypereosinophilic syndrome, and Churg-Strauss disease. In other conditions, eosinophils are admixed with neutrophils in the corium, with or without small-vessel vasculitis. Exemplary disorders with those patterns include drug eruptions, chronic idiopathic urticaria, urticarial vasculitis, granuloma faciale, and Schnitzler syndrome (chronic urticarial with a monoclonal gammopathy).
authors.affiliation: Section of Dermatopathology, Division of Surgical Pathology & Cytopathology, University of Virginia Medical Center, Room 3020 University of Virginia Hospital, 1215 Lee Street, Charlottesville, VA 22908-0214, USA. Electronic address: mrwick1@usa.net.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Wick
mesh_terms: D003872:Dermatitis / Q000209:etiology* / Q000473:pathology*; D006801:Humans
keywords: Arthropod bite reactions; Autoinflammatory dermatitis; Bullous pemphigoid; Chronic urticaria; Churg-Strauss disease; Cutaneous lymphoid hyperplasia; Dermal inflammatory diseases; Drug eruptions; Gyrate erythemas; Hidradenitis suppurativa; Hypereosinophilic syndrome; Parasitic infestations; Pigmented purpura; Polymorphous light eruption; Pyoderma gangrenosum; Sweet syndrome; Tumid lupus; Urticarial vasculitis; Viral exanthems; Wells syndrome