Background

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.

Skin

Last Updated 1/23/2001

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