Multinucleated epidermal giant cells in inflammatory skin diseases

Abstract

The occurrence of multinucleated epidermal giant cells (MEGCs) with more than three clumping nuclei has been considered an episodic and exceptional phenomenon in inflammatory skin diseases. However, we have found them in 97 histologic specimens obtained from inflammatory lesions. They appeared in 88 of 196 biopsy specimens from a group of patients with chronic eczema or prurigo. In pruriginous lesions alone, they were found in 67 (74%) of 90 specimens. On the other hand, MEGCs were found rarely in lichen amyloidosus (2/11), dermatitis herpetiformis (1/6), erythema multiforme (1/11), pustular psoriasis (1/17), lichen planus (1/29), lupus erythematosus (1/30), and pustulosis palmaris et plantaris (1/41), probably representing just a chance occurrence in these dermatoses.

Grape Cells (Multinucleated Keratinocytes) in Noninfectious Dermatoses

“…The cytoplasm of the multinucleated keratinocytes has more of a hyalinized pink color. 6 – 8 Mitotic rate can be increased in multinucleated and mononuclear epithelial cells but not as significantly as seen in neoplastic processes. 6 , 7 We propose the name “grape cells” for multinucleated keratinocytes because of their distinct histology that reminds us of a cluster of grapes.…”

“… 6 – 8 Mitotic rate can be increased in multinucleated and mononuclear epithelial cells but not as significantly as seen in neoplastic processes. 6 , 7 We propose the name “grape cells” for multinucleated keratinocytes because of their distinct histology that reminds us of a cluster of grapes. It is important to note that although this finding is indicative of external manipulation, any underlying inflammatory, infectious, or neoplastic processes should be excluded.…”

“… 3 Multinucleated keratinocytes with at least 3 clumped nuclei per cell were originally thought to be a rare histological finding resulting from inflammatory skin diseases, including contact dermatitis, pityriasis lichenoides chronica, 4 and pityriasis rosea. 5 Tagami and Uehara 6 found that multinucleated keratinocytes were frequently found in pruritic and lichenified lesions, most commonly prurigo nodularis. More recently, multinucleated keratinocytes with up to 16 nuclei per cell were noted in a biopsy of a patient with factitial disorder.…”

Giant cells in dermatology

“…These are giant cells formed by epidermal cells in response to various types of inflammation. [17] These giant cells are seen in[1617]…”

A Papulovesicular Eruption Revealing Multinucleated Giant Cells on Tzanck Smear

“…8 Such changes have been reported to be frequent in chronic eczema and prurigo and infrequent in dermatitis herpetiformis, erythema multiforme, pustular psoriasis, li¬ chen planus, and lichen amyloidosus. Histologically, these cells may be seen as clumped nuclei (lacking syncytial formation) within "linear, elongated, bizarre, or irregu¬ lar" epidermal giant cells in all layers of the epidermis, excluding the stratum corneum.…”