Figure 3

(a) "Cutaneous" reaction pattern of CHC in a skin flap. Thick orthokeratotic plaque (asterisk) covers epidermis (E) of increased thickness. Bacterial colonies (arrowhead) are seen on the surface of the plaque. Although the plaque is largely compact, superficial (vertical arrows) and deep (horizontal arrow) areas of variably decreased/lost intercellular cohesion (dyscohesion) are seen. While the superficial dyscohesion leads to desquamation of individual cornified cells, lateral expansion/"burrowing" of deep dyscohesion could eventually effect the loss of the overlying non-dyscohesive cornified heap. The processes would result in formation of surface ditches. (b) Even without special staining, candidal hyphae deeply "entombed" within the plaque, are discernible. Note the nuclear "ghosts" of the polygonal cornified keratinocytes. (c)The septate and grouped hyphae (arrowheads) are highlighted on PAS-staining. Compare the unstained nuclear ghosts (arrow) with the viable haematoxyphilic nuclei in the right lower corner of the photomicrograph.