Introduction to Civatte Bodies
Civatte bodies, also known as colloid bodies, are eosinophilic, round or oval structures found in the epidermis and papillary dermis. These bodies are essentially apoptotic keratinocytes and are often associated with various dermatoses, particularly
lichen planus and
cutaneous lupus erythematosus. Their presence is a key histopathological feature that aids in the diagnosis of these conditions.
Formation and Appearance
Civatte bodies form as a result of
keratinocyte apoptosis, which is a programmed cell death process. During this process, keratinocytes undergo morphological changes, including cell shrinkage and chromatin condensation, ultimately leading to the formation of these distinct bodies. Histologically, Civatte bodies appear as homogeneous, pink or red structures on routine
H&E staining.
Diagnostic Significance
The presence of Civatte bodies is often indicative of interface dermatitis, where an inflammatory infiltrate is seen at the dermoepidermal junction. This feature is crucial in diagnosing conditions like
lichen planus, where Civatte bodies are characteristically observed. In lichen planus, these bodies are seen alongside a band-like lymphocytic infiltrate,
sawtooth rete ridges, and
hypergranulosis.
Associated Conditions
Civatte bodies are associated with several dermatological conditions, including:
Lichen planus: A common condition characterized by flat-topped, violaceous papules.
Lupus erythematosus: Particularly the discoid form, where Civatte bodies may appear in affected skin.
Erythema multiforme: Another condition where Civatte bodies can be observed, although they are not pathognomonic.
Interpretation in Biopsies
The identification of Civatte bodies in skin biopsies requires careful interpretation. While their presence supports a diagnosis of interface dermatitis, it is important to correlate with clinical findings and other histological features. For instance, in
lichen planus, the combination of Civatte bodies, a band-like infiltrate, and
hyperkeratosis is considered diagnostic.
Limitations and Considerations
Although Civatte bodies are a valuable diagnostic clue, they are not entirely specific. They can be seen in other conditions, such as
graft-versus-host disease and
fixed drug eruptions. Therefore, it is crucial to consider the entire histological pattern and clinical presentation. Additionally, their absence does not rule out potential diagnoses associated with interface dermatitis.
Conclusion
Civatte bodies play a significant role in the histological assessment of skin conditions characterized by interface dermatitis. Their identification can guide pathologists in making accurate diagnoses, but it is essential to interpret them within the context of other histological features and clinical information. Understanding the nuances of Civatte bodies enhances the diagnostic process and contributes to better patient outcomes.
