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Am J Dermatopathol. 2015 Dec;37(12):e143-6. doi: 10.1097/DAD.0000000000000330.

Grape Cells (Multinucleated Keratinocytes) in Noninfectious Dermatoses: Case Series and Review of the Literature.

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*Department of Dermatology, MD Anderson Cancer Center, University of Texas Health Sciences Center at Houston, Houston, TX; †Department of Dermatology, Walter Reed National Military Medical Center, Bethesda, MD; and ‡Department of Obstetrics and Gynecology, Uniformed Services University of Health Sciences, Bethesda, MD.


Multinucleated keratinocytes (also known as multinucleated epidermal giant cells) are a frequently overlooked histological finding in noninfectious inflammatory dermatoses. They are sometimes found in conditions characterized by chronic rubbing and pruritus, such as lichen simplex chronicus or prurigo nodularis, and may be a helpful clue in making the clinical diagnosis. This finding must be differentiated from other conditions characterized by multinucleated keratinocytes on histopathology, specifically herpes simplex, varicella zoster, or measles viral infections. The authors present a case series of 2 patients with unique clinical noninfectious diagnoses but similar histopathologic findings on biopsy. The histopathologic findings on both cases demonstrated multinucleated keratinocytes, which were related to manipulation of the epidermis.

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