18 research outputs found
S-100 immunostaining in the distinction of borderline tuberculoid leprosy from other cutaneous granulomas
No full textBackground: Histopathologic diagnosis of borderline tuberculoid leprosy (BTL) is fraught with hurdles. It overlaps with other granulomas and documenting nerve involvement is the key to correct diagnosis. This is difficult on H and E sections alone. S-100 immunostaining may help in this regard. Objectives: To study the patterns of nerve involvement in BTL and other cutaneous granulomas using S-100 immunostain and compare its sensitivity with that of H and E staining, in both adequate and inadequate biopsies. Materials and Methods: A total of 20 cases of BTL were reviewed. And, 19 biopsies from other cutaneous granulomas were taken as controls. S-100 immunostaining was done on paraffin sections. The pattern of nerve involvement was graded as intact, infiltrated and/or fragmented, intact with perineural inflammation. Results: Of the 20 cases of BTL, S-100 demonstrated infiltrated and/or fragmented nerves in 15 and absent nerves in 5 cases. H and E stain identified neuritis in eight cases. The sensitivity of S-100 and H and E is 0.78 and 0.41. In the 19 controls, S-100 identified normal nerves in 16 with 7 showing perineural inflammation only and their absence in 2 cases. H and E identified normal nerves in nine cases. The sensitivity of S-100 and H and E is 0.83 and 0.41. In biopsies where subcutis was absent, the sensitivity of S-100 in identifying nerve involvement is 0.66 compared with H and E 0.33. Conclusion: S-100 staining is an efficient ancillary aid in distinguishing BTL from other granulomas and is superior to H and E in identifying nerve involvement, even where subcutis is absent. Infiltration and/or fragmentation of nerves by S-100 is the only reliable marker of BTL
Early mycosis fungoides vs. inflammatory mimics: How reliable is histology?
No full textBackground: The histologic diagnosis of early mycosis fungoides (MF)
and its distinction from inflammatory dermatoses is challenging, owing
to the overlap of several features. Aims: 1) To assess the efficacy of
histologic criteria to diagnose early MF, 2) to study their utility in
differentiating inflammatory mimics of MF. Methods: We retrospectively
reviewed slides from 50 cases clinically/histologically suspicious for
MF. The diagnoses were established based on response to treatment and
follow-up. The slides were analyzed double-blinded by two observers
independently. Twenty-eight histologic criteria were assessed and each
criterion was graded. Univariate analysis was performed on the results.
Results: There were 17 cases of MF and 33 of inflammatory dermatoses.
Of the 28 criteria, the following 15 achieved significance on
univariate analysis: disproportionate epidermotropism, tagging of
lymphocytes along the basal layer, haloed lymphocytes, convoluted
lymphocytes, Pautrier′s abscesses, larger epidermal lymphocytes,
wiry dermal collagen, absence of edema, eccrine infiltration,
folliculotropism, follicular mucin, involvement of papillary and
reticular dermis, monomorphous infiltrates, and atypia of dermal
lymphocytes. The criteria that were 100% specific for MF included
convoluted lymphocytes, eccrine infiltration, and follicular mucin.
Absence of edema was 100% sensitive and specific in distinguishing MF
from its inflammatory mimics. Conclusions: A combination of histologic
patterns and cytology of lymphocytes is reliable in distinguishing MF
from inflammatory dermatoses. No single criterion is effective in
achieving this. Rather than merely recording the presence or absence of
a criterion, grading each of them adds objectivity to the diagnosis
Early mycosis fungoides vs. inflammatory mimics: How reliable is histology?
Get PDFBackground: The histologic diagnosis of early mycosis fungoides (MF)
and its distinction from inflammatory dermatoses is challenging, owing
to the overlap of several features. Aims: 1) To assess the efficacy of
histologic criteria to diagnose early MF, 2) to study their utility in
differentiating inflammatory mimics of MF. Methods: We retrospectively
reviewed slides from 50 cases clinically/histologically suspicious for
MF. The diagnoses were established based on response to treatment and
follow-up. The slides were analyzed double-blinded by two observers
independently. Twenty-eight histologic criteria were assessed and each
criterion was graded. Univariate analysis was performed on the results.
Results: There were 17 cases of MF and 33 of inflammatory dermatoses.
Of the 28 criteria, the following 15 achieved significance on
univariate analysis: disproportionate epidermotropism, tagging of
lymphocytes along the basal layer, haloed lymphocytes, convoluted
lymphocytes, Pautrier′s abscesses, larger epidermal lymphocytes,
wiry dermal collagen, absence of edema, eccrine infiltration,
folliculotropism, follicular mucin, involvement of papillary and
reticular dermis, monomorphous infiltrates, and atypia of dermal
lymphocytes. The criteria that were 100% specific for MF included
convoluted lymphocytes, eccrine infiltration, and follicular mucin.
Absence of edema was 100% sensitive and specific in distinguishing MF
from its inflammatory mimics. Conclusions: A combination of histologic
patterns and cytology of lymphocytes is reliable in distinguishing MF
from inflammatory dermatoses. No single criterion is effective in
achieving this. Rather than merely recording the presence or absence of
a criterion, grading each of them adds objectivity to the diagnosis
Follicular mycosis fungoides - A report of four Indian cases
No full textBackground: Follicular Mycosis Fungoides (FMF) is an under-recognized disease in India. Its clinical mimics include Hansen′s disease and Sarcoidosis. Aims: To describe the clinical and pathological features of FMF. Materials and Methods: All cases of FMF between January and December 2007 were retrieved. Cases of conventional epidermotropic MF with a minor follicular component were excluded. Slides were reviewed by two observers. The following criteria were assessed: degree and density of folliculotropism of lymphocytes, location of folliculotropism (infundibular / isthmic / bulbar), follicular mucin, eosinophils, granulomas, and conventional epidermotropism. Each feature was assigned a semi-quantitative grade. Results: There were four cases of FMF, with an equal gender distribution and a mean age of 17.5 years. All lesions were on the face. They presented as: hypopigmented patches (2) and erythematous plaques (2). Alopecia was seen in two cases. The clinical diagnosis was Hansen′s disease in all four, with a differential of Alopecia mucinosa / Sarcoidosis in two cases.The histological features seen were: disproportionate folliculotropism, lymphocyte tagging with haloes, follicular mucin, and nucleomegaly / convolution in all four cases, prominent eosinophils (2), epithelioid granulomas (1), eccrine infiltration (4), parakeratosis at the follicular ostia (2), and sebaceotropism (1). The infiltrate was bulbar (4) and isthmic (2). The rest of the epidermis showed no hint of conventional MF. Conclusion: The preferential features for FMF were involvement of face, dominant folliculotropism, nuclear atypia and convolution, and follicular mucin. Presence of granulomas and eosinophils necessitated exclusion of infectious causes. The absence of findings of MF in the rest of the epidermis should not deter pathologists from rendering this diagnosis
Follicular mycosis fungoides - A report of four Indian cases
No full textAbstract
Background:Follicular Mycosis Fungoides (FMF) is an under-recognized disease in India. Its clinical mimics include Hansen′s disease and Sarcoidosis.Aims:To describe the clinical and pathological features of FMF.Materials and Methods:All cases of FMF between January and December 2007 were retrieved. Cases of conventional epidermotropic MF with a minor follicular component were excluded. Slides were reviewed by two observers. The following criteria were assessed: degree and density of folliculotropism of lymphocytes, location of folliculotropism (infundibular / isthmic / bulbar), follicular mucin, eosinophils, granulomas, and conventional epidermotropism. Each feature was assigned a semi-quantitative grade.Results:There were four cases of FMF, with an equal gender distribution and a mean age of 17.5 years. All lesions were on the face. They presented as: hypopigmented patches (2) and erythematous plaques (2). Alopecia was seen in two cases. The clinical diagnosis was Hansen′s disease in all four, with a differential of Alopecia mucinosa / Sarcoidosis in two cases.The histological features seen were: disproportionate folliculotropism, lymphocyte tagging with haloes, follicular mucin, and nucleomegaly / convolution in all four cases, prominent eosinophils (2), epithelioid granulomas (1), eccrine infiltration (4), parakeratosis at the follicular ostia (2), and sebaceotropism (1). The infiltrate was bulbar (4) and isthmic (2). The rest of the epidermis showed no hint of conventional MF.Conclusion:The preferential features for FMF were involvement of face, dominant folliculotropism, nuclear atypia and convolution, and follicular mucin. Presence of granulomas and eosinophils necessitated exclusion of infectious causes. The absence of findings of MF in the rest of the epidermis should not deter pathologists from rendering this diagnosis.</jats:p
Pilot Study on Temperature Dynamics of Pinda Sweda: A Step Toward Developing a Temperature Regulating Instrument
Get PDFSwedana, a key treatment for musculoskeletal disorders caused by Vata and Kapha, includes Sankara Sweda. Sankara Sweda is the first and foremost Sweda type of Sagni Sweda by Acharya Charaka. So, it must have special importance in the management of various diseases. Sankara Sweda again is of many types. Based on its properties generally, it can be further broadly classified into Snigdha Sankara Sweda and Ruksha Sankara Sweda. In practice, the Sankara Sweda procedure struggles to maintain a consistent temperature throughout treatment. To address this, two Pottalis and two therapists are required, making the process time-consuming. Our Pilot study revealed an average body temperature drop of 4°F and a Pottali temperature drop of 69°F within a 2-minute inter-Pottali change period, with each Pottali applied for 2 minutes. A study on Upanaha Swedana demonstrated that maintaining a constant temperature yielded statistically significant results, outperforming the conventional method while reducing treatment time to 30 minutes. Therefore, this pilot study aims to modify Sankara Sweda Pottali for consistent temperature, enhancing its efficacy in managing musculoskeletal and other diseases
Pilomatricoma with apocrine poroma: A novel cutaneous collision tumor
No full textThe term “collision tumor” implies the occurrence of two or more neoplasms in a single biopsy specimen. This is a rare feature in skin biopsies, with most of the reported combinations involving melanocytic lesions or basal cell carcinomas. Combinations of adnexal tumors are found very sporadically. We report a 67-year-old woman with a scalp nodule, clinically suspected to be verrucous carcinoma, who underwent a wide excision. Histopathology showed apocrine poroma with adjacent regressing pilomatricoma
