DOCSLIB.ORG

Histopathological Analysis of Scaly Skin Lesions of Non-Infectious Etiology

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Histopathological Analysis of Scaly Skin Lesions of Non-Infectious Etiology HISTOPATHOLOGICAL ANALYSIS OF SCALY SKIN LESIONS OF NON-INFECTIOUS ETIOLOGY Dissertation submitted to THE TAMILNADU DR.M.G.R MEDICAL UNIVERSITY, CHENNAI – 600032. In partial fulfillment of the requirement for the degree of Doctor of Medicine in Pathology (Branch III) M.D. (PATHOLOGY) APRIL 2017 DEPARTMENT OF PATHOLOGY CHENNAI MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTRE TRICHY – 621 105. DECLARATION I solemnly declare that the dissertation entitled “HISTOPATHOLOGICAL ANALYSIS OF SCALY SKIN LESIONS OF NON INFECTIOUS ETIOLOGY” is a bonafide research work done by me in the Department of Pathology at Chennai Medical college Hospital & Research centre, Trichy during the period from July 2014 to July 31st 2016 under the guidance and supervision of DR. S. PRIYA BANTHAVI MD., Associate Professor, Department of Pathology, CMCH&RC, Trichy. This dissertation is submitted to the Tamilnadu Dr. M.G.R.Medical University, Chennai towards the partial fulfillment of the requirement for the award of M.D., Degree (Branch III) in Pathology. I have not submitted this dissertation on any previous occasion to any university for the award of any degree. Place: Trichy Date: DR.MANIMEGALAI.S ACKNOWLEDGEMENT It is my honour and privilege to thank Dr. S. PRIYA BANTHAVI M.D., Associate Professor, Department of Pathology, my guide, who at every moment has been a constant source of inspiration throughout my post-graduate programme. It gives me great pleasure and pride to be a post graduate student under Prof. Dr. V. SARADA M.D., Professor & H.O.D, Department of Pathology, who has been helping me and guiding me at every stage since the genesis of idea for this study. Her valuable suggestions and timely advice were of immense help to me, through all stages of this study. She has always been a great moral support and encouragement throughout the conduct of the study and also during my postgraduate course. I owe my sincere gratitude to her. I express my deep sense of gratitude towards Dr. N. BALASUBRAMANIAN M.D., Professor, my co-guide, Department of Dermatology, Chennai Medical College Hospital & Research Centre, for constant encouragement and timely advice with respect to this study. I thank our Dean, DR. SUKUMARAN ANNAMALAI M.D., D.H.H.M., Chennai Medical Hospital and Research Centre, Trichy for acknowledging the research work. I express my sincere gratitude to the formal Dean, DR.RAMAKRISHNAN M.D., Chennai Medical Hospital and Research Centre, Trichy for permitting me to conduct this study. I thank DR.C.GURUDATTA PAWAR M.D., Vice Principal, Chennai Medical Hospital and Research Centre, Trichy for his encouragement in completing this study. I thank Dr. SEETHA LAKSHMI, Assistant professor, Department of Dermatology, Chennai Medical College Hospital & Research Centre., for having been a great moral support, constant encouragement, motivation and advice. I thank my fellow postgraduate Dr. SEKAR LALITHA with all my heart for having been a great moral support throughout the conduct of the study and an absolutely wonderful colleague during my postgraduate period. I extend my gratitude to Dr. ROLAND MANOJ, Dr. VIVEKA and Dr. R. AKILA , Department of Pathology, Chennai Medical College Hospital & Research Centre who has been very supportive and ever encouraging in completing this study. I acknowledge my sincere thanks to all Professors, Associate professors and Assistant professors of department of pathology, Chennai Medical College Hospital, for their valuable opinions and illuminating views regarding this study. I shall ever remain indebted to my parents, family and friends for their encouragement and constant support. I express my heartfelt thanks towards the lab technicians and non- teaching fraternity of our department, who have been a significant support throughout my course. I sincerely thank all the patients without whom the study would not have been possible. Digital Receipt This receipt acknowledges that Turnitin received your paper. Below you will f ind the receipt inf ormation regarding your submission. The f irst page of your submissions is displayed below. Submission author: 201413601 Md Path S.Manimegalai Assignment title: 2015-2015 plagiarism Submission title: MANI EDITED THESIS File name: f inal_thesis.docx File size: 4.87M Page count: 86 Word count: 9,079 Character count: 53,943 Submission date: 22-Sep-2016 06:13PM Submission ID: 708022407 Copyright 2016 Turnitin. All rights reserved. CONTENTS S.NO. PARTICULARS PAGE NO. 01. INTRODUCTION 1 - 2 02. AIMS AND OBJECTIVES 3 03. REVIEW OF LITERATURE 4 - 37 04. MATERIALS AND METHODS 38 - 44 05. RESULTS 45 - 68 06. DISCUSSION 69 - 74 07. SUMMARY 75 - 76 08. CONCLUSION 77 09. BIBLIOGRAPHY ANNEXURES • PROFORMA 10. • CONSENT FORM • MASTER CHART LIST OF TABLES S.NO TITLE PAGE NO. 1. CD34 SCORING 44 2. AGE DISTRIBUTION OF PATIENTS STUDIED 45 3. GENDER DISTRIBUTION OF PATIENTS 47 STUDIED 4. AGE AND SEX DISTRIBUTION OF SCALY 48 SKIN DISEASE IN THE STUDY POPULATION 5. PRESENTING SYMPTOMS OF PATIENTS 50 STUDIED 6. THE SPECTRUM OF CLINICAL DIAGNOSIS 51 WITH GENDER CO-RELATION IN THE STUDY POPULATION 7. AGE DISTRIBUTION OF PATIENTS STUDIED 53 IN RELATION TO CLINICAL DIAGNOSIS 8. HISTOPATHOLOGICAL DIAGNOSIS WITH 55 GENDER CO-RELATION OF THE PATIENTS STUDIED. 9. CD34 DISTRIBUTION IN CO-RELATION TO 58 THE GENDER OF THE PATIENTS 10. COMPARISON OF PSORIASIS AND 59 PSORIASIFORM DERMATITIS USING CD34 MARKER 11. HISTOPATHOLOGICAL DIAGNOSIS 60 ACCORDING TO CLINICAL DIAGNOSIS 12. HISTOPATHOLOGICAL CORRELATION WITH 63 CLINICAL CORRELATION 13. COMPARISON OF AGE IN DIFFERENT 69 STUDIES 14. COMPARISON OF SEX DISTRIBUTION IN 70 DIFFERENT STUDIES 15. COMPARISON OF CLINICAL COMPLAINTS 71 16. HISTOPATHOLOGICAL DIAGNOSIS- 71 COMPARISON OF PSORIASIS IN VARIOUS STUDIES 17. HISTOPATHOLOGICAL DIAGNOSIS- 72 COMPARISON OF LICHEN PLANUS IN DIFFERENT STUDIES 18. CLINICAL AND HISTOPATHOLOGICAL 73 CORRELATION IN VARIOUS STUDIES LIST OF CHARTS S.NO. TITLE Page No. 1 AGE DISTRIBUTION OF PATIENTS STUDIED 46 2. SEX DISTRIBUTION OF SCALY LESIONS OF 47 NON INFECTIOUS ETIOLOGY 3. AGE AND SEX DISTRIBUTION OF SCALY SKIN 49 LESION 4 PRESENTING SYMPTOMS OF PATIENTS 50 STUDIED 5 THE SPECTRUM OF CLINICAL DIAGNOSIS 52 WITH GENDER CO-RELATION IN THE STUDY POPULATION 6. AGE DISTRIBUTION OF PATIENTS STUDIED 54 IN RELATION TO CLINICAL DIAGNOSIS 7. HISTOPATHOLOGICAL DIAGNOSIS WITH 56 GENDER CO- RELATION OF THE PATIENTS STUDIED 8. CD34 DISTRIBUTION IN CO-RELATION TO 58 THE GENDER OF THE PATIENTS 9. HISTOPATHOLOGICAL DIAGNOSIS 63 ACCORDING TO CLINICAL DIAGNOSIS 10. CLINICO PATHOLOGICAL CORRELATION 64 LIST OF FIGURES S.NO FIGURES PAGE NO. 1. EMBRYOLOGY OF SKIN 6 2. INTEGUMENTARY HISTOLOGY 7 3. LAYERS OF EPIDERMIS 8 4. HISTOPATHOLOGY OF PSORIASIS 22 5. HISTOPATHOLOGY OF LICHEN PLANUS 26 6. HISTOPATHOLOGY OF LICHEN NITIDUS 27 7. HISTOPATHOLOGY OF LICHEN STRIATUS 28 8. HISTOPATHOLOGY OF PARAPSORIASIS 30 9. HISTOPATHOLOGY OF PITYRIASIS ROSEA 31 10. HISTOPATHOLOGY OF PITYRIASIS RUBRA 33 PILARIS 11. HISTOPATHOLOGY OF PRURIGO NODULARIS 34 12. HISTOPATHOLOGY OF ERYTHEMA ANNULARE 35 CENTRIFUGUM LIST OF COLOUR PLATES S.NO FIGURES PAGE NO. 1. Hypopigmeted scaly lesion in the back 65 2. Histological section show parakeratosis, acanthosis and 66 elongation of rete ridges-PSORIASIS VULGARIS(H &E 40X) 3. Histological section shows Munro’s microabscess- 66 PSORIASIS VULGARIS(H &E 100X) 4. Histological section reveals epidermal hyperplasia and 66 spongiosis-PSORIASIFORM DERMATITIS(H & E 40X) 5. Histological section showing orthokeratosis, wedge 67 shaped hypergranulosis and band like inflammatory infiltrate in the upper dermis-LICHEN PLANUS(H &E 40X) 6. CD34 Immunostaining showing strong 67 positivity(400X) 7. CD 34 Immunostaining showing weak 68 positivity(400X) LIST OF ABBREVIATIONS VEGF Vascular Endothelial Growth Factor TNF Tumor Necrosis Factor IL Interleukin IFN Interferon CD Cluster Differentiation UV Ultraviolet MHC Major Histocompatibility Complex HHV Human Herpes Virus NGF Nerve Growth Factor AD Allergic Dermatitis IHC Immunohistochemistry LPP Large Plaque Parapsoriasis Introduction INTRODUCTION Skin is the largest organ in the body which has limited patterns of reaction in response to different pathological stimuli. Like other organ systems, proper clinical history and examination is important for skin diseases as well. Clinically different lesions may show similar histological patterns. Therefore, though histopathology is considered the gold standard in dermatological diagnosis, there exist few limitations and very often a definite ‘specific’ diagnosis is not possible. In such instances, the correlation of histopathological findings with clinical findings will aid in arriving at a plausible diagnosis and thereby help in the disease treatment. Studies in pathology have documented the extent of spread of various skin lesions and have made significant contribution to the understanding of etiology and pathogenesis1 Papulosquamous diseases form the largest conglomerate group of skin disease and are characterized by scaling papules or plaques. Scaly skin is the loss of the outer layer of the epidermis in large, thin flakes i.e. the outer layer of skin turns dry and peels away in large pieces like that of scales. Since papulosquamous diseases are all characterized by scaling papules, clinical confusion may result in their diagnosis. Therefore histopathological analysis is important for a more definitive differentiation. Separation of each of these conditions into different entities becomes 1 important because the treatment and prognosis is disease-specific. These lesions
Load more

Recommended publications
  • JMSCR Vol||06||Issue||03||Page 652-655||March 2018
    JMSCR Vol||06||Issue||03||Page 652-655||March 2018 www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 71.58 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i3.110 A Clinico-Pathological Correlation Study of the Spectrum of Non-Infectious, Scaly Skin Lesions Authors Dr Priya Banthavi Sivasubramanian1, Dr R.Suganya2, Dr Manimegalai Singaram3, Dr V.Sarada4, Dr N. Balasubramanian5 1Associate Professor of Pathology, Chennai Medical College Hospital and Research Centre, Irungalur, Tiruchirappalli 621105 2Assistant Professor of Pathology, Chennai Medical College Hospital And Research Centre, Irungalur, Tiruchirappalli.621105 3Consultant Pathologist, Tiruchirappalli.621105 4Prof and Head, Dept of Pathology, Chennai Medical College Hospital and Research Centre, Irungalur, Tiruchirappalli.621105 5Prof and Head, Dept of Dermatology, Chennai Medical College Hospital and Research Centre, Irungalur, Tiruchirappalli.621105 Corresponding Author Dr Priya Banthavi Sivasubramanian Associate Professor, Department of Pathology, Chennai Medical College Hospital and Research Centre, Irungalur, Tiruchirappalli, Tamilnadu.621105 Email: [email protected], Phone: 9842445404 Abstract A prospective correlation study was done on 51 patients, clinically diagnosed to have non-infectious, scaly skin lesions falling under the spectrum of Papulosquamous disorders. Thirty six of these patients were found to have good clinical and histopathological correlation. Keywords: non-infectious scaly skin lesions, papulosquamous disease. Introduction dermatologist in instituting proper therapy and can Papulosquamous diseases form the largest vary the prognosis significantly. conglomerate group of skin disease(1) wherein all are characterized by scaling papules, hence Materials and Methods confusion may result in their clinical diagnosis. All patients attending the Dermatology OPD Therefore, histopathological analysis is important between July 2014 and June 2016, with a clinical for a more definitive differentiation.
    [Show full text]
  • A Deep Learning System for Differential Diagnosis of Skin Diseases
    A deep learning system for differential diagnosis of skin diseases 1 1 1 1 1 1,2 † Yuan Liu ,​ Ayush Jain ,​ Clara Eng ,​ David H. Way ,​ Kang Lee ,​ Peggy Bui ,​ Kimberly Kanada ,​ ​ ​ ‡ ​ 1​ ​ 1 ​ 1 ​ Guilherme de Oliveira Marinho ,​ Jessica Gallegos ,​ Sara Gabriele ,​ Vishakha Gupta ,​ Nalini 1,3,§ 1 ​ ​ 4 ​ 1 ​ ​ 1 Singh ,​ Vivek Natarajan ,​ Rainer Hofmann-Wellenhof ,​ Greg S. Corrado ,​ Lily H. Peng ,​ Dale ​ ​ 1 1 ​ † 1, ​ 1, ​ 1, ​ R. Webster ,​ Dennis Ai ,​ Susan Huang ,​ Yun Liu *​ , R. Carter Dunn *​ *, David Coz *​ * ​ ​ ​ ​ ​ ​ Affiliations: 1 G​ oogle Health, Palo Alto, CA, USA 2 U​ niversity of California, San Francisco, CA, USA 3 M​ assachusetts Institute of Technology, Cambridge, MA, USA 4 M​ edical University of Graz, Graz, Austria † W​ ork done at Google Health via Advanced Clinical. ‡ W​ ork done at Google Health via Adecco Staffing. § W​ ork done at Google Health. *Corresponding author: [email protected] **These authors contributed equally to this work. Abstract Skin and subcutaneous conditions affect an estimated 1.9 billion people at any given time and remain the fourth leading cause of non-fatal disease burden worldwide. Access to dermatology care is limited due to a shortage of dermatologists, causing long wait times and leading patients to seek dermatologic care from general practitioners. However, the diagnostic accuracy of general practitioners has been reported to be only 0.24-0.70 (compared to 0.77-0.96 for dermatologists), resulting in over- and ​ ​ ​ ​ ​ ​ ​ under-referrals, delays in care, and errors in diagnosis and treatment. In this paper, we developed a deep learning system (DLS) to provide a differential diagnosis of skin conditions for clinical cases (skin photographs and associated medical histories).
    [Show full text]
  • Obligate and Facultative Paraneoplastic Dermatoses: an Overview
    DERMATOLOGY PRACTICAL & CONCEPTUAL www.derm101.com Obligate and facultative paraneoplastic dermatoses: an overview Stefano Caccavale1, Gabriella Brancaccio1, Marina Agozzino1, Paola Vitiello1, Roberto Alfano2, Giuseppe Argenziano1 1 Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy 2 Department of Anesthesiology, Surgery and Emergency, University of Campania Luigi Vanvitelli, Naples, Italy Key words: dermatological paraneoplastic syndromes, obligate paraneoplastic dermatoses, facultative paraneoplastic dermatoses, malignancy, oncological dermatology Citation: Caccavale S, Brancaccio G, Agozzino M, Vitiello P, Alfano R, Argenziano G. Obligate and facultative paraneoplastic dermatoses: an overview. Dermatol Pract Concept. 2018;8(3):191-197. DOI: https://doi.org/10.5826/dpc.0803a09 Received: January 15, 2018; Accepted: March 9, 2018; Published: July 31, 2018 Copyright: ©2018 Caccavale et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: None. Competing interests: The authors have no conflicts of interest to disclose. All authors have contributed significantly to this publication. Corresponding author: Stefano Caccavale, MD, Dermatology Unit, University of Campania Luigi Vanvitelli, Via Sergio Pansini, 5, 80131 Naples, Italy. Email: [email protected] ABSTRACT Dermatological paraneoplastic syndromes are a group of cutaneous diseases associated with malig- nancy, but not directly related to the primary tumor itself or to its metastases. It is of utmost impor- tance for the dermatologist to recognize the major cutaneous paraneoplastic syndromes to diagnose the underlying tumors that trigger them as early as possible. In this overview, skin conditions that are highly correlated with malignancy, whose recognition implies a mandatory investigation of internal cancer, are described.
    [Show full text]
  • Use of Serine Protease Inhibitors in the Treatment
    (19) TZZ _T (11) EP 2 244 728 B1 (12) EUROPEAN PATENT SPECIFICATION (45) Date of publication and mention (51) Int Cl.: of the grant of the patent: A61P 17/00 (2006.01) A61K 38/55 (2006.01) 31.08.2016 Bulletin 2016/35 A61Q 19/00 (2006.01) A61K 38/48 (2006.01) G01N 33/50 (2006.01) (21) Application number: 09703640.4 (86) International application number: (22) Date of filing: 21.01.2009 PCT/IB2009/000089 (87) International publication number: WO 2009/093119 (30.07.2009 Gazette 2009/31) (54) USE OF SERINE PROTEASE INHIBITORS IN THE TREATMENT OF SKIN DISEASES VERWENDUNG VON SERINPROTEASEHEMMERN BEI DER BEHANDLUNG VON HAUTERKRANKUNGEN UTILISATION D’INHIBITEURSDE SÉRINE PROTÉASES POUR TRAITER DES MALADIES DE PEAU (84) Designated Contracting States: (56) References cited: AT BE BG CH CY CZ DE DK EE ES FI FR GB GR EP-A- 0 567 816 WO-A-00/07620 HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL WO-A-2004/045634 WO-A-2005/117955 PT RO SE SI SK TR WO-A-2006/037606 WO-A-2006/090282 WO-A-2007/072012 WO-A-2009/024528 (30) Priority: 21.01.2008 US 22386 US-A1- 2003 054 445 22.01.2008 US 6576 • ONG C ET AL: "LEKTI demonstrable by (43) Date of publication of application: immunohistochemistry of the skin: a potential 03.11.2010 Bulletin 2010/44 diagnostic skin test for Netherton syndrome" BRITISHJOURNAL OF DERMATOLOGY,vol. 151, (73) Proprietors: no.6, December 2004 (2004-12), pages 1253-1257, • DERMADIS XP002548095 ISSN: 0007-0963 74160 Archamps (FR) • SCHECHTER N M ET AL: "Inhibition of human • Institut National de la Santé et de la Recherche kallikrein-5 (SCTE) and-7 (SCCE) by Médicale lympho-epithelial Kazal-type inhibitor (LEKTI) 75013 Paris (FR) supports a role for proteolysis in Netherton disease and desquamation" JOURNAL OF (72) Inventors: INVESTIGATIVE DERMATOLOGY, vol.
    [Show full text]
  • Pityriasis Rosea • Pityriasis Rotunda • Granular Parakeratosis SMALL PLAQUE PARAPSORIASIS
    Papulo-Squamous Disorders Papulo-Squamous Disorders • Small Plaque Parapsoriasis • Large Plaque Parapsoriasis • Pityriasis Lichenoides Et Varioliformis Acuta & Pityriasis Lichenoides Chronica • Pityriasis Rubra Pilaris • Pityriasis Rosea • Pityriasis Rotunda • Granular Parakeratosis SMALL PLAQUE PARAPSORIASIS • Chronic, asymptomatic, erythematous scaly patches. Lesions are generally <5 cm in diameter or digitate. • Histologically, mild, nonspecific spongiotic dermatitis with parakeratosis is seen • CD4+ T cells predominance in the lymphocytic infiltrate • A dominant T-cell clonality is demonstrable in some cases. • This group is significant for the tendency of its disorders to coexist or overlap with one another and for its association with lymphomas. • Small plaque parapsoriasis typically presents as round–oval patches that are generally <5 cm in diameter. • They are variably erythematous (but often less intense than psoriasis) and covered with a fine scale. • Variants: • Xanthoerythrodermia perstans: yellow hue • Digitate dermatosis: – Elongated – Finger-like patches – Symmetrically distributed – On the flanks. LARGE PLAQUE PARAPSORIASIS • Chronic, asymptomatic, erythematous scaly patches • Lesions are generally >5 cm in diameter • Histologically, a nonspecific spongiotic dermatitis or an interface lymphocytic infiltrate with a variable degree of lichenoid features is seen • CD4+ T cells predominance in the lymphocytic infiltrate • A dominant T-cell clonality is demonstrable in many cases • It is thought that large plaque parapsoriasis represents the earliest stage of mycosis fungoides • Variably erythematous, round or irregularly shaped, scaly patches that are >5 cm in diameter. • They may or may not exhibit the clinical triad of atrophy, telangiectasia, and hyper/hypopigmentation (poikiloderma vasculare atrophicans). • Variant: “Retiform parapsoriasis” • Syn. Parapsoriasis variegata, parakeratosis variegata or parapsoriasis lichenoides. • Rare variant. • Widespread, ill-defined patches in a net-like or zebra-stripe pattern.
    [Show full text]
  • FULL TEXT CONGRESS BOOK Oral Presentations Poster Presentations
    Scientific Program Lecture Summaries FULL TEXT CONGRESS BOOK Oral Presentations Poster Presentations 1 11 March Thursday 12 March Friday 13 March Saturday 14 March Sunday 09:00-09:15 OPENING SPEECH & LECTURE 09:00-09:50 INFECTIVE SKIN DISEASES 09:00-10:10 DERMATOSCOPY SESSION-2 09:00-10:40 SESSION: ADVANCED TECHNOLOGIES IN DERMATOLOGY 09:30-11:10 ERCIN OZUNTURK SESSION 10:05-11:45 INVESTIGATIVE DERMATOLOGY-2 10:25-10:45 TRICHOSCOPY COURSE 10:55-12:25 SESSION: GENERAL (AESTHETIC DERMATOLOGY)-1 DERMATOLOGY 3 11:25-12:45 INVESTIGATIVE DERMATOLOGY-1 12:00-13:00 DEBATABLE TOPICS FOR 11:00-12:00 SESSION: ORPHAN DISEASES IN 12:25-12:55 LUNCH DERMATOLOGIC THERAPY DERMATOLOGY 12:45-13:15 LUNCH 13:00-13:30 LUNCH 12:15-12:45 LUNCH 12:55-14:05 INVESTIGATIVE DERMATOLOGY-3 13:15-14:25 DERMATOSCOPY SESSION-1 13:30-14:50 SESSION: SYSTEMIC TREATMENT 12:45-14:15 TOPICAL TREATMENT IN 14:20-15:30 DIET AND ALTERNATIVE IN DERMATOLOGY-1 DERMATOLOGY THERAPY FOR DERMATOLOGIST 14:40-15:40 SATELLITE 15:05-16:05 SATELLITE 14:30-15:30 SATELLITE 15:35-16:35 BREAK Pfizer PFE İlaçları 15:55-17:35 ERCIN OZUNTURK SESSION 16:20-17:50 ERCIN OZUNTURK SESSION 15:45-16:25 NAIL SURGERY SESSION 16:40-17:20 PSORIASIS (AESTHETIC DERMATOLOGY)-2 (AESTHETIC DERMATOLOGY)-3 17:50-18:40 SESSION: SUN, LIGHT, VITAMIN D 18:05-19:05 SESSION: ALLERGY AND 16:40-17:40 PSORIASIS 17:35-18:35 SESSION: PSYCHODERMATOLOGY AND THE SKIN PRURITUS-1 18:55-19:25 ATOPIC DERMATITIS 19:20-20:00 DERMATOLOGIC SURGERY 17:55-18:35 SESSION: UCARE 18:50-19:50 HOW CAN WE TREAT SESSION CHALLENGE CASES? (4 DIFFICULT/CHALLENGE
    [Show full text]
  • Copyrighted Material
    1 Index Note: Page numbers in italics refer to figures, those in bold refer to tables and boxes. References are to pages within chapters, thus 58.10 is page 10 of Chapter 58. A definition 87.2 congenital ichthyoses 65.38–9 differential diagnosis 90.62 A fibres 85.1, 85.2 dermatomyositis association 88.21 discoid lupus erythematosus occupational 90.56–9 α-adrenoceptor agonists 106.8 differential diagnosis 87.5 treatment 89.41 chemical origin 130.10–12 abacavir disease course 87.5 hand eczema treatment 39.18 clinical features 90.58 drug eruptions 31.18 drug-induced 87.4 hidradenitis suppurativa management definition 90.56 HLA allele association 12.5 endocrine disorder skin signs 149.10, 92.10 differential diagnosis 90.57 hypersensitivity 119.6 149.11 keratitis–ichthyosis–deafness syndrome epidemiology 90.58 pharmacological hypersensitivity 31.10– epidemiology 87.3 treatment 65.32 investigations 90.58–9 11 familial 87.4 keratoacanthoma treatment 142.36 management 90.59 ABCA12 gene mutations 65.7 familial partial lipodystrophy neutral lipid storage disease with papular elastorrhexis differential ABCC6 gene mutations 72.27, 72.30 association 74.2 ichthyosis treatment 65.33 diagnosis 96.30 ABCC11 gene mutations 94.16 generalized 87.4 pityriasis rubra pilaris treatment 36.5, penile 111.19 abdominal wall, lymphoedema 105.20–1 genital 111.27 36.6 photodynamic therapy 22.7 ABHD5 gene mutations 65.32 HIV infection 31.12 psoriasis pomade 90.17 abrasions, sports injuries 123.16 investigations 87.5 generalized pustular 35.37 prepubertal 90.59–64 Abrikossoff
    [Show full text]
  • Atypical Pityriasis Rosea in a Young Colombian Woman
    case reports 2021; 7(2) https://doi.org/10.15446/cr.v7n2.88809 ATYPICAL PITYRIASIS ROSEA IN A YOUNG COLOMBIAN WOMAN. CASE REPORT Keywords: Pityriasis Rosea; Exanthema; Herpesviridae. Palabras clave: Pitiriasis; Exantema; Herpesviridae. Julián Felipe Porras-Villamil Universidad Nacional de Colombia - Bogotá Campus- Faculty of Medicine - Master’s degree in Infections and Health in the Tropics - Bogotá D.C. - Colombia. Ángela Catalina Hinestroza Gabriela Andrea López-Moreno Doris Juliana Parra-Sepúlveda Universidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Medical program - Bogotá D.C. - Colombia. Corresponding author Julián Felipe Porras-Villamil, Maestría en Infecciones y Salud en el trópico, Facultad de Medicina, Universidad Nacional de Colombia. Bogotá D.C. Colombia. E-mail: [email protected] Received: 02/07/2020 Accepted: 03/12/2020 atypical pityriasis rosea in a young colombian woman ABSTRACT RESUMEN 9 Introduction: Pityriasis rosea is an acute Introducción. La pitiriasis rosada es un exante- and self-limited exanthem first described by ma agudo y autolimitado que fue descrito formal- Gilbert in 1860. Its treatment is symptomatic, mente por Gilbert en 1860. Su tratamiento es sin- and although there is no conclusive evidence, tomático y, aunque faltan pruebas concluyentes, it has been associated with the reactivation su aparición se ha asociado a la reactivación de of the human herpesviruses 6 and 7 (HHV-6 los herpevirus humanos 7 y 6 (HHV6 y HHV7). and HHV-7). Presentación del caso. Mujer de 28 años Case presentation:
    [Show full text]
  • Boards' Fodder
    boards’ fodder Skin Signs of Internal Malignancy By Amandeep Sandhu, MD, Caroline Perez, MD, and Sharon E. Jacob, MD Dermatologic manifestation Description Associated malignancy or syndrome (or malignancies) Acanthosis nigricans (Malignant Hyperpigmented velvety plaques, com- GI adenocarcinoma acanthosis nigricans) monly of the neck, axilla, and groin. Acquired hypertrichosis Growth of lanugo hairs. Distribution can be Various internal malignancies, most often lanuginosa specific to the face or generalized. Hairs lung, colon or breast carcinoma. can become coarser with time. Acquired ichthyosis Clinically similar to ichthyosis vulgaris, with Hodgkin lymphoma, non-Hodgkin lympho- symmetrical fine, rough scale, typically ma, multiple myeloma, mycosis fungoides, more pronounced on lower extremities. carcinomatosis. Adenopathy and extensive skin Red-brown, violaceous patch or plaque. Plasmacytoma patch overlying a plamacytoma Biopsy: dermal vascular hyperplasia with (AESOP) syndrome increased surrounding dermal mucin. Alopecia neoplastica Solitary or multiple patches or plaques Breast most common, also GI, lung, renal, of cicatricial hair loss OR non-scarring gastric, and pancreatic. resembling alopecia areata. Bazex syndrome Violaceous erythema and scaling of the Primarily squamous cell carcinoma of upper (Acrokeratosis paraneoplastica) fingers, toes, nose and aural helices. May respiratory or GI tract. see nail dystrophy or palmoplantar kera- toderma. Bullous pemphigoid Tense, fluid-filled, subepidermal bullae. Renal cell carcinoma, lung carcinoma. Aman Sandhu, MD, is PG-4 and chief Carcinoid syndrome Flushing and erythema of head and neck. GI with liver metastases. Bronchial carcinoid dermatology resident In later disease, may see sclerodermoid tumors. changes and pellagra-like dermatitis. at Loma Linda University Medical Carcinoma en cuirasse/ Means “encasement of armor;” indurated, Breast cancer most common, also stomach, sclerodermoid fibrotic, scar-like plaques to the trunk, kidneys, or lungs.
    [Show full text]
  • Early Apoptosis Plays an Important Role in the Healing Mechanism Of
    FLORE Repository istituzionale dell'Università degli Studi di Firenze Early apoptosis plays an important role in the healing mechanism of cutaneous basal cell carcinomas after photodynamic therapy Questa è la Versione finale referata (Post print/Accepted manuscript) della seguente pubblicazione: Original Citation: Early apoptosis plays an important role in the healing mechanism of cutaneous basal cell carcinomas after photodynamic therapy / F. PRIGNANO; B. BIANCHI; L. DOMENICI; R. ROSSI; P. ROMAGNOLI; N. PIMPINELLI; P. CAPPUGI; B. GIANNOTTI. - In: BRITISH JOURNAL OF DERMATOLOGY. - ISSN 0007-0963. - STAMPA. - 149(2003), pp. 205-206. Availability: This version is available at: 2158/312905 since: Terms of use: Open Access La pubblicazione è resa disponibile sotto le norme e i termini della licenza di deposito, secondo quanto stabilito dalla Policy per l'accesso aperto dell'Università degli Studi di Firenze (https://www.sba.unifi.it/upload/policy-oa-2016-1.pdf) Publisher copyright claim: (Article begins on next page) 07 October 2021 British Journal of Dermatology 2003; 149: 193–227. CORRESPONDENCE Bexarotene reverses alopecia in cutaneous T-cell improved in all five patients, irrespective of the route of lymphoma delivery. Hair regrowth began within 2–9 months and full regrowth was evident by 1Æ5 years. SIR, Mycosis fungoides (MF) is characterized by clonal Patient 1. A 77-year-old Native American woman presen- helper ⁄ memory (CD4+ CD45RO+) T-cells in the epidermis, ted with a 3-month history of a single patch of alopecia whereas follicular mucinosis or alopecia mucinosis has accompanied by pruritus and mild tenderness, generalized perifollicular T-cell infiltrates and may clinically resemble xerosis, fatigue and a 4Æ5-kg unintentional weight loss.
    [Show full text]
  • A Review of Paraneoplastic Syndromes in Gastrointestinal Tumors
    DOI: https://doi.org/10.22516/25007440.155 Review articles A Review of Paraneoplastic Syndromes in Gastrointestinal Tumors Laura Rodríguez P.1, James Yurgaky S.2, William Otero R.3, Michel Faizal4 1 Intern in the Faculty of Medicine at the National Abstract University of Colombia in Bogotá, Colombia 2 Internist, Endocrinologist and Gastroenterology Paraneoplastic syndromes produce tumors at sites distant from themselves and are not physically related Fellow at the National University of Colombia and the to those tumors or to their metastases. Various gastrointestinal tumors may present syndromes or systemic, National University of Colombia Hospital in Bogotá, dermatological, hematological, renal, neurological and other manifestations. This study reviews these mani- Colombia 3 Professor of Medicine in the Gastroenterology festations. Unit of the National University of Colombia and the National University of Colombia Hospital and Keywords Gastroenterologist at the Foundations Clinic in Bogotá, Colombia. Email: [email protected] Paraneoplastic syndrome, gastrointestinal, tumors. 4 Professor of Medicine in the Dermatology Unit at the National University of Colombia and the National University of Colombia Hospital in Bogotá, Colombia ......................................... Received: 25-07-16 Accepted: 28-07-17 INTRODUCTION finally result in accumulation of immune complexes. (3, 4, 5) The various PNS are classified according to the organ or Paraneoplastic syndromes (PNS) are a heterogeneous system they affect as endocrine and metabolic, dermato- group of clinical manifestations that occur when a tumor logical, hematological, rheumatological and neurological. causes damage to a distant organ or system and that are not (3) This review describes PNS produced by gastrointesti- physically related to the tumor or its metastases.
    [Show full text]
  • Enlarging, Firm Nodule P.32 7
    DERM CASE Test your knowledge with multiple-choice cases This month – 13 cases: Large ©Plaque on the Shoulder p.40 1. Enlarging, Firm Nodule p.32 7. t n ghAsymptomatic Rash on the Back tiop.42 2. Red, Scaly Plaques on the Abdomepn yp.34ri8. tribu o Band-like EruDptioni son the Toarsdo , p.43 3. Lesion Left after Excision C p.35 9. ial ownlo eYerllcowish-bro wcna nE lbdow Nodule p.44 4. Painful Tongue Lesion pm.36 m10. users use Co orised sonal Erosive, Crusted Skin on Coherek s p..3 8Aut1h1. A Mass onr tphee rDorsum of the Wrist p.45 5. ale hibited copy f r S se pro in1g2le. Unilateral Dermatitis on Lower Leg p.46 6. Scta lyf Loesions on itshe dS cualp rintp .a3 9 s No author and p Maculopapular Arm Rash p.48 Un y, view 13. displa Case 1 Enlarging, Firm Nodule A 36-year-old female presents with an asympto - matic, firm nodule of several years duration on her leg. She thinks the papule is slowly enlarging. What is your diagnosis? a. Dermatofibroma b. Spitz nevus c. Compound nevus d. Dysplastic nevus e. Juvenile xanthogranuloma Answer A dermatofibroma (answer a) is a benign, firm tumour of the skin. It is generally observed on the lower legs, though it can be found elsewhere. These thought to be due to a minor trauma, such as a mos - lesions often start out red in colour and eventually quito bite or ingrown hair, but increasingly it is felt become brown. They are typically asymptomatic, to be a clonal proliferative growth, akin to a neo - though occasionally tenderness may be experi - plastic process but with a benign, natural history.
    [Show full text]