ABSTRACT
Introduction: Chronic subdural haemorrhage is known for high recurrence rates. Recently, VEGF and COX2 have been implicated as causal agents for recurrences, which can be targeted to prevent repeated surgeries and reduce morbidity. Material and Methods: Retrospective study including all cases (n=40) of chronic subdural haemorrhage from 2013 to 2017. The membranes were classified into four histologic subtypes. COX 2 and VEGF antibodies were applied on all cases. Ap value of <0.05 was considered statistically significant. Results: Four subtypes were type 1: non inflammatory (22.5%), type 2: inflammatory (20%), type 3: haemorrhagic inflammatory (27.5%) and type 4: scar inflammatory (30%). Glasgow coma score less than 13 (30%), maximum mean thickness of subdural haemorrhage (6.88), highest VEGF positivity rate (100%) and highest COX 2 positivity rate (91.67%) were found in type 4 membrane [p value 0.003 and 0.0001]. Conclusion:We found that type 4 membranes had worst Glasgow coma score, maximum thickness on CT, highest positivity for VEGF and COX2. Therefore, these are likely to have maximum recurrences and hence can be targeted for anti COX 2 and VEGF therapy.
Subject(s)
Adenoma/complications , Adenoma/diagnosis , Adenoma/pathology , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/pathology , Cystadenocarcinoma, Papillary/complications , Cystadenocarcinoma, Papillary/diagnosis , Cystadenocarcinoma, Papillary/pathology , Histocytochemistry , Humans , Male , Microscopy , Middle Aged , Nevus, Sebaceous of Jadassohn/complications , Nevus, Sebaceous of Jadassohn/pathology , Skin Neoplasms/complications , Skin Neoplasms/diagnosis , Skin Neoplasms/pathologyABSTRACT
A 28-year-old man presented with a partially eroded growth on the back of his right thigh for the last 15 years. Tuberculosis verrucosa cutis and pyogenic granuloma were suspected on clinical examination. Histopathological examination revealed syringocystadenoma papilliferum (SCAP). SCAP is rare on the thigh and a review of the English literature revealed eight cases. Non-descript clinical presentation in an unusual location and the rare linear and segmental variants lead to misdiagnosis. Onset at puberty should alert one to the possibility of the unusual location of SCAP.
ABSTRACT
Pure red cell aplasia is an uncommon complication of diphenylhydantoin therapy. It has not been reported in Indian literature. Awareness of the entity helps in establishing the cause of anaemia in these patients and alerts the physicians to the need of comprehensive haematological monitoring in these patients. A case of 58-year-old male who developed pure red cell aplasia following three months of diphenylhydantoin therapy is reported here.