Granuloma formation in discoid lupuserythematosus: a novel microscopic feature

Lupus erythematosus is an autoimmune disease with marked pleotropism. If several systems are involved then the disease is named as systemic lupus erythematosus [SLE] and if skin is exclusively involved the term discoid lupus erythematosus [DLE] is used. One of the several histopathological features of DLE includes periappendageal inflammation. This may at times ; completely wipe out sebaceous glands forming sebaceous granulomas. To determine the frequency of sebaceous granulomas formation in discoid lupus erythematosus. In this prospective observational study was conducted at the Departments of Dermatology and Pathology, Pakistan Institute of Medical Sciences, Islamabad. 100 cases of DLE spanning over two years and with the age range of 3 years to 70 years were examined for the presence of sebaceous granuloma. Other features of DLE like hyperkeratosis, follicular plugging, epidermal atrophy, basal layer vacuolization, basement membrane deposits, pigmentary incontinence, perivascular inflammation, periappendageal inflammation, and collagen damage were also noted., Out of these 100 cases, 8 cases contained sebaceous granulomas. These granulomas were,, . composed of epithelioid cells, foreign body giant cells containing partially digested sebaceous material and a few lymphoctytes. Sebaceous granulomas formation was seen in 8% cases of DLE cases. This feature must be recognized both by dermatologists and pathologist so that diagnosis of DLE may not be distracted and erroneous diagnosis due to presence of granulomas may not be rendered

Response to treatment of cutaneous leishmaniasis with intralesional chloroquine vs intralesional meglumine antimoniate

In Pakistan, cutaneous leishmaniasis [CL] is mostly caused by Leishmania major. For simple lesions which are few in number and where there is no risk of disfigurement or joint mobility restriction, topical application or local treatment e.g. intralesional antimony compounds are valuable. To compare the effect of intralesional chloroquine with meglumine antimoniate in the treatment of CL. In this quasi experimental study, 60 patients of CL with 1 to 3 lesions and aged >3years were divided into 2 treatment groups to receive either intralesional chloroquine [treatment group] or meglumine antimoniate [control group]. Both drugs were used Ice per cm[2] of lesion, once weekly for 8 weeks [8 injections]. 8 more injections were given to those who showed partial response. Both treatments showed 100% response; however, greater number of injections was required with meglumine antimoniate [p<0.05]. Both drugs were well tolerated. Intralesional chloroquine appears to be an effective, safe and cheap alternative to meglumine antimoniate in the treatment of CL

Sebaceous granulomas: a novel feature of discoid lupus erythematosus

To determine the frequency of sebaceous granulomas formation in discoid lupus erythematosus, Retrospective observational study. Departments of Dermatology and Pathology, Pakistan Institute of Medical Sciences, Islamabad. 100 cases of Discoid Lupus Erythematosus [DLE] spanning over two years and with the age range of 3 years to 70 years were examined for the presence of Sebaceous Granuloma. Other features of DLE like hyperkeratosis, follicular plugging, epidermal atrophy, basal layer vacuolization, basement membrane deposits, pigmentary incontinence, perivascular inflammation, periappendigeal inflammation, and collagen damage were also noted. Lupus erythematosus is an immune complex, type Ill hypersensitivity disease where antibodies are formed against native Deoxyribose Nucleic Acid [DNA]. The immune compexes are deposited in various organs and various sites causing marked pleotropism. If several systems are involved then the disease is named Systemic Lupus Erythematosus [SLE] and if skin is exclusively involve the term Discoid Lupus Erythematosus [DLE] is used. One of the several features of DLE includes periappengeal inflammation. This may at times completely wipe out sebaceous glands forming sebaceous granulomas. Out of these 100 cases 8 cases contained sebaceous granulomas. These granulomas were composed of epithelioid cells, foreign body giant cells containing partially digested sebaceous material and a few lymphoctytes. Sebaceous granulomas formation was seen in 8% cases of discoid lupus erythematosus. This feature must be recognized both by dermatologists and pathologist so that diagnosis of DLE may not be distracted and erroneous diagnosis due to presence of granulomas may not be rendered