Clinico-radiologic, laboratory, and histopathologic profile of patients diagnosed with neonatal cholestasis at Philippine Children's Medical Center

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Neonatal Cholestasiswarrants early, accurate and prompt intervention and comprises a wide spectrum of differential diagnosis which present with overlapping features, thus making a diagnosis difficult.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> To evaluate the clinical and laboratory parameters that could aid to differentiate between intrahepatic and extrahepatic neonatal cholestasis.</p><p style="text-align: justify;"><strong>METHODS</strong>: Retrospective and Descriptive study of Neonatal Cholestasis patients who underwent Liver Biopsy and admitted at the Philippine Children's Medical Center from January 2007 to December 2011.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Factors that favor an intrahepatic cause of Cholestasis are ultrasound finding of a normal gallbladder, marked degree of giant cell transformation and presence of extramedullary hematopoiesis. Factors that favor an Extrahepatic cause of Cholestasis are presence of Splenomegaly, markedly elevated GGT, and histopathology findings of Portal and Periportal Ductal proliferation, bile plugs, lesser degree of giant cell transformation, septal fibrosis and cirrhosis, portal and neoductular cholestasis, and Portal-Portal bridges.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> In this study, meticulous history and physical examination aid in the diagnosis of Neonatal Cholestasis. Splenomegaly and markedly elevated serum GGT are suggestive of Biliary Atresia, and a normal Gallbladder by Ultrasound favors Neonatal Hepatitis. Although there is significant overlap of histopathologic findings of patients with neonatal cholestasis, certain parameters favor an extrahepatic over an intrahepatic process.</p>

Clinical and Histopathological Features in Inverted Follicular Keratosis / 대한피부과학회지

BACKGROUND: Inverted follicular keratosis has distinctive histopathological features and is infrequently encountered by dermatologists. To date, the pathogenesis of inverted follicular keratosis has not been elucidated. Many authors have suggested several theories for the nature of inverted follicular keratosis including verruca vulgaris with squamous eddies, irritated seborrheic keratosis and distinctive follicular tumors. There are no comprehensive studies about the clinical and histopathological features of inverted follicular keratosis in Korea. OBJECTIVE: The purpose of this study was to analyze the clinical features and histopathological findings of inverted follicular keratosis with literature review. METHODS: We studied 14 patients with inverted follicular keratosis for clinical features including the duration of the disease, the location and size of the lesions, the clinical impressions at the first visit and we made a record of the patients' age and sex, histopathological findings. RESULTS: Eight of the 14 patients were male and the ages ranged from 40 to 83 years(mean 59.3 years). The lesions were situated on the face(5/14), scalp(3/14), abdomen(2/14), hand(2/14), buttocks(1/14), shin(1/14). The average size of the lesions was 1.38cm. Seborrheic keratosis was the most common clinical diagnosis(6/14), followed by verruca vulgaris(4/14), cutaneous horn(1/14), melanoma(1/14), soft fibroma(1/14) and pigmented nevus(l/14). Solid and nodular types were the most common histopathological type(7/14), followed by keratoacanthoma-like type(5/14), filiform or wart like type(2/14). CONCLUSION: Inverted follicular keratosis have unusual clinical and histopathological features. We recommend that verrucous plaque lesions should be diagnosed correctly by histopathologic examination and it may be helpful to avoid inappropriate therapeutic approach.