Histopathological finding of vesiculobullous lesions of skin in relation to their clinical presentation: Prospective study from a tertiary care center

Background: Vesiculobullous disorders (VBDs) are extant with diverse clinical manifestations. Vesicles and bullae are fluid-filled cavities present within or beneath the epidermis. They are autoimmune blistering disorders in which autoantibodies are directed against target antigens present in the epidermis and dermo-epidermal junction. Objective: Evaluation of the various clinicodemographic profile of patients with a pattern of distribution (subtypes) of VBDs of the skin and assess the association between clinical aspects and histological changes in vesiculobullous lesions of the skin. Materials and Methods: The study material constituted 93 cases of VBDs out of 936 skin biopsies reported over two and a half years (January 2016 to June 2018) from the tertiary care center. A detailed history of the patients was taken, and a complete physical and dermatological examination with findings including clinical diagnosis was recorded. Histopathological examination (incisional/excisional/punch biopsy) was done in each case. The clinico-demographic evaluation was done and the results were correlated with histopathological findings. Results: Vesiculobullous lesions constituted 10.06% of all skin biopsies. The majority of cases were of pemphigus vulgaris (PV) 30 (32.25%) followed by 16 (17.2%) of bullous pemphigoid. In 83 cases (89.24%) histopathology findings were consistent with clinical diagnosis. Out of 34 cases that were diagnosed clinically as PV , the histopathological study proved 30 cases (88.23%) as PV. Conclusion: Vesiculobullous lesions of the skin are a heterogeneous group of disorders. It is essential to differentiate each pattern of subtype based on clinical examination and histopathological findings. Histopathological diagnosis with clinical correlation plays a major role in arriving at the diagnosis.

Poroma Ecrino Plantar. Presentación de un caso

RESUMEN Los poromas ecrinos son tumores anexiales benignos que se originan de la porción intraepidérmica del conducto de la glándula sudorípara, representan aproximadamente el 10 % de todos los tumores de estas glándulas. La variante clásica de poroma se caracteriza por una neoformación de aspecto papular de color piel oeritematosa, con predilección por las palmas y plantas. Presentamos el caso de una paciente femenina de 53 años de edad, con antecedentes de diabetes mellitus tipo I que acude a consulta de dermatología del policlínico de suárea de salud, por presentar lesión en planta del pie izquierdo de 2 años de evolución, asintomática que comenzó como una bolita, notando que aumentaba de tamaño, acude primeramente a la consulta de podología y la envían a nuestra especialidad, donde es evaluada y se diagnóstica clínicamente un poroma ecrino. En el estudio histopatológico fue de gran valor en función de la orientación diagnóstica y se precisó la presencia de esta entidad. El caso presentado contribuye a visibilizar la necesaria revisión del tema teniendo en cuenta que representa un reto diagnóstico, por su gran variedad morfológica y se hacen necesarios los estudios histológicos.

ABSTRACT Eccrine poromas are benign adnexal tumors that originate from the intraepidermal portion of the sweat gland duct, representing approximately 10% of all tumors of these glands. The classic variant of poroma is characterized by a skin-colored or erythematous papular-looking neoformation, with a predilection for the palms and soles. We present the case of a 53-year-old female patient with a history of type I diabetes mellitus who attended the dermatology clinic of the polyclinic in her health area due to a 2-year history of an asymptomatic lesion on the sole of her left foot. It started as a small ball, noticing that it was increasing in size, she first went to the podiatry consultation and was sent to our specialty, where she was evaluated and an eccrine poroma was clinically diagnosed. In the histopathological study it was of great value depending on the diagnostic orientation and the presence of this entity was specified. The case presented contributes to make visible the necessary review of the subject, taking into account that it represents a diagnostic challenge, due to its great morphological variety and histological studies are necessary.

RESUMO Os poromas écrinos são tumores anexiais benignos que se originam da porção intraepidérmica do ducto das glândulas sudoríparas, representando aproximadamente 10% de todos os tumores dessas glândulas. A variante clássica do poroma é caracterizada por uma neoformação papular da cor da pele ou eritematosa, com predileção pelas palmas das mãos e plantas dos pés. Apresentamos o caso de uma paciente do sexo feminino, 53 anos, com histórico de diabetes mellitus tipo I, que compareceu ao ambulatório de dermatologia da policlínica de sua área de saúde devido a história de 2 anos de lesão assintomática em planta do pé esquerdo Começou por ser uma bolinha, notando que estava a aumentar de tamanho, foi primeiro à consulta de podologia e foi encaminhada para a nossa especialidade, onde foi avaliada e diagnosticado clinicamente um poroma écrino. No estudo histopatológico foi de grande valia dependendo da orientação diagnóstica e foi especificada a presença desta entidade. O caso apresentado contribui para tornar visível a necessária revisão do assunto, tendo em conta que representa um desafio diagnóstico, devido à sua grande variedade morfológica e são necessários estudos histológicos.

A Study of Placental Changes in Polycystic Ovarian Syndrome Patients with Gestational Diabetic Mellitus

Placenta is a vital organ for the development of foetus and maintenance of pregnancy. Placenta helps in the development and growth of foetus in uterus. In between maternal and foetal circulation the transfer of waste products and nutrients was done by the placenta which is a complex organ of a short life span. The diabetic pregnancy is characterised by numerous disturbances in foetal growth and development.METHODSA cross sectional study on placental changes in 60 pregnant women was done over a period of 18 months. Pregnant women in the age group of 25 years to 40 years who were suffering from polycystic ovarian syndrome (PCOS) were included in the study. Placental specimens were collected from obstetrics department and fixed overnight in 10% formalin. Thorough gross examination was done and few bits from the abnormal areas were given for microscopic examination. Routine histopathological process was followed for microscopic examination.RESULTSOut of 60 pregnant women with PCOS, seven patients were found to be having PCOS with gestational diabetes mellitus. These seven patients showed gross and microscopic changes in the placenta when compared with non-diabetic PCOS pregnant women.CONCLUSIONSPlacenta of diabetic women with PCOS showed both gross and microscopic abnormalities which may affect the growth and development of baby during intrauterine life.

To Evaluate Efficacy Of Asthishrunkhala (cissus Quadrangularis) On Acceleration Of Bone Healing In Fractured Bone

The healing of a fracture is one of the most remarkable of all the repair processes in the body since results not in a scar but in the actual reconstitution of the injured tissue in something very like its original form. It is not to be expected therefore that the mechanisms controlling such a process will be easily elucidated and indeed they involve problems of cellular homeostasis which are among the most fundamental in biology. If it is not quite thou cunning'st pattern of excelling nature, then it is something quite close to it and a great deal of that pattern. Present study shows experimental evaluation of effect of Asthishrunkhala (Cissus quadrangularis) on bone healing in fractured bone by histo-pathological study. During study concerned literature was reviewed critically. The study was divided into phytochemical, pharmacological and histopathological study. Drug was identified and authenticated from authorized institute and phytochemical screening done after successive extraction of extract. Two groups were made. First Group A (Treatment group) was further divided into six subgroups containing five animals each received extract of Cissus quadrangularis 500mg/kg body weight, Group B is control group. After completing the study it was observed that mature bone or bone repair process seen weakly at 2nd – 3rd week proving the acceleration of bone healing process with gradual re-modeling. Statistical analysis shows that histopathological study in group A found to be highly significant p<0.001 from 4th week onwards. Overall the bone healing process shows 10% faster healing period in group A than group B.

Histopathological and cholinesterase changes in the gills of Clarias gariepinus as a result of cadmium exposure

Aim: The cholinesterase (ChE) based inhibition and histopathological studies from fish were investigated and represented in this study to develop as one of the great potential biomarkers for heavy metals monitoring. Methodology: In this study, the histopathological study of gills were observed a under microscope. The capability of ChE extracted from the gills of Clarias gariepinus was assessed for declining Cd. ChE was purified through affinity chromatography and continued with the optimisation and inhibition study (IC50) of cholinesterase. Results: Histopathological study of gills was carried out and several changes such as aneurysm, necrosis and lamella fusion were noted. Purification fold obtained from purified enzyme was 1.15 with 30% a yield specific activity 20.726. The optimum temperature for purified AChE was 35°C along with acetylthiocholine iodide (ATC) as a preferable substrate that had the highest Vmax value of 0.5452 U mg-1 and the lowest Km value of 0.0311 mM. The optimum pH was observed to be 10 of Tris-HCl as a medium. Meanwhile, the IC50 of cadmium was 6.808 mg l-1 with R2 value of 0.9532. Interpretation: The result of the study can be used as a tool for further developing a biomarker for the detection of heavy metals in aquatic ecosystems. In addition, the baseline data provided can also be used for designing a kit, which would give rapid and accurate result.

Incidencia del edema pulmonar no cardiogénico mediante estudio histopatológico periodo 2013 ­ 2016 / Incidence of noncardiogenic pulmonary edema by histopathological study period 2013 ­ 2016

El edema pulmonar no cardiogénico es una entidad fisiopatológica caracterizada por una lesión generalizada de los capilares pulmonares que provoca un aumento de su permeabilidad a los líquidos, proteínas y otros elementos formes de la sangre, ocasionando un constante flujo de líquidos desde la circulación pulmonar hacia el espacio intersticial y los alvéolos, resultando el edema pulmonar no cardiogénico. El objetivo de este estudio es considerar la incidencia de esta entidad en los casos de muertes súbitas, por medio del estudio histopatológico y caracterizar los factores predisponentes relacionados a esta patología. Todas las muestras fueron sometidas a procedimientos técnicos para estudio histopatológico para confirmar o descartar el diagnóstico macroscópico emitido en la necropsia. Para este estudio se analizaron 518 informes de estudio histopatológico correspondientes a los años 2013, 2014, 2015 y 2016, las cuales 119 correspondieron a edema pulmonar no cardiogénico, siendo el 22,97 % de estos 119 informes de estudio histopatológico se analizaron e interpretaron de acuerdo con los factores predisponentes teniendo como hallazgo importante 39,49 % al síndrome metabólico; 21,84 % a la intoxicación alcohólica; 14,28 % a la intoxicación medicamentosa, entre otros. De esto concluimos que es importante realizar el estudio histopatológico a los casos de muerte súbita sin diagnóstico, puesto que algunas pueden ser encasilladas en un síndrome metabólico o intoxicaciones que ameritan investigación para determinar la causa de muerte.

Non-cardiogenic pulmonary edema is a pathophysiological entity characterized by a generalized lesion of the pulmonary capillaries that causes an increase of its permeability to the fluids, proteins and other form elements of the blood, causing a constant flow of liquids from the pulmonary circulation towards the interstitial space and alveoli, resulting in non-cardiogenic pulmonary edema. The aim of this study is to consider the incidence of this entity in cases of sudden deaths, through the histopathological study and to characterize the predisposing factors related to this pathology. All samples were subjected to technical procedures for histopathological study to confirm or rule out the macroscopic diagnosis emitted at necropsy. For this study, 518 histopathological reports corresponding to the years 2013, 2014, 2015 and 2016 were analyzed, of which 119 corresponded to non-cardiogenic pulmonary edema, with 22.97% of these 119 histopathological reports being analyzed and interpreted according to to the predisposing factors having as important finding 39.49% to the metabolic syndrome; 21.84% to alcoholic intoxication; 14.28% to drug intoxication among others. From this we conclude that it is important to carry out the histopathological study to cases of sudden death without diagnosis since some may be pigeonholed in a metabolic syndrome or poisonings that warrant investigation to determine the cause of death.

An Analytical Study Of Histopathological Findings Of 100 Cases Of Fistula-in-ano

Fistula-in-ano is one of the most difficult diseases confronted in ano-rectal patients in Shalyatantra OPD. Sushruta described Bhagandara along with its etiology, clinical presentation and treatment. The description of different types of Bhagandara (fistula-in-ano) are at par with the aetiopathogenesis of Fistula-in-ano of modern medical science. It is a very complicated condition arising out of various causes like pyogenic, tubercular, lymphogranuloma inguinale, inflammatory bowel diseases like Crohn's disease, ulcerative colitis etc. Identification of the aetiopathological factor is necessary for the success of treatment of fistula-in-ano. Histopathological study of tissue from tract of fistula-in-ano is an useful diagnostic tool for assessing the underlying pathology. In this study we use the benefits of histopathological examination from the primary site of the disease to detect the basic etiology. 100 cases diagnosed as fistula-in-ano attending Shalya OPD, Government Ayurvedic College Hospital were randomly selected for a period of one year i.e 2016-2017. After necessary investigations, tissue is collected from the primary site of fistulous tract during primary threading for Kshar Sutra therapy, in OT under local anaesthesia and sent for histopathological examination. The results of the above study were tabulated and lots of cases other than pyogenic cause were detected. The data were analysed with standard statistical methods. Without histopathological examination it is not possible to detect the underlying cause of fistula-in-ano.

Correlación entre diagnóstico ecográfico e histopatológico de poliposis vesicular en la Clínica Good Hope 2008-2014 / Correlation between sonographic diagnosis and histopathological results of gallbladder poliposis in Good Hope Clinic 2008-2014

Objetivo: determinar la correlación entre el diagnóstico ecográfico y el resultado histopatológico de poliposis vesicularen los pacientes y encontrar el valor predictivo positivo de la ecografía en el diagnóstico de esta patología.Material y Métodos: Es una investigación no experimental, transversal, descriptiva y correlacional, realizada en unamuestra de 128 pacientes operados con diagnóstico de poliposis vesicular en la clínica Good Hope entre 2008 y 2014. Serevisaron los informes ecográficos e histopatológicos de estos pacientes y se buscó la relación mediante el coeficiente decorrelación de Spearman.Resultados: El 67,2% de la muestra correspondió al sexo femenino y el 32,8% al sexo masculino; la edad promedio fue de43,4 años. El 74,2% de los 128 casos presentó pólipos según el examen histopatológico, de los cuales el 94,7% fueronpseudopólipos y 84% fueron pólipos de colesterol; solo el 5,3% de los pólipos fueron verdaderos (adenomas) y ninguno deellos fue maligno, el pólipo más grande midió 13 mm. El valor predictivo positivo de la ecografía en el diagnóstico depoliposis vesicular fue 74.21%. La correlación entre el número de pólipos por ecografía e histopatología según elcoeficiente de Spearman fue muy baja, directa y significativa (Rho=0,189, p=0,032).Conclusión: Existe una correlación directa entre el diagnóstico ecográfico y el resultado histopatológico de poliposisvesicular; la ecografía puede considerarse como un método confiable para el diagnóstico de esta patología.

Objective: To determine the correlation between sonographic diagnosis and histopathological results of gallbladderpolyposis and find the positive predictive value of ultrasound in the diagnosis of this pathology.Material and Methods: It is a non experimental, transversal, descriptive and correlational study with a sample composedof all patients operated with a diagnosis of gallbladder polyps in the Good Hope Clinic between the years 2008 and 2014. Atotal of 128 patients were observed. Histopathological and sonographic reports of these patients were reviewed and thestatistical correlation of both studies was sought by the test of Spearman.Results: Reveals that 67,2% were females and 32,8% were males; the average age was 43,4 years; 74,2% presented polypsby histopathological examination, of which 94,7% were pseudopolyps, with 82 % cases of cholesterolpolyps, only 5,3% weretrue polyps (adenomas) and none of them were malignant. The positive predictive value of ultrasound in the diagnosis ofgallbladder polyposis was 74,21%. According to the Spearman coefficient the correlation between the number of polyps byultrasonography and histopathology was low, direct and significant (Rho = 0,189; p = 0,032).Conclusions: We conclude that there is a correlation between the ultrasound diagnosis and histopathological result ofgallbladder polyps and ultrasound can be considered a reliable method for the diagnosis of gallbladder polyps.

Effect of nettle (Urtica dioica) extract on gentamicin induced nephrotoxicity in male rabbits

To investigate the antioxidant effect of an orally administered ethanol extract of nettle (Urtica dioica) and its protective role in preventing or ameliorating oxidative stress as a major factor in gentamicin-induced nephrotoxicity in male rabbits. Methods: Twenty rabbits were divided into 4 equal groups: (G1) control group, (G2) gentamicin treated group (100 mg/kg), (G3) nettle treated group (100 mg/kg), (G4) combination treated group with both gentamicin (100 mg/kg) and nettle (100 mg/kg) for 10 days. The antioxidant properties of nettle were evaluated using different antioxidant tests, such as determination of glutathione and malondialdehyde levels and total phenolic content analysis. Results: Biochemical and histopathological study revealed that gentamicin caused nephrotoxicity observed clearly in the histopathological section of the kidney in the gentamicin treated group. Serum creatinine and blood urea nitrogen were biochemical indicators for nephrotoxicity which increased significantly in gentamicin treated group; other groups have no significant change in these two parameters. Nettle extract protected the rabbits from alteration in the level of blood urea nitrogen and serum creatinine when given after inducing of gentamicin nephrotoxicity. The nettle treated group showed a great effect as an antioxidant factor by increasing the glutathione level and reducing malondialdehyde level. No significant changes in biochemical parameters and no renal histopathological changes observed in the groups treated with nettle extract, which meant nettle had powerful antioxidant activity. Conclusions: Therefore, it can be assumed that the nephroprotective effect shown by nettle in gentamicin-induced nephrotoxicity can reserve intracellular levels of biological pathways and supportively enhance excretion of toxic levels of gentamicin.

A Clinical and Histopathological Study of 76 Cases of Neurofibroma / 대한피부과학회지

No abstract available.

Lesions of Tongue : A Five Year Experience.

Context: Tongue lesions are quite common and affect both genders and all age groups. However, very few studies concentrate on the histopathological spectrum of tongue lesions, usually including them as a part of oral cavity lesions. No such study has been published from the newly formed state of Uttarakhand. Aim: A retrospective review of histopathology of various types of tongue lesions in different age groups of both genders, amongst cases reported in the department of pathology. Methods and Materials: Study included a total of 121 cases of tongue lesions reported in the histopathology section over a duration of five years, from July 2004 to June 2009. Result: In this study, the most common lesions were malignant (58.7%), followed by benign lesions (33%) and pre-malignant lesions (8.3%). The most common site for tongue lesions was base of tongue (52.8%). Common age groups affected were 41- 50 years (27.2%) and 51-60 years (28.0%). The most common clinical presentation was growth and induration. Overall males were affected more than females; with Male:Female ratio of 3.3:1. Conclusions: The commonest tongue lesion in this study was moderately differentiated squamous cell carcinoma among the malignant lesions whereas chronic inflammation was the commonest out of non-malignant lesions. Tongue may show some less common tumours like schwannoma and hemangioma etc.

In Vitro and In Vivo Evaluation of Combined Time and pH- Dependent Oral Colonic Targeted Prednisolone Microspheres.

Aims: to enhance the anti-inflammatory effect as well as oral absorption of prednisolone (PR), through formulation of colonic targeted microspheres prepared from a blend of time and pH- dependent polymers and loaded with PR. Study Design: In Vitro and In Vivo Evaluation of Combined Time and pH- Dependent Oral Colonic Targeted Prednisolone Microspheres. Place and Duration of Study: Department of Pharmaceutics and Industrial Pharmacy, Helwan University, Cairo, Egypt between June 2011 and October 2012. Methodology: Microspheres were prepared by solvent evaporation method using different ethyl cellulose (EC) and Eudragit® S-100 (ES100) ratios with 0.5 and 1% w/v span® 80 as emulsifier. The microspheres were evaluated for surface morphology, particle size, drug encapsulation efficiency % and in vitro drug release at pH 1.2 and 7.4. The antiinflammatory activity of selected formula was compared to that of conventional PR tablets. Results: A decrease in drug entrapment efficiency % was obtained with increasing both polymers and surfactant concentrations. Based on drug release results, the formula of 1: 1: 0.16 w/w/w, EC: ES100: PR ratio with 1% w/v span® 80 was selected for further histopathological evaluation of the anti-inflammatory activity in colitis induced-rats. Histopathological study showed undefined tissue necrosis after treatment with the selected microspheres; however, diffused necrosis was observed in rats treated with the commercial tablets. In vivo absorption study showed that values of Cmax and AUC0-24 of both formulations were insignificantly different. However, the occurrence of Cmax of microspheres was significantly delayed in comparison to free drug (9.17 to 2.67hr) (P<.001). Conclusion: This study has supplied us with brightening results concerning the therapeutic efficacy of a blend of time and pH- dependent polymers colonic targeted microspheres.

Bioanálisis predictivo de tolerancia dérmica de cosméticos para bebés in vivo / Predictive bioanalysis of skin tolerance of cosmetics for babies in vivo

Objetivo: prever el riesgo potencial de irritabilidad dérmica de una crema y una loción para bebés, con el fin de obtener el registro sanitario y disminuir la eventualidad de riesgo para la salud. Métodos: se realizó el bioanálisis predictivo de tolerancia dérmica in vivo en conejos, a través de un estudio de tipo exploratorio clínico cualitativo e histopatológico, basado en el enfoque de la ley del Arte para explicar el riesgo/efectividad comparable en humanos. Se aplicó la técnica de exposición aguda simple (prueba parche oclusivo) en seis conejos, por cada producto. Se estimaron los efectos dérmicos mediante una escala de valores que define la probabilidad de inseguridad atribuible por la exposición al cosmético, según prueba de toxicidad dérmica de la Organización para la Cooperación Económica y Desarrollo 2004 (OCED), con ciertas modificaciones por los autores. Resultados: en el bioanálisis se encontró cierta irritabilidad dérmica en la piel de los conejos al aplicarles el cosmético en una dosis única por 92 días. El estudio clínico se complementó con el análisis histopatológico de una muestra de piel irritada y no mostró cambios significativos a los observados. Conclusiones: el bioanálisis clínico e histopatológico permite inferir una irritabilidad dérmica entre insignificante y leve, lo que sugiere la necesidad de mejorar la formulación de los cosméticos estudiados para obtener el registro sanitario, y así alertar tempranamente al productor y a la comunidad de la seguridad y eficacia de los productos(AU)

Objective: to prevent the potential risk of dermal irritability from a cream and a lotion for babies, in order to obtain health registration and to reduce possible health risks. Methods: in vivo predictive bioanalysis of dermal tolerance carried out in rabbits through a qualitative and histopathological clinical exploratory-type study, based on the Lex Artis approach to explain the comparable risk/effectiveness in humans. There was applied the single acute exposure technique (occlusive patch test) in six rabbits to test each product. Dermal effects were then measured in a value scale defining the cosmetic exposure-attributed unsafeness probabilities, according to the dermal toxicity test of the Organization for Economic Cooperation and Development, with some modifications by the authors. Results: the bioanalysis found some dermal irritability in the rabbits' skin after using the single dose of cosmetic for 92 days. The clinical study was supplemented with the histopathological analysis of a sample of irritated skin, without significant changes other than those observed. Conclusions: the clinical and hisopathological analysis showed mild to negligible dermal irritability, which indicates the need for improvements to the formulation of the studied cosmetics in order to obtain the health registration and thus to early advise the manufacturer and the community about the safety and efficacy of products(AU)

Sub-acute toxicological studies 2α, 3β, 21β, 23, 28-penta hydroxyl 12-oleanene isolated from roots of Laportea crenulata Gaud.

Background: 2α,3β,21β,23,28-penta hydroxyl 12-oleanene was isolated from roots of Laportea crenulata Gaud (Urticaceae) as a new triterpenoid and its antifungal activities was evaluated against a number of fungi where moderate antifungal activities were reported. However, no toxicological study has yet been carried out. Objective: The sub-acute toxicity of 2α,3β,21β,23,28-penta hydroxyl 12-oleanene was studied on albino mice. Methods: The triterpenoid was administered on intraperitoneal route at 300 μg per mouse (20-27g) daily for 14 consecutive days. The studies included the determination of changes in body weight, hematological profiles (total count of red blood cell, white blood cell and platelet, differential count of white blood cell, erythrocyte sedimentation rate, and hemoglobin percentage), and biochemical parameters of blood (serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, serum alkaline phosphatase, serum bilirubin, creatinine, and urea) as well as histopathology of the liver, kidney, heart, and lung. Result: The changes in body weight, hematological, and biochemical parameters were statistically not significant when compared to control group mice. Histopathologically no abnormality was found on liver, kidney, heart, and lung of experimental group mice after treatment when compared to that of control group mice. Conclusion: In sub-acute toxicity studies, the triterpenoid was found to be nontoxic. We suggest further studies such as chronic toxicological studies as well as route selection experiments.

Avaliação histopatológica em ratos após tratamento agudo com o extrato etanólico de partes aéreas de Jatropha gossypiifolia L. / Histopathological evaluation in rats after acute treatment with the ethanol extract from aerial parts of Jatropha gossypiifolia L.

A Jatropha gossypiifolia L. apesar de ser usada na medicina popular com finalidades diversas, é uma espécie classicamente catalogada como tóxica. Este trabalho teve como objetivo a pesquisa de alterações histopatológicas em vísceras de ratos sob tratamento agudo com o extrato etanólico (EE) da Jatropha gossypiifolia L. Ratos Wistar foram tratados por via oral (gavagem) com doses únicas do extrato de até 5 g/kg e observados por 14 dias. Após esse período, os animais foram sacrificados por tração cervical e as vísceras foram coletadas. O coração, o fígado e o rim foram seccionados por incisão sagital e os pulmões submetidos à perfusão via traquéia, com solução de formol a 10 por cento. As secções teciduais foram processadas conforme os métodos habituais, coradas pela hematoxilina-eosina e tricômico e observadas ao microscópio óptico. Apenas nos animais tratados com a maior dose do extrato (5 g/kg) foram observadas alterações em fígado e pulmão evidenciadas por resposta inflamatória e estimulação do sistema imunitário. Estes resultados indicam uma toxicidade aguda oral relativamente baixa; entretanto, corroboram com os indícios de hepatotoxicidade já publicados, expondo ainda um potencial de toxicidade pulmonar do produto, o que ressalta a importância de estudos toxicológicos de longa duração com o EE da espécie Jatropha gossypiifolia L.

Jatropha gossypiifolia L. has been used in folk medicine in Brazil despite its classification as a toxic plant. The aim of this work was the assessment of histopathological a lterations in rats after acute treatment with the ethanol extract (EE) from Jatropha gossypiifolia L. Wistar rats were treated by gavage with single doses of EE until the limit dose of 5 g/kg (w.b.). 14 days after treatment the rats were sacrificed and the viscera were collected. The hard, liver and kidney were sectioned by sagittal incision and the lung submitted to perfusion with phormol (10 percent). The histological sections were processed by the usual methods in hematoxilin-eosin and trichrome staining and were observed through optical microscopy. Only in treated rats with 5 g/kg (w.b.) we observed some alterations in the liver and lung that means inflammatory response and immune activation. These results indicate a low oral acute toxicity, in relative terms, however, it was confirmed the hepatic toxicity already reported and showed the importance of long-term toxicological studies of the EE from Jatropha gossypiifolia L.

A Clinical and Histopathologic Study of Lichen Sclerosus et Atrophicus / 대한피부과학회지

BACKGROUND: Lichen sclerosus et atrophicus (LS et A) is an uncommon chronic lymphocyte-mediated dermatosis that causes substantial discomfort and morbidity, most commonly in adult women. It occurs predominantly in the anogenital area, and extragenital lesions also occur. OBJECTIVE: The aim of this study is to compare clinical and histopathologic features of genital and extragenital LS et A. METHODS: We retrospectively reviewed the medical records and 31 biopsy specimens of 29 patients who had been diagnosed with LS et A between January 2001 to June 2007 in Asan Medical Center. RESULTS AND CONCLUSION: The male to female ratio of genital LS et A and extragenital LS et A was 1:20, 1:3 respectively. Mean age at onset of genital LS et A and extragenital LS et A was 47.8 and 36.9 respectively. The color of the lesions was mostly white, irrespective of the involved area. Genital LS et A lesions were mostly located on labium majora or minora. Extragenital LS et A lesions were mostly located on the trunk, head and neck. The predominant symptom for genital LS et A was pruritus, whereas extragenital LS et A was mostly asymptomatic. The main treatment regime of LS et A was topical corticosteroid. The combination therapy with topical corticosteroid and pimecrolimus/tacrolimus resulted in symptomatic relief as well as improvement of skin lesions, without significant side effect. Histopathologically all LS et A cases showed vacuolar alteration, papillary dermal hyalinization, and dermal lymphohistiocytic infiltration. Hypergranulosis, exocytosis, red blood cell extravasation, lichenoid inflammatory cell infiltration were more frequently observed in genital LS et A (p<0.05). Follicular plugging, epidermal atrophy and loss of rete ridges were more frequently observed in extragenital LS et A (p<0.05).

The Clinical and Histopathological Study of Ota's Nevus / 대한피부과학회지

BACKGROUND: Ota's nevus, characterized by the presence of melanocytes in the dermis, has been familiar among dermatologists, but the etiology, the pathophysiology, the clinical and histological classification are not entirely clear. To understand and elucidate them, more clinical studies and researches are necessary. OBJECT: The aim of this study was to document the clinical and histopathological features of Ota's nevus. METHODS: We examined 299 patients with Ota's nevus who visited the dermatology clinic in Korea from February 1993 to August 2003. Among them, 188 patients were biopsied. All the specimens were stained with hematoxylin and eosin. We examined the age & sex distribution, age of onset, seasonal variation, associated skin diseases, aggravating factors and color. We clinically classified Ota's nevus into 4 types according to Tanino's classification and histologically into 5 types based on the pattern of pigmentation. RESULTS: 1. The ratio of male and female was 1: 3. 2. The peak age of onset was at birth (28.4%) and puberty (24.8%). 3. Seasonal variation was observed with distinct aggravation in the summer (60%). 4. The associated diseases were 9 cases of persistent mongolian spot, 6 cases of nevus flameus, 4 cases of blue nevus, 3 cases of vitiligo, 3 cases of nevus of Ito, 2 cases of atopic dermatitis, 2 cases of psoriasis, 2 cases of cafe au late macules and 2 cases of contact dermatitis. 5. The aggravating factors were sunlight (35.8%), emotional stress (21.0%), menstruation (12.6%), cold exposure (9.5%), pregnancy (9.5%), fatigue (9.5%) and chemical agents (2.1%). 6. The color of lesions were blue black (36.8%), brown (34.8%), dark brown (16.1%) and slate (11.0%). 7. All cases were classified according to Tanino's METHODS: type Ia (23.1%), type Ib (20.1%), type II (26.7%), type III (9.4%), type IV (20.7%). 8. The histological subtypes of Ota's nevus were classified as: the superficial type (35.6%); the middermis type (5.9%), the superficial-middermis type (18.6%); the mid-lower dermis type (2.7%); the diffuse type was composed of the superficial dominant type (19.7%), the middermis dominant type (4.8%), the dispersed (true diffuse) type (12.2%) and the deep dominant type (0.5%). 9. In the relation between histological types and the color of the lesion: the superficial type had 31 cases of brown color, 15 cases of blue black color, 11 cases of dark brown color and 9 cases of slate color; the middermis type had 6 cases of blue black color and 2 cases of dark brown color, query number of cases of slate color; the superficial-middermis type had 12 cases of blue black color, 10 cases of dark brown color, 7 cases of brown color and 6 cases of slate color: the mid-lower dermis type had 3 cases of blue black color; for the diffuse type, the superficial dominant type had 13 cases of brown color, query number of cases of blue black color and 7 cases of dark brown color; the mid-dermis dominant type had 4 cases of brown color, query number of cases of dark brown color, the dispersed type had 14 cases of blue black color and 5 cases of brown color; the deep dominant type had 1 case of blue black color. CONCLUSION: The histological reclassification of Ota's nevus may be very useful in making a therapeutic prognosis of the disease.

A Clinical and Histopathological Study of Parapsoriasis / 대한피부과학회지

BACKGROUND: Parapsoriasis described a group of cutaneous disease that can be characterized by scaly patches or slightly elevated plaques that have a resemblance to psoriasis, hence the nomenclature. Up to now, a uniformly accepted definition of parapsoriasis remains lacking. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathological features of parapsoriasis in Korea. METHODS: The clinical charts, photographs and skin biopsy slides of patients who had been clinically diagnosed as parapsoriasis at the initial visit were reviewed. Then the evaluation of age at onset, sex distribution, disease duration, anatomical distribution, clinical features of the skin lesions, associated symptoms, family history, co-existing disease, and histopathologic features were conducted. Six cases from small plaque parapsoriasis group and four cases from large plaque parapsoriasis group were investigated for the presence of TCR gene rearrangement using a PCR technique. RESULTS: The male to female ratio was 1: 1.2. The average ages of onset in large plaque type and small plaque type were 44.7 and 32.9 years respectively. 1) According to the clinical classification, 7 (29%) of the patients had large plaque type and 17 (71%) had small plaque type. 2) Many lesions of large plaque parapsoriasis group exhibited varying degrees of epidermal atrophy, fine wrinkles and telangiectasia. 3) Large plaque parapsoriasis showed more histologic changes consisting of epidermal atrophy, exocytosis and atypical lymphocytes. 4) Monoclonal T-cell receptor gene rearrangement was not detected in all of 10 patients with large and small plaque parapsoriasis. CONCLUSION: In our study, some of our findings are in agreement with those already in the literature, whereas others, particularly the male to female ratio and constitutional symptoms, differ. Our results also indicate that there are many clinical and pathological differences between large plaque and small plaque parapsoriasis.

A Clinical and Histopathologic Study of Pityriasis Rubra Pilaris / 대한피부과학회지

BACKGROUND: Pityriasis rubra pilaris (PRP)is a rare papulosquamous disorder of unknown etiology. Although the clinical and histopathologic features of PRP are relatively well known in western patients, there are few available studies in Korea. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathologic features of pityriasis rubra pilaris(PRP) in Korea METHODS: The clinical charts, photographies and skin biopsy slides of patients clinically diagnosed as PRP at the initial visit were reviewed. Finally 30 patients were diagnosed as PRP. They were classified into 5 groups according to the Griffiths classification. And then the evaluation of age at onset, sex distribution, clinical feature of the skin lesion, associated symptoms, clinical course and histopathologic features were conducted. RESULTS: 1) The male to female ratio was 1:1.14. The age of onset was varied from 1 to 65 years with two peaks in first and fifth decades. The average ages of onset in adult type and juvenile type were 40.1 and 5.1 years respectively. 2) According to the Griffiths classification, 14(47%) of the patients had type I, 4(13%) had type III, 7(23%) had type IV, and 3(10%) had type V. However, 2(7%)patients could not be classified under any of these five types due to atypical clinical feature or insufficient follow-up periods. 3) The common clinical features during the disease course were follicular hyperkeratosis(83%), knee and/or elbow involvement(83%), palm and/or sole hyperkeratosis(80%). Erythroderma was present in 5 patients(17%) during the disease course. 4) There were no specific symptoms in most cases, but 9 patients had ben suffered from mild itching. 5) 3 patients had a positive family history, and were thought to have inherited autosomal dominant trait. 6) The frequent histopathologic findings were alternating parakeratosis and orthokeratosis (100%), superficial perivascular infiltration(100%), broad rete ridge(97%), acanthosis(93%), hypergranulosis (87%), follicular plugging(73%). CONCLUSION: We investigated the clinical and histopathological features of PRP in Korea. In our study, the clinical and histopathological features of PRP were not different from those observed in western patients.

Morphologic and Immunohistochemical Studies of Attached Retina in Intravitreal Silicone Oil

Intraocular silicone oil is known to induce irreversible histological changes in retina. We enucleated an eyeball which was filled with silicone oil for 6 years following pars plana vitrectomy for the treatment of proliferative vitreoretinopathy. Purified 1000 cs silicone oil was used. The reattached retina tissue was examined histopathologically and immunohistochemically. Microscopic examination revealed severe retinal degenerations with many vaculoes in inner retina, the proliferation of glial cells, and the presence of phagocytes. The proliferation of the retinal pigment epithelium and the localized calcification of retinal tissues were also observed. Immunohistochemical study showed retinal tissue expressions of vimentin, S-100, and glial fibrillary acidic protein(GFAP). Electron microscopic examination of the retinal tissues demonstrated some phagocytes with large vacules, which probably had been filled with silicone oil. Our study confirmed that intravitreal silicone oil might damage the retinal tissues.