A comparative study on the Waist Hip Ratio and Serum Lipid Profile in Information Technology employees with Non Information Technology Employees

Background: In Information Technology (I.T) employees, occupational stress is more common which cause alterations in biochemical parameters and diseases. Aim: To compare the Waist Hip Ratio (WHR), Body Mass Index (BMI) and serum lipid profile like Total cholesterol, Triglycerides, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL) and Very Low Density Lipoprotein (VLDL), in I.T employees with non I.T employees. Materials and methods: This was a comparative study in which employees who were working in I.T Company compared with employees not working in I.T Company. The study included totally 300 subjects of whom 150 were I.T employees and 150 were Non I.T employees. Weight, height, waist and hip measurement were taken. Fasting blood samples were analyzed for Total cholesterol, Triglycerides, HDL, LDL and VLDL. The data were analyzed using SPSS software version 11.5. Results were expressed as mean ± SD. Results: BMI and WHR were significantly decreased in I.T employees than in Non I.T employees. There was no significant difference in Total cholesterol, Triglycerides, HDL, LDL and VLDL. Conclusion: The significant reduction in BMI and WHR in I.T employees may be due to their relaxation exercises in between the working hours, regular physical exercise, periodical health check – up, and life style modification which were not seen in non I.T employees.

Cutaneous amyloidosis at the site of insulin injection with coexistence of acanthosis nigricans.

Skin is one of the important organs affected by amyloidosis which is characterized by extracellular deposition of fibrillary proteins having homogenous, eosinophilic on routine staining with distinct tinctorial properties. Nodular cutaneous amyloidosis is rare and may affect dermis, subcutis and also vascular walls. Nodular amyloid deposits in the deeper dermis occurring at the site of insulin injection are a rare observation, which is described here. This description indicates that cutaneous amyloidosis may be associated with local subcutaneous injections of insulin and may clinically mimic a neoplasm or lipodystrophic lesion.

Pilomatricoma: A tumor with hidden depths.

Background: Pilomatricoma is a benign tumor of hair matrix differentiation and has been classically described as comprising of basaloid and shadow cells admixed with multinucleated giant cells and areas of calcification. However, there are a diverse range of histologic features this tumor displays that are often unrecognized. Aims: This study was undertaken to record the histopathologic features of pilomatricoma with an emphasis on the occurrence of other forms of differentiation. Methods: The study included all skin biopsy specimens over a 13-year period from 1995 to 2007 that had a histologic diagnosis of pilomatricoma. Hematoxylin and eosin-stained slides were reviewed. Results: This study included 21 cases of pilomatricoma. Supramatrical differentiation was seen in all cases and three-quarters of the cases showed matrical differentiation. Also observed in some of the cases were clear cell differentiation toward the outer root sheath, infundibular differentiation, calcification, ossification and secondary inflammation with a foreign body giant cell reaction. Epidermal induction in the form of a downward plate-like growth of the epidermis was seen in a few cases. Conclusion: Pilomatricoma, although considered a tumor of hair matrix differentiation, can show cellular evolution toward the other parts of the hair follicle, such as the outer and inner root sheaths, sebaceous and infundibular components and, therefore, can be considered a panfollicular neoplasm.

Clinicopathologic analysis of 21 cases of nevus sebaceus: a retrospective study.

BACKGROUND: Nevus sebaceus (NS), otherwise designated as 'organoid nevus', involves proliferative changes of the sebaceous glands, sweat glands, and the hair follicles. It displays a range of appearances, depending on the lesion's age. AIMS: To study the histopathological features of NS and correlate these with clinical findings. METHODS: All skin biopsy specimens over a 12-year period from 1995 to 2007 which had a diagnosis of NS were included. Clinical data with follow-up notes and histopathology were reviewed. RESULTS: Half of the cases had a verrucous clinical appearance, while the rest presented as papules, plaques, or patches. All the cases showed immature hair follicles, and 24% of cases showed immature sebaceous glands. Normal terminal hair follicles were characteristically absent in the lesion. Nineteen percent of the cases showed dilated apocrine glands, and 14% showed hyperplasia of eccrine glands. Epidermal changes in the form of acanthosis, papillomatosis, and hyperkeratosis were seen in 86% of cases. Dilated keratin-filled infundibula were observed in 24% of cases. One case was associated with a squamous cell carcinoma. CONCLUSIONS: Nevus sebaceus is a cutaneous hamartoma, consisting of various elements indigenous to the organ. Normal terminal hair follicles are characteristically absent in the lesion although the same may be seen in rest of the epidermis, a feature of diagnostic importance, not usually highlighted in literature. The divergent differentiation observed in NS is consistent with the common embryologic origin of the folliculosebaceous-apocrine unit and should not mislead the pathologist.

Early mycosis fungoides vs. inflammatory mimics: how reliable is histology?

BACKGROUND: The histologic diagnosis of early mycosis fungoides (MF) and its distinction from inflammatory dermatoses is challenging, owing to the overlap of several features. AIMS: 1) To assess the efficacy of histologic criteria to diagnose early MF, 2) to study their utility in differentiating inflammatory mimics of MF. METHODS: We retrospectively reviewed slides from 50 cases clinically/histologically suspicious for MF. The diagnoses were established based on response to treatment and follow-up. The slides were analyzed double-blinded by two observers independently. Twenty-eight histologic criteria were assessed and each criterion was graded. Univariate analysis was performed on the results. RESULTS: There were 17 cases of MF and 33 of inflammatory dermatoses. Of the 28 criteria, the following 15 achieved significance on univariate analysis: disproportionate epidermotropism, tagging of lymphocytes along the basal layer, haloed lymphocytes, convoluted lymphocytes, Pautrier's abscesses, larger epidermal lymphocytes, wiry dermal collagen, absence of edema, eccrine infiltration, folliculotropism, follicular mucin, involvement of papillary and reticular dermis, monomorphous infiltrates, and atypia of dermal lymphocytes. The criteria that were 100% specific for MF included convoluted lymphocytes, eccrine infiltration, and follicular mucin. Absence of edema was 100% sensitive and specific in distinguishing MF from its inflammatory mimics. CONCLUSIONS: A combination of histologic patterns and cytology of lymphocytes is reliable in distinguishing MF from inflammatory dermatoses. No single criterion is effective in achieving this. Rather than merely recording the presence or absence of a criterion, grading each of them adds objectivity to the diagnosis.

Direct immunofluorescence in cutaneous vesiculobullous lesions.

Direct Immunofluorescence (DIF) is invaluable in the diagnosis of cutaneous vesiculobullous lesions (VBL). It is limited by technical factors and disease nature. 1) To record the sensitivity of DIF in VBL 2) To correlate DIF with clinical, histologic findings and analyse discrepancies. Material and Methods: A retrospective study of 100 DIFs on suspected VBL of skin. DIF, histology and clinical data were reviewed. 73/100 cases showed DIF patterns concordant with clinical/histologic diagnosis. The sensitivity of DIF was 88% in Pemphigus group (39/ 44), 82% in Bullous Pemphigoid (BP) (23/28), and 20% in Dermatitis Herpetiformis (DH) (1/5).18 cases of histologically proven VBL were negative and of these, 4 had no epidermis. The remaining 9 cases were discordant with clinical/histologic features, including 4 BP and 5 DH, whose histology was non-specific and will be discussed in detail. One case of DH showed an aberrant vasculitic pattern. DIF is of great value in the diagnosis of VBL, specially in clinical/histologic dilemmas. In DH, neither biopsy nor DIF were very useful and response to therapy was the standard. Sampling errors contributed to false negative results. Proper selection of cases and judicious use are mandatory to optimize its' utility.

Intestinal neuronal dysplasia type A.

Intestinal neuronal dysplasia is a rare cause of bowel obstruction in neonates and infants, the diagnosis of which poses a formidable challenge to both clinicians and pathologists alike. The importance of this entity lies not only in the fact that it mimics Hirschsprung's disease, but also in that untreated cases, particularly of type A, may prove fatal. The authors describe one such case of intestinal neuronal dysplasia of type A, which was diagnosed at autopsy.

Colonic carcinomas masquerading as Crohn's colitis.

When colonic carcinomas present with acute abdomen, the operating surgeon and the pathologist face a plethora of diagnostic and therapeutic problems. In this retrospective study of 92 cases of carcinoma colon, 4 presented with acute intestinal obstruction of which three had a turbulent post operative period and died. The resected colonic segment showed on gross examination cobblestone appearance characteristic of Crohn's disease but microscopically was ischemic with the stricture site showing features of an infiltrating poorly differentiated adenocarcinoma. We have made an attempt to study the various pathologic features and analyse their significance with reference to prognosis.