ABSTRACT
Vascular hyperplasia is a common finding in prurigo nodularis/lichen simplex chronicus (LSC). The term prurigiform angiomatosis was recently proposed to describe a histologic pattern characterized by prominent vascular hyperplasia in patients with LSC. The aim of this study was to identify cases of LSC with this pattern and analyze associations with clinical and pathologic features and disease course. We reviewed 54 cases of histologically confirmed LSC and detected findings consistent with prurigiform angiomatosis in 10 (18.5%). The patients (7 men, 3 women) had a mean age of 59.7 years. The lesions were pruritic and predominantly located on the extremities and trunk. The most notable histologic finding was vascular proliferation in the superficial dermis associated with a lymphocytic inflammatory infiltrate. Recognition of prurigiform angiomatosis is important as it helps not only to distinguish LSC from other entities (mainly vascular tumors) but also to detect lesions that need to be surgically excised due to poor response to topical treatment.
Subject(s)
Melanoma , Skin Neoplasms , Humans , Melanoma/diagnosis , Skin Neoplasms/diagnosis , Dermoscopy , Tumor Suppressor Proteins , Ubiquitin ThiolesteraseSubject(s)
Humans , Male , Young Adult , Accidents, Traffic , Diaphragm/diagnostic imaging , Diaphragm/injuries , Rupture , Tomography, X-Ray ComputedABSTRACT
En esta serie de 2 artículos realizamos una revisión de las principales entidades dermatopatológicas que cursan con granulomas. Esta primera parte se ha centrado en la aclaración de los conceptos, la presentación de los tipos de granulomas y de las células gigantes, así como en entidades muy diversas de origen no infeccioso. Algunas de ellas de origen metabólico, como la necrobiosis lipoídica: otras relacionadas con linfomas, como la micosis fungoides granulomatosa, y otras tan extendidas que casi resultan un problema cotidiano en las consultas de dermatología, como la rosácea (AU)
This series of 2 articles on dermatopathologic diagnoses reviews conditions in which granulomas form. Part 1 clarifies concepts, discusses the presentation of different types of granulomas and giant cells, and considers a large variety of noninfectious diseases. Some granulomatous diseases have a metabolic origin, as in necrobiosis lipoidica. Others, such as granulomatous mycosis fungoides, are related to lymphomas. Still others, such as rosacea, are so common that dermatologists see them nearly daily in clinical practice (AU)
Subject(s)
Humans , Granuloma/classification , Granuloma/pathology , Giant Cells/pathology , Giant Cells, Langhans/pathologyABSTRACT
Esta es la segunda parte de una serie dedicada a la patología granulomatosa en la biopsia cutánea. Mientras que en la primera parte hablamos, entre otras, de algunas condiciones metabólicas y tumorales, esta segunda parte abordará fundamentalmente patología infecciosa de diversos tipos, junto con otras condiciones relativamente frecuentes en las consultas de dermatología (AU)
Part 2 of this series on granulomatous diseases focuses on skin biopsy findings. Whereas the first part treated noninfectious conditions (metabolic disorders and tumors, among other conditions), this part mainly deals with various types of infectious disease along with other conditions seen fairly often by clinical dermatologists (AU)
Subject(s)
Humans , Granuloma/classification , Granuloma/diagnosis , Giant Cells/pathology , Giant Cells, Langhans/pathology , BiopsyABSTRACT
This series of 2 articles on dermatopathologic diagnoses reviews conditions in which granulomas form. Part 1 clarifies concepts, discusses the presentation of different types of granulomas and giant cells, and considers a large variety of noninfectious diseases. Some granulomatous diseases have a metabolic origin, as in necrobiosis lipoidica. Others, such as granulomatous mycosis fungoides, are related to lymphomas. Still others, such as rosacea, are so common that dermatologists see them nearly daily in clinical practice.
ABSTRACT
Part 2 of this series on granulomatous diseases focuses on skin biopsy findings. Whereas the first part treated noninfectious conditions (metabolic disorders and tumors, among other conditions), this part mainly deals with various types of infectious disease along with other conditions seen fairly often by clinical dermatologists.
ABSTRACT
La patología vascular oclusiva es causante de diversas y variadas manifestaciones clínicas, algunas de ellas con catastróficas consecuencias para el paciente. Dado que las causas de tal oclusión son muy variadas, hemos abordado en un artículo previo reciente en esta misma revista las causas trombóticas. En el presente artículo recopilamos diversas causas adicionales de oclusión intravascular
Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. It also has a wide variety of causes, including thrombi, which we recently addressed in part I of this review. In this second part, we look at additional causes of vascular occlusion
Subject(s)
Humans , Peripheral Vascular Diseases/etiology , Peripheral Vascular Diseases/pathology , Thrombosis/etiology , Thrombosis/pathology , Blood Coagulation Disorders/complications , Embolism/complications , Skin/blood supply , Skin/pathology , NecrosisABSTRACT
La patplogía vascular oclusiva es causante de diversas y variadas manifestaciones clínicas, algunas de las cuales son de catastróficas consecuencias para el paciente. Sin embargo, las causas de tal oclusión son muy variadas, extendiéndose desde trombos por acción descontrolada de los mecanismos de coagulación, hasta anomalías de los endotelios de los vasos u oclusión por materiales extrínsecos. En una serie de dos artículos hacemos una revisión de las principales causas de oclusión vascular, resumiendo sus manifestaciones clínicas principales y los hallazgos histopatológicos fundamentales. Esta primera parte corresponde a las oclusiones vasculares que cursan con trombos
Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. The causes of vascular occlusion are also highly variable, ranging from thrombi triggered by the uncontrolled activation of coagulation mechanisms, on the one hand, to endothelial dysfunction or occlusion by material extrinsic to the coagulation system on the other. In a 2-part review, we look at the main causes of vascular occlusion and the key clinical and histopathologic findings. In this first part, we focus on vascular occlusion involving thrombi
Subject(s)
Humans , Vascular Diseases/etiology , Venous Thrombosis/complications , Venous Thrombosis/pathology , Vascular Diseases/pathology , Risk FactorsABSTRACT
BACKGROUND: Ex vivo confocal microscopy is a technique for tissue examination, which generates images of fresh samples with an optical resolution comparable to those obtained by conventional pathology. The objective of this study was to evaluate the feasibility of using ex vivo confocal microscopy in fusion mode (reflectance and fluorescence) and the H&E-like digital staining that is obtained for the analysis of non-neoplastic kidney biopsies. METHODS: Twenty-four renal samples acquired from autopsies were scanned in a 4th generation ex vivo confocal microscopy device. The imaging process was completed in an average of three minutes. RESULTS: Confocal images correlated very well to the corresponding conventional histological sections, both in normal tissue and in chronic lesions (glomerulosclerosis, fibrosis and tubular atrophy). The ex vivo confocal microscopy protocol did not add artifacts to the sample for the ulterior study with light microscopy, nor to the histochemical or immunohistochemical studies. CONCLUSION: The ease and speed of grayscale and fluorescence image acquisition, together with the quality of the H&E-like digitally stained images obtained with this approach, suggest that this technique shows promise for use in clinical nephrology and renal transplantation.
Subject(s)
Microscopy, Confocal , Biopsy , Humans , Staining and LabelingABSTRACT
Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. It also has a wide variety of causes, including thrombi, which we recently addressed in partI of this review. In this second part, we look at additional causes of vascular occlusion.
Subject(s)
Blood Coagulation Disorders/complications , Embolism/complications , Skin Diseases, Vascular/etiology , Anticoagulants/adverse effects , Antiphospholipid Syndrome/complications , Antiphospholipid Syndrome/pathology , Calciphylaxis/complications , Calciphylaxis/pathology , Cocaine/adverse effects , Female , Foreign Bodies/complications , Foreign Bodies/pathology , Humans , Ischemia/etiology , Ischemia/pathology , Levamisole/adverse effects , Livedo Reticularis/etiology , Livedo Reticularis/pathology , Male , Malignant Atrophic Papulosis/pathology , Necrosis , Neoplasms/complications , Neoplasms/pathology , Paraproteinemias/complications , Paraproteinemias/pathology , Skin/blood supply , Skin Diseases, Vascular/chemically induced , Skin Diseases, Vascular/pathology , Skin Ulcer/etiology , Skin Ulcer/pathology , Sneddon Syndrome/pathologyABSTRACT
Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. The causes of vascular occlusion are also highly variable, ranging from thrombi triggered by the uncontrolled activation of coagulation mechanisms, on the one hand, to endothelial dysfunction or occlusion by material extrinsic to the coagulation system on the other. In a 2-part review, we look at the main causes of vascular occlusion and the key clinical and histopathologic findings. In this first part, we focus on vascular occlusion involving thrombi.
Subject(s)
Thrombosis , Blood Coagulation , Humans , Thrombosis/etiologyABSTRACT
Introducción. La disfunción endotelial juega un papel preponderante en la génesis de las complicaciones vasculares de la diabetes y precede a las evidencias anatómicas más tempranas de ateroesclerosis El Eco-Doppler vascular, mediante la determinación de laDilatación arterial flujo-dependiente en la arteria braquial ha demostrado una buena correlación con las pruebas invasivas parael diagnóstico de la Disfunción Endotelial. Objetivo: Determinar la presencia de Disfunción endotelial en pacientes diabéticos con o sin úlceras del pie. Método. Se diseñó un estudio observacional, prospectivo de corte transversal, tipo caso-control en pacientes diabéticos con y sin úlceras del pie, con un muestreo simple no probabilístico, con una población de estudio constituida por 100 pacientes diabéticos subdivididos en Grupo A (de estudio) 50 y Grupo B (control) 50. Resultados. La vasoactividad mediada por el flujo (VMF), en el grupo de estudio fue de 3,1% y en el grupo de control 4,3%, resultados ambos que traducen la presencia de disfunción endotelial, pero más intensa en los pacientes con úlceras del pie diabético. Conclusiones. La disminución de la vasoactividad mediada por el flujo constituye una manifestación temprana de la enfermedad arteriosclerótica, detectable inclusive antes de la aparición de eventos clínicos vasculares periféricos en pacientes diabéticos con o sin úlceras del pie. (AU)
Introduction. Endothelial dysfunction plays a preponderant role in the genesis of vascular complications of diabetes and precedes the earliest anatomical evidence of atherosclerosis. Vascular Echo-Doppler, by determining the flow-dependent arterial dilation inthe brachial artery, has demonstrated a good correlation with invasive tests for the diagnosis of Endothelial Dysfunction. Objective: To determine the presence of endothelial dysfunction in diabetic patients with or without foot ulcers. Method. An observational,prospective, cross-sectional, case-control study was designed in diabetic patients with and without foot ulcers, with a simple non-probabilistic sampling, with a study population consisting of 100 diabetic patients subdivided into Group A (of study) 50 and Group B (control) 50. Results. The flow-mediated vasoactivity (VMF) in the study group was 3.1% and 4.3% in the control group, both results that reflect the presence of endothelial dysfunction, but more intense in patients with diabetic foot ulcers. Conclusions: The decrease in flow-mediated vasoactivity constitutes an early manifestation of arteriosclerotic disease, detectable even before the appearance of peripheral vascular clinical events in diabetic patients with or without foot ulcers. (AU)
