ABSTRACT
BACKGROUND: When biopsy specimens lack a "swarm of bees" peribulbar lymphoid infiltrate, the diagnosis of alopecia areata depends on the recognition of other histologic features of the disease. OBJECTIVE: Our objective was to determine the frequency of the presence of eosinophils in biopsy specimens of alopecia area'a in relation to the other major histologic features of the disease. METHODS: Biopsy specimens from 71 patients with alopecia areata were studied. RESULTS: Eosinophils were present in 38 of the 71 cases. A peribulbar lymphoid infiltrate was absent in 27 of the 71 cases. Eosinophils were present in 13 of these cases. Multiple catagen hairs and pigment casts (features which may lead to confusion with trichotillomania) were present in 39 cases. The presence of eosinophils was found to be a helpful diagnostic feature in cases with potential for misdiagnoses as trichotillomania. CONCLUSION: Eosinophils are common in all stages of alopecia areata, both within the peribulbar infiltrate and within fibrous tracts. A "swarm of bees" peribulbar infiltrate may be absent. The presence of eosinophils is a helpful diagnostic feature of alopecia areata.
Subject(s)
Alopecia Areata/diagnosis , Eosinophils/pathology , Hair Follicle/pathology , Scalp/pathology , Alopecia Areata/pathology , Biopsy , Hair/pathology , HumansABSTRACT
Human papillomaviruses (HPV) have been associated with squamous cell carcinomas (SCC) of the skin in both the immunocompetent and the immunocompromised individual. A paucity of literature, however, exists concerning the presence of HPV in SCCs from patients with mycosis fungoides (MF)-[cutaneous T-cell lymphoma (CTCL.)]. We describe a case of multiple SCCs in which HPV DNA was detected over a 9-year period from a patient with MF. This patient with a long history of MF developed 7 small red scaly indurated lesions of sun and non-sun-exposed areas during a 9-year period (1981-1989). Histologic examination of all the lesions revealed that they were SCCs. The patient had no recorded history of arsenic exposure. To investigate the possible role of HPV as a co-carcinogen, we tested the 7 cases of SCC for HPV. Polymerase chain reaction (PCR) was performed on formalin-fixed tissue sections using HPV L.1 consensus sequence primers. Four of the 7 SCCs were positive for HPV DNA. These results suggest a possible role for HPV as a co-carcinogen in the development of SCCs in this patient.
Subject(s)
Carcinoma, Squamous Cell/virology , DNA, Viral/analysis , Mycosis Fungoides/virology , Papillomaviridae/genetics , Papillomavirus Infections/genetics , Skin Neoplasms/virology , Tumor Virus Infections/genetics , Aged , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/pathology , Female , Humans , Neoplasms, Multiple Primary/virology , Papillomavirus Infections/pathology , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Tumor Virus Infections/pathologyABSTRACT
Antimalarial agents have long been known to cause a variety of pigmentary disturbances. Quinidine, a cincha alkaloid and D-isomer of quinine, is widely used for the treatment of ventricular arrhythmias. A paucity of literature, however, exists concerning quinidine-associated hyperpigmentation. We describe a case of focal ceruloderma we believe to be secondary to quinidine therapy.
