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2017| January-June | Volume 4 | Issue 1
Online since
June 6, 2017
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ORIGINAL ARTICLES
Histopathological spectrum of lichen sclerosus Et atrophicus
Varsha Dalal, Manveen Kaur, Chandra Bhushan Rai, Avninder Singh, V Ramesh
January-June 2017, 4(1):8-13
DOI
:10.4103/ijdpdd.ijdpdd_66_16
Introduction:
Lichen sclerosus (LS) et atrophicus is an inflammatory disorder of unknown etiology affecting skin and mucosa, especially the genital area. Clinically, its main features are whitish papules which converge to form plaques and atrophic patches. Histopathology of LS et atrophicus is characterized by the constellation of an atrophic epidermis with loss of rete ridges, some lymphocytes in the basal layer, a subepidermal band of sclerosis, and a lichenoid infiltrate of lymphocytes beneath that band is diagnostic of LS.
Materials and Methods:
Skin specimens from 25 patients with LS were collected from the hospital records for 5 years. The diagnosis of all cases was made on the basis of clinical morphology and histopathologic features. Sections were stained with hematoxylin and eosin, periodic acid-Schiff, and Elastic-Van Gieson. Criteria evaluated included hyperkeratosis, epidermal atrophy, follicular plugging, basal cell vacuolation, vascular ectasia, hyalinosis, inflammatory infiltrate, dermal edema, and deep dermal fibrosis.
Results and Conclusion:
Of a total of 25 patients, 18 patients had extragenital (EG) LS and 7 had genital manifestations. Mean age of patients with EG was 28 years, and genital was 38 years. To summarize, the main histopathological findings seen in LS are essentially the same as reported in literature, namely, hyperkeratosis, epidermal atrophy, follicular plugging, basal cell vacuolation, vascular ectasia, hyalinosis, inflammatory infiltrate, dermal edema, and deep dermal fibrosis. Moreover, some interesting differences between the EG and genital forms of LS were seen. However, since the figures are too small to comment on, studies comprising larger series of patients are required to bring out a statistical significance.
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Suprabasal mitotic index: A cell kinetic aid in psoriasis diagnosis
Susan Maria Mendonca, Sumanth Devaraju
January-June 2017, 4(1):2-7
DOI
:10.4103/ijdpdd.ijdpdd_33_16
Background:
Psoriatic cell kinetic studies attribute psoriatic hyperplasia to increased germinative cell layer and increased mitotic rate causing rapid cell turnover, resulting in suprabasal mitotic activity. The significant Ki-67 and p53 positivity in psoriatic suprabasal layers as opposed to basal layers in normal skin corroborates this finding. Morphology holds importance in differentiating psoriasis among plaque forming lesions as they clinically mimic each other. In this study, the significance of morphologically derived suprabasal mitotic index was evaluated in the diagnosis of psoriatic lesions.
Methods:
H and E stained paraffin sections of histopathology confirmed cases of psoriasis and its variants (
n
= 52) were retrieved from archives and studied. For comparison, control group (
n
= 30) comprising normal skin and other plaque lesions was used. Suprabasal mitoses/100 basal keratinocytes were calculated in both groups and evaluated using Student's
t
-test and receiver operator characteristics.
Results:
The suprabasal mitotic index was significantly higher in psoriatic lesions as compared to controls (
P
< 0.001) with lower counts in palmoplantar psoriasis (
n
= 14). The cutoff of suprabasal mitoses for non-palmoplantar psoriasis was 1/100 keratinocytes with sensitivity, specificity, positive, and negative predictive value of 94.9%, 86.7%, 90.2%, and 92.9%, respectively. The diagnostic accuracy was 91.3%. Palmoplantar psoriasis had comparatively lower values and a diagnostic accuracy of 70.45%.
Conclusion:
The morphological evaluation of suprabasal mitoses is a reliable and cost-effective cell kinetic tool in diagnosing psoriasis and its variants. This will aid in the differential diagnosis of plaque forming lesions.
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CASE REPORT
Primary mucinous eccrine carcinoma of axillary skin: Report of a rare case
Rajashree Pradhan, Subrata Pal, Palash Kr Mondal, Sajeeb Mondal
January-June 2017, 4(1):14-16
DOI
:10.4103/ijdpdd.ijdpdd_62_16
Primary mucinous eccrine carcinoma is a rare low-grade malignancy of sweat gland. Axilla is an uncommon site of this tumor. Primary mucinous carcinoma mimics metastatic mucinous carcinoma from breast, gastrointestinal tract, lung, and ovary. Histopathology with immunohistochemistry and other ancillary investigations are necessary to confirm the diagnosis and to exclude metastatic mucinous carcinoma. We present a rare case of primary mucinous carcinoma of axillary skin in an elderly male patient, diagnosed by histopathology and immunohistochemistry.
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4,451
314
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LETTERS TO EDITOR
Giant solitary trichoepithelioma over the nose
Mukunda Ranga Swaroop, Belagola Dassegowda Sathyanarayana, Priyanka Kumari Chaurasia, Yogesh Devaraj, Monica Dukkipati, Aneesa Sajid
January-June 2017, 4(1):17-18
DOI
:10.4103/ijdpdd.ijdpdd_65_16
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3,986
292
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EDITORIAL
Dermatopathology in India: Overcoming the roadblocks
Raghavendra Rao
January-June 2017, 4(1):1-1
DOI
:10.4103/ijdpdd.ijdpdd_16_17
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3,700
271
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LETTERS TO EDITOR
Giant verrucous porokeratosis with psoriasiform alteration: A rare entity with atypical clinico-histopathologic features
Anup Kumar Tiwary, Dharmendra Kumar Mishra
January-June 2017, 4(1):19-20
DOI
:10.4103/ijdpdd.ijdpdd_54_16
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3,493
267
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© Indian Journal of Dermatopathology and Diagnostic Dermatology | Published by Wolters Kluwer -
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Online since 3 Dec, 2013