Nonspecific Dermatitis Research Articles

Clinically Suspicious Cases of Hansen's Disease at a Tertiary Care Hospital in South India: A Clinicopathological Study.

Background and objective Hansen's disease, also known as leprosy, is a chronic granulomatous condition caused by Mycobacterium leprae, primarily affecting the skin and peripheral nerves. The disease has a wide spectrum of clinical and histopathological manifestations, often mimicking other inflammatory and infectious conditions. This variability poses significant challenges in its early diagnosis and management. Aligning clinical suspicion with histopathological evidence is critical for effective treatment and control of transmission. This study was designed to explore the concordance between clinical impressions and histopathological diagnoses and to understand the diagnostic utility of various histopathological techniques. We aimed to establish and correlate the histopathological types of leprosy with clinical presentations. We also sought to determine the extent to which different histopathological techniques, including special stains, can corroborate with clinical types, thereby enhancing diagnostic precision. Materials and methods This was a hospital-based, retrospective study of clinically suspicious cases of leprosy at a tertiary care hospital in South India. A total of 100 cases of various age groups were identified and included in the study. All cases underwent skin biopsy with samples subjected to routine hematoxylin and eosin (H&E) staining and acid-fast bacilli (AFB) staining for the detection oflepra bacilli. Results Among the 100 clinically suspicious cases of leprosy, 50were histopathologically confirmed as leprosy and 50were categorized as non-specific dermatitis. Among the 50 histologically confirmed cases of leprosy, the most common type was lepromatous leprosy (LL) (38%) followed by borderline tuberculoid (BT) (30%) leprosy.Modified AFBstain was positive in 21 cases and was instrumental in confirming the suspected cases of leprosy. The overall correlation between the clinical and histopathological diagnosis was significant, with the highest correlation noted in LL cases. Conclusions Our findings underscorethe complexity of diagnosing leprosy due to its varied clinical and pathological presentations. Despite a high overall concordance rate, the discrepancies between clinical impressions and histopathological findings observed highlight the need for a multidimensional diagnostic approach. Incorporating a combination of clinical assessment, routine histology, and special staining can enhance diagnostic accuracy, leading to better patient management and outcomes.

An Observational Study to Correlate the Histopathological and Dermoscopic Features in Leprosy Patients in a Tertiary Care Hospital.

Leprosy is a chronic granulomatous infection with varied clinical presentations. Dermoscopy is a noninvasive technique widely used in the diagnosis of various skin diseases. To see the correlation between the clinical and dermoscopic features with the histopathological findings in leprosy. A prospective observational study was conducted on clinically suspected leprosy patients attending the dermatology outpatient department (OPD) for 18 months. Representative lesions were observed by dermoscopy, and a biopsy was performed, followed by histopathology for final diagnosis. Patients were categorized by Ridley-Jopling classification. A total of 70 clinically suspected leprosy patients were included in the study. Amongst 70 cases, 56 cases were diagnosed as leprosy by dermoscopy, and 53 cases were confirmed as leprosy by histopathology (hematoxylin and eosin [H and E] staining and Fite-Faraco staining). The other six cases were diagnosed as other nonspecific dermatitis by histopathological findings. Eleven cases that were dermoscopically negative were also confirmed by histopathology to be truly negative. There are three inconclusive cases of dermoscopic findings, which were diagnosed as mid-borderline leprosy by histopathology. Dermoscopic and histopathological correlation was found above 87% in all types of leprosy except mid-borderline leprosy, which showed only a 25% correlation. Dermoscopy is a useful noninvasive tool to assess lesions of leprosy, requires less time for diagnosis, skin features are magnified several times and may become evident before clinical presentation. It definitely helps to reduce the number of biopsies in case of diagnosis of leprosy. However, in doubtful cases, histopathology is required for definitive diagnosis as it is the gold standard to date.

Efficacy of Bath PUVA in the treatment of Palmoplantar hyperkeratosis

Background: Palmoplantar hyperkeratosis, or palmoplantar keratoderma, is a combination of skin conditions that are characterized by excessive thickening of the skin, mainly on the soles and palms. There are various treatment methods for keratoderma, and one of those methods are treatment through bathwater PUVA. It is a type of photochemotherapy. Objective of the study: The aim of the study was to observe the efficacy of bath PUVA treatment for palmoplantar hyperkeratosis. Methodology: This randomized clinical trial study was conducted at the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The study duration was 6 months, from September 2007 to February 2008. A total of 30 patients presented with with palmoplantar hyperkeratosis were enrolled in this study through random sampling method following the inclusion and exclusion criteria. Results: Majority of participant (33.3%) were from the age group of 31-40 years. The mean ±SD age was 38.40±10.89 years, and the age range of the participants was 20-58 years. 70% of the participants were male, 83.3% were from low socioeconomic class, and 36.7% were businessmen respectively. Histopathological diagnosis revealed that 52% patients had psoriasis, 33% had nonspecific dermatitis, and 10% patients had chronic inflammatory dermatitis. Gradual improvement was observed from baseline to 8 weeks follow-up in regards to palmoplantar surface area involvement, erythema, and hyperkeratosis. 46.7% of the participants reported skin tenderness, and 93.3% have a burning sensation and no other side effects. Conclusion: Bath PUVA may be an effective option in the treatment palmoplantar keratosis particularly of psoriatic patients. A mild form of nonspecific dermatitis may be treated with bath PUVA. Mugda Med Coll J. 2022; 5(2): 76-81

Skin involvement in systemic lymphoma of follicular helper T‐cell origin: A cohort study of 57 patients

AbstractBackgroundAngioimmunoblastic T‐cell lymphoma (AITL) is one of the most frequent peripheral T‐cell lymphomas (PTCL) in western countries. Skin involvement is common and may reveal the malignancy. Despite its frequency, skin involvement in AITL has been poorly described.ObjectivesWe aimed to analyze the cutaneous expression of PTCL of TFH origin and its prognostic impact.MethodsWe conducted a multicenter retrospective cohort study by retrieving histopathological reports including the mention ‘AITL’ or ‘PTCL with T‐follicular helper phenotype’ (PTCL‐TFH) from five French tertiary hospital centers.ResultsFrom 2000 to 2022, we reviewed 382 histopathological records and identified 52 AITL cases and 5 PTCL‐TFH cases with cutaneous involvement. Thirty‐two (56%) patients were males with a mean age of 63 years. Fifty‐six (98%) patients presented with lymphadenopathy, 32 (56%) splenomegaly and 17 (30%) hepatomegaly. B signs were present in 34 (60%) patients. Skin lesions were present on the lower limbs in 44 (77%) patients, trunk in 38 (67%) patients, upper limbs in 35 (61%) and head in 27 (47%). Macules and papules were the most frequent lesions found in 47 (82%) patients, followed by nodules in 10 (17%) patients, erythemato‐squamous plaques in 10 (17%) patients, purpura in 9 (16%), urticaria in 9 (16%) and blisters in 5 (9%) patients. Erythroderma affected seven patients (12%). A skin biopsy was taken in 50 patients and revealed a specific lymphomatous infiltrate in 36 cases. A dominant skin T‐cell clone was detected in 13 out of 17 (76%) patients. Among the 14 patients with a nonspecific dermatitis, various histopathological patterns were observed including interface dermatitis, psoriasiform dermatitis, vasculitis, bullous dermatitis, granulomatous dermatitis and thrombotic vasculopathy. After a median follow‐up of 24 months (range, 0–121 months), median overall survival was 121 months (95% CI, 25.2–NA). At last follow‐up, 33 patients (58%) were alive, 20 (35%) were in complete remission and 7 (12%) were in partial remission; 30 (53%) patients experienced at least one relapse, including nodal relapses in 24 (80%) cases and cutaneous relapses in 12 (40%).ConclusionsThis study revealed the deep heterogeneity of skin presentations in AITL. Atypical skin presentations were common and included blistering, purpuric and psoriasiform eruptions.

A rapidly-growing erythematous nodule on the right upper neck

A rapidly-growing erythematous nodule on the right upper neck

Hypopigmented Skin Lesions with Doubtful/Minimal Sensory Impairment: A Histopathology-Based Analysis.

Cardinal criteria proposed by the World Health Organisation (WHO) lack sensitivity to diagnose indeterminate leprosy. To estimate the frequency of hypopigmented skin lesions with doubtful/minimal sensory impairment showing histopathology features of indeterminate leprosy. To compare between the histopathology findings noted in specimens showing features suggestive of indeterminate leprosy and those showing a non-specific dermatitis pattern. Data on patients who attended our department with hypopigmented patches with doubtful/minimal sensory impairment from January 2018 to December 2019 and who underwent a skin biopsy were collected. A pathologist blinded to the clinical findings reviewed the histopathology specimens using a pre-set questionnaire. We studied sixteen biopsy specimens from 14 patients. Eight specimens (50%) showed histopathology suggestive of indeterminate leprosy and the remaining eight showed a non-specific dermatitis pattern. A higher percentage of patients with indeterminate pattern showed mast cells (87.5% vs 25%) and fibrosis around nerve twig or sweat duct (75% vs 12.5%) when compared to those who showed a non-specific dermatitis pattern. Small sample size and retrospective study design were the limitations. We found histopathology features of indeterminate leprosy in 50% of the skin biopsy specimens from hypopigmented lesions with doubtful/minimal sensory impairment. The present study highlights the need to improve the diagnostic definition of indeterminate leprosy.

An Updated Review on Wrightia tinctoria (Roxb). R Br

Since ancient times human utilized the nature to cure various ailments. The knowledge of medicinal plants resulted in the development of various indigenous systems of medicine worldwide. Serendipitous discovery as well as scientific approach on the reason for medicinal properties of plants gave the knowledge of chemical constituents such as secondary metabolites in plants. Wrightia tinctoria which is commonly known as ‘Danthapala’ is a known potential medicinal plant, the leaves of which is traditionally used in the treatment of psoriasis and non-specific dermatitis in Siddha and Ayurvedic systems of medicine and distributed in tropical region belongs to the family Apocynaceae. This plant is beneficial for the treatment of dandruff, various scalp and skin disorders. Phytochemical and pharmacological investigation on the various parts of the plant showed anti-ulcer, anti-inflammatory, analgesic, anthelmintic, anti-cancer, anti-dandruff, wound healing and anti-anxiety activity. The current review focus on providing an update on the recent pharmacological and phytochemical investigations on the plant by researchers around the globe with special emphasis on Antisporiatic, Antifungal, Antibacterial, Antiviral, Cytotoxic, Anti-inflammatory, Anti-diabetic, Analgesic, Hepatoprotective, Anthelmintic, and Wound healing activities.

The investigation of allergic skin diseases susceptibility

Background: Studies from around the world show that the prevalence and incidence of sensitization to allergens are higher in urban settings. Skin Prick Test (SPT) is being used more frequently now to investigate specific allergen sensitivity along with serum IgE level. Objective: The objective of our study was to evaluate the prevalence of sub-clinical allergy susceptibility and to see association with gender, season, age, urticaria, eczema, dermatitis and total serum IgE. Method and methodology: Eight hundred and ninety-two patients referred by dermatologist to rule out allergic sensitizations underwent SPT within one year. We calculated susceptible group and evaluated its ability to predict diseases like urticaria, eczema and non-specific dermatitis in general population. Result: The antigens that had the highest prevalence throughout the year were Mould II (32.38%) and Dermatophagoides farina (33.78%). The susceptibility to allergen was affected by season and age, however was not affected by gender. The predictability was highly statistically significant for Urticaria, Eczema and Non-specific Dermatitis. Conclusion: We conclude that the allergen susceptibility is high and is significantly correlated to the prevalence of allergic disorders in the sample population of a modern city like Shanghai. The susceptibility to allergen is affected by season and age. Keywords: skin prick test; total serum IgE; sub-clinical allergy susceptibility.

Fever, rash, and eosinophilia – early signs of angioimmunoblastic T-cell lymphoma

Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon lymphoma of elderly adults with a poor prognosis. AITL patients show systemic symptoms, lymphadenopathy, and not infrequently, skin rash with various dysimmune phenomena rashes. The case is presented of a 68-year-old male with skin rash, lymphadenopathy and hypereosinophilia who, after investigations, was diagnosed with AITL. Despite the treatment used, the patient's condition gradually deteriorated and died due to heart and kidney failure. The diagnosis of AITL is often established only after several weeks or months because of transient physical findings, non-specific symptoms, and a broad range of serologic or radiologic abnormalities. Some patients with AITL experience non-specific dermatitis and eosinophilia. The presented case should raise awareness of the presentations of AITL which is important for physicians to reach an accurate diagnosis.

Diagnosis of mange in West African Dwarf (WAD) and Red Sokoto (RS) goats

The diagnosis of mange is problematic in the absence of mites in skin scrapings because many skin diseases present similar gross features as mange. The study evaluated the stepwise procedure for herd diagnosis of mange in the West African Dwarf (WAD) and Red Sokoto (RS) goats with greater specificity and sensitivity. Twenty-seven WAD goats (n = 27) and forty RS goats (n = 40) goats with mange-like skin lesions (alopecia, scabs, crusts, and scratch injuries) out of a total herd population of 114 WAD goats and 317 RS goats respectively in Nsukka, Eastern Nigeria, were examined by directed sampling method. Skin scrapings and biopsies were collected from the goats and processed using standard procedures. The skin scrapings revealed Sarcoptes scabiei in 7 out of 27 WAD goats with mange-like gross lesions and Psoroptes spp. together with lice (Linognathus spp.) and their eggs in 2 out of 40 RS goats with mange-like gross lesions. Histopathological studies showed that 12 out of 27 WAD goats and 2 out of 40 RS goats with mange-like gross lesions had microscopic features highly suggestive of mange; in other words, the prevalence of mange was 44.4% in WAD and 5% in RS goats. The negative samples were diagnosed as fungal infections, neoplasms, nonspecific dermatitis, and dermatoses. The combination of directed sampling by gross appearance, a parasitological study of skin scrapings, and histopathological features of the skin biopsies were used to increase the sensitivity and specificity of mange diagnosis.

Skin and Soft Tissue Lesions in a District Hospital in Central Nigeria: A Histopathological Study.

Introduction. Skin and soft tissue diseases form a large and heterogeneous group of mesenchymal extraskeletal and dermatologic lesions in humans. Diseases of the skin and soft tissue can develop virtually anywhere in the body, extremities, the trunk, the retroperitoneum, the head, and the neck. Our study aims to review skin and soft tissue specimens from our centre describing the histopathological patterns. Method A cross sectional study was done using secondary data of all skin and soft tissue specimens over a 3 year period. Patients' demographics, sites of specimen, and histological diagnoses were extracted from the surgical day book. The data were analysed in terms of age and sex distribution and histological characteristics of pathologic lesions using the SPSS version 22. The data for these patients were presented in tables and figures. Result 451 skin and soft tissue specimens constituting 18% of all the specimens with an M : F ratio of 1 : 1.2. The age range of our patients was 4–85 years with a mean of 33.52 ± 15.05 years. The peak age of occurrence was 30–39 years. Most of our cases were seen in the extremities (50.7%) followed by head (22.2%), while the least common sites were the perineal and neck areas (5.3% each). The commonest site in females was the upper limb (32.4%); the head and lower limb were the commonest sites in males (28.4% each). Most of our patients have neoplastic lesions of skin and soft tissue constituting 68.3%, inflammatory lesions (16.9%), and the least common lesion being hamartoma (0.2%). The most common category of lesions includes inflammatory (nonspecific dermatitis 6.5%); cysts (dermoid cyst 6%); reactive (hypertrophic scar 1%); and neoplastic (lipoma 32.4%). The benign neoplasms were more common (92.9%) than the malignant ones (7.1%). The neoplastic lesions were relatively more common in males than females and the reverse was true for the inflammatory lesions. Conclusion Skin and soft tissue lesions are relatively common in our environment with majority being benign neoplastic lesion.

Histopathological spectrum of pediatric skin biopsies in a rural setup

Prevalence of pediatric skin disorders vary worldwide. In India, geographic variations in pediatric skin disorders is noted by numerous authors from different parts of the country. Dermatoses in children are much more influenced by socioeconomic status, climatic exposure, dietary habits and external environment as compared to adult skin disorders. Aims and Objectives: The present study was aimed at determining the spectrum of pediatric dermatopathological lesions and correlate the clinical and histopathological diagnosis over a period of 2 years in a tertiary care hospital in a rural setup. Results: Pediatric skin biopsies constituted 12.41% of all the skin biopsies received at our laboratory during the study period. Study consisted of 115 cases ranging from 1 to 18 years of age with a mean age of 12.02 years. A slight female preponderance (53.91%) was noted. The Biopsies received were categorized into various age groups as follows: Infants, n = 2(1.73%); toddler, n= 4(3.47%); preschool, n = 14(12.17%); school, n= 40 (34.78%) and adolescence, n= 55(47.82%). Papulosquamous diseases, n= 36(31.30%) were the most common cause of skin disorders followed by Genodermatosis (12.17%). Overall, Lichen Planus (8 cases; 6.95%) was the most common dermatoses encountered in the study. Fifteen cases (13.04%) were reported as non-specific dermatitis. A positive correlation with the initial clinical diagnosis was obtained in 95 cases (82.61%). Conclusion: A combination of good clinical expertise and histopathological confirmation helps in the proper management of the patients. The importance of histopathology as the gold standard in the diagnosis and management of pediatric skin lesions has been documented by our study. Keywords: Skin biopsy, Pediatric dermatoses, Papulosquamous diseases, Lichen planus, Genodermatoses.

Evaluation of medicines containing mometasone furoate or methylprednisolone aceponate with ceramides influence on the development of non-specific contact dermatitis

Topicality . High level of dermatitis diseases in the population of Ukrainian, increasing the number of severe clinical forms and low indicator of recovery make a problem of dermatitis therapy, which is the one of topical problems in dermatology. Aim . the evaluation of medicines containing mometasone furoate or methylprednisolone aceponate with ceramides influence on the development of non-specific contact dermatitis. Medicines effect investigation were on the level of proteins of the inflammation acute phase and the antioxidant system state. Materials and methods . Studies were conducted on a model non-specific contact dermatitis in rats. The effectiveness of the treatment was assessed by the intensity of skin lesions, by the level of proteins of the acute phase of inflammation (haptoglobin, CRP), and the state of the antioxidant system (AOS) – by the content of SH-groups. Results and discusssion . It was found that application of crem mometasone with ceramides and ointment methylprednisolone with ceramides reduces skin lesions (on 67.3 % and 78.5 %, respectively) and promotes normalization of antioxidant system. Therapeutic effectiveness of the study medicines were consistent with the comparator drug. Conclusions . The further pharmacological study of the proposed combinations with glucocorticosteroids and ceramides is promising in dermatology.

Early clinical manifestations of Sézary syndrome: A multicenter retrospective cohort study

Classic Sézary syndrome (SS) is defined by erythroderma, generalized lymphadenopathy, and leukemic blood involvement. Clinical observations suggest that SS begins as a nonerythrodermic disease. To describe the early clinical characteristics of patients with SS. A retrospective, multicenter chart review was performed for 263 confirmed cases of SS diagnosed during 1976-2015. Erythroderma was the earliest recorded skin sign of SS in only 25.5% of cases, although most patients (86.3%) eventually developed erythroderma. In patients without erythroderma during their initial visit, the first cutaneous signs of SS were nonspecific dermatitis (49%), atopic dermatitis-like eruption (4.9%), or patches and plaques of mycosis fungoides (10.6%). The mean diagnostic delay was 4.2years overall, 2.2years for cases involving erythroderma at the initial presentation, and 5.0years for cases not involving erythroderma at the initial presentation. This study is retrospective. Erythroderma is uncommon as an initial sign of SS. Early SS should be considered in cases of nonerythrodermic dermatitis that is refractory to conventional treatments. In these cases, examination of the blood by PCR for monoclonal T-cell receptor rearrangement and by flow cytometry to identify an expanded or aberrant T-cell population should be considered.

Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis.

BackgroundMycosis fungoides (MF) is a significant diagnostic challenge; it has various differential diagnosis especially at an early stage. Our aim was to describe mimics of MF clinically and histologically, and to define significant diagnostic criteria of the disease.MethodsThis was a retro-prospective cohort of 370 patients in whom the diagnosis of MF was suspected clinically.ResultsMF was histologically confirmed in 15.4% of cases and rejected in 84.5%. Other identified histologically diagnosis were eczema, psoriasis; nonspecific dermatitis, lichen, lupus; pseudolymphoma, parapsoriasis and toxidermia. 4 patients with palmoplantar MF were wrongly treated as eczema, and 10 patients with psoriasiform MF were initially treated as psoriasis. We also described the clinical, histological and immunohistochemistry diagnostic criteria for distinguishing MF from benign dermatosis.ConclusionsMisdiagnosis of MF was a real problem for this study, because it shared common clinical and histological characteristics with other inflammatory diseases like eczema and psoriasis. Therefore, defining significant clinico-histological diagnosis criteria of MF would be of great help and would increase the accuracy of the diagnosis.

Mycosis Fungoides: A Retrospective Study of 44 Swedish Cases.

Mycosis fungoides (MF) is a primary cutaneous T-cell lymphoma with slow disease progression. There is a lack of descriptive data from Sweden concerning patients with this diagnosis. This study extracted data on patients admitted to the dermatology department at Lund University Hospital, Sweden from 1996 to 2010. Forty-four patients with clinically and histopathologically verified MF were identified during the period, with a mean follow-up time of 5.6 years. Median age at initial diagnosis was 64 years. In several cases other skin diseases preceded MF onset, such as non-specific dermatitis (32%) and parapsoriasis (30%). The majority of patients (86%, n = 38) had limited-stage (IA-IB) disease at the time of diagnosis. Overall response rate to psoralen plus ultraviolet A (PUVA) treatment was 81%. In adnexal MF, a trend to higher rate of progression to an advanced stage was observed when compared with non-adnexal disease (40% and 21%, respectively). Increased levels of soluble interleukin-2 (IL-2) receptor correlated with disease stage, being elevated in advanced stages or adnexal disease, but almost never elevated in early non-adnexal limited-stage disease. Overall mortality was 25%, but only 11% could be verified as caused by MF.

The spectrum of non- neoplastic skin lesions in Ibadan, Nigeria: a histopathologic study.

IntroductionNon-neoplastic skin lesions constitute the majority of skin diseases. There is a paucity of histopathology studies of non-neoplastic skin diseases in Nigeria and the West Africa sub-region in general. This is because the dermato-pathology sub-specialty is poorly developed. Therefore, the main aim of this study is to determine the spectrum of histologically diagnosed non-neoplastic skin lesions in Ibadan, Nigeria.MethodsThis is a retrospective study. All non-neoplastic skin lesions diagnosed in the Department of Pathology, University College Hospital, Ibadan over a five year period. (January 2006 to December 2010) was reviewed. The lesions were classified into eight groups according to the International Classification of Diseases (ICD)-10 of skin and subcutaneous disorders. The main classes include Dermatitis/Eczema, Papulosquamous disorders, Infectious disorders, Connective tissue diseases, Bullous disorders, Naevi/Developmental lesions, Granulomatous lesions, keratinizing disorders and other categories/Miscellaneous group.ResultsA total of 209 non-neoplastic skin lesions comprised 1.3% of all surgical pathology specimen received within the study period. The modal age group was 20-29. The Dermatitis/Eczema group has the highest frequency of 87 cases representing 41.6% of cases, papulosquamous disorders 39 (18.7%), infectious disorders 37 (17.7%), bullous disorders 11 (5.3%) and connective tissue disorder 9 (4.3%). Chronic non-specific dermatitis was the commonest specific diagnosis comprising 60 cases (28.7%) of all the skin diseases. The other common specific skin lesions were lichen planus/lichenoid dermatitis 27(12.9% of 209 cases), verruca vulgaris 25 (12% of 209 cases).ConclusionThe number of histologically diagnosed non-neoplastic skin lesions is relatively small. There is a very wide spectrum of non-neoplastic skin lesions diagnosed within this period. There is a need for a specific diagnosis considering the high frequency of chronic non-specific dermatitis.

Mucocutaneous lesions in free-ranging Atlantic bottlenose dolphins Tursiops truncatus from the southeastern USA.

Mucocutaneous lesions were biopsied from free-ranging Atlantic bottlenose dolphins Tursiops truncatus inhabiting the Indian River Lagoon (IRL), Florida, and estuarine waters of Charleston (CHS), South Carolina, USA, between 2003 and 2013. A total of 78 incisional biopsies from 58 dolphins (n=43 IRL, n=15 CHS) were examined. Thirteen dolphins had 2 lesions biopsied at the same examination, and 6 dolphins were re-examined and re-biopsied at time intervals varying from 1 to 8 yr. Biopsy sites included the skin (n=47), tongue (n=2), and genital mucosa (n=29). Pathologic diagnoses were: orogenital sessile papilloma (39.7%), cutaneous lobomycosis (16.7%), tattoo skin disease (TSD; 15.4%), nonspecific chronic to chronic-active dermatitis (15.4%), and epidermal hyperplasia (12.8%). Pathologic diagnoses from dolphins with 2 lesions were predominately orogenital sessile papillomas (n=9) with nonspecific chronic to chronic-active dermatitis (n=4), TSD (n=3), lobomycosis (n=1), and epidermal hyperplasia (n=1). Persistent pathologic diagnoses from the same dolphins re-examined and re-biopsied at different times included genital sessile papillomas (n=3), lobomycosis (n=2), and nonspecific dermatitis (n=2). This is the first study documenting the various types, combined prevalence, and progression of mucocutaneous lesions in dolphins from the southeastern USA. The data support other published findings describing the health patterns in dolphins from these geographic regions. Potential health impacts related to the observed suite of lesions are important for the IRL and CHS dolphin populations, since previous studies have indicated that both populations are affected by complex infectious diseases often associated with immunologic disturbances and anthropogenic contaminants.

Manifestations dermatologiques des gammapathies monoclonales : apport de l’histopathologie cutanée

Skin manifestations associated with monoclonal gammapathy are common and can present with various clinical and pathological aspects. They can be the first events leading to the diagnosis of monoclonal gammapathy. They may be present either as specific lesions, including lymphoplasmacytic or pure plasma cell neoplastic infiltrates and monoclonal immunoglobulin deposits, or as non-specific dermatitis, such as leukocytoclastic vasculitis, neutrophilic dermatoses, mucinoses or xanthomatosis, giving little clues for the diagnosis of the underlying disease.

A Study of Correlation Between Clinical and Histopathological Findings of Erythroderma in North Bengal Population.

Background:Erythroderma is a reaction pattern characterized by erythema and desquamation of 90% or more body surface area along with some metabolic alterations.Materials and Methods:Here we studied 32 patients of erythroderma at of North Bengal Medical College for a period of 1 year to find the etiology, clinical features and histological changes. Detailed history was taken from all the patients followed by relevant biochemical investigations and histological examination. To correlate the clinical and histopathological findings chi square test was used.Results:Male preponderance was present and most of them were in the 4th or 5th decade. Etiologically the patients were divided into secondary erythroderma developing over pre-existing dermatoses, and idiopathic erythroderma. Secondary erythroderma (n = 24) cases outnumbered the idiopathic cases (n = 8). Among the pre-existing dermatoses, psoriasis was found to be the most common etiologic agent. Apart from erythema the other common presenting features were scaling and itching. Histopathological categorization was possible in 59.3% cases, rest of the cases showed non-specific dermatitis. The most common histopathologic diagnosis was psoriasis (21.8% of cases).Conclusions:Our study of clinicopathological correlation of erythroderma patients among north bengal population corroborates with most of the previous studies done in other areas. As ours is a cross-sectional study in a undefined population so we could not determine the true incidence of erythroderma in north bengal population. We might have missed lymphoma as a cause of erythroderma in idiopathic cases due to lack of long follow-up, so we understand that further studies over a defined population with long follow-up is needed to determine the true incidence and causes of idiopathic erythroderma.