Sporotrichosis is a cosmopolitan, chronic granulomatous mycosis, acquired by traumatic inoculation and caused by Sporothrix schenckii complex. Several methods of diagnostic are available, from KOH to molecular biology. In this review, we describe from the simplest (clinical diagnosis) to the most advanced diagnostic techniques (molecular biology).
27 February 2017 in International Journal of Dermatology
Actinic prurigo is an idiopathic photodermatosis, the pathophysiology of which has been hypothesized to involve subtype IV type b (Th2) hypersensitive response, whereby IL4, IL5, and IL13 are secreted and mediate the production of B cells, IgE, and IgG4. To examine the association of serum IgE levels and the clinical severity of injuries. This case-control study comprised patients with a clinical and histopathological diagnosis of actinic prurigo, as well as clinically healthy subjects, from whom 3cc of peripheral blood was taken for immunoassay. Cases were classified by lesion severity as mild, moderate, and severe. Descriptive statistics were analyzed, and chi-square test was performed. We included 21 actinic prurigo patients and 21 subjects without disease; 11 patients with actinic prurigo had elevated serum IgE levels, and 10 had low serum levels. Six actinic prurigo (AP) patients with elevated serum levels of IgE had moderate injuries, 4 had severe injuries, and 1 had minor injuries. Eight out of 10 patients with normal IgE levels presented with minor injuries in the clinical evaluation. The 21 controls did not have increased serum IgE levels. Elevated IgE levels are associated with moderate to severe clinical lesions, suggesting that actinic prurigo entails a type IV subtype b hypersensitivity response in which Th2 cells predominate.
1 January 2014 in International Journal of Trichology
Introduction: Basal cell carcinoma (BCC) is the most common malignant neoplasm in the skin and is considered to have a low degree of malignancy. BCC is invasive but rarely metastatic and originates in hair follicle-derived cells or interfollicular zones of the epidermis. Trichoblastoma (TB) is an infrequent benign skin neoplasm that differentiates toward follicular germinative cells. Both of these cutaneous lesions comprise nests of basaloid cells, and because the differential diagnosis is hard to obtain between them histologically due to their similarity, the correct diagnosis must be established. Materials and Methods: The sample size of this descriptive study consisted of 20 cases: 10 paraffin-embedded tissues that were diagnosed with carcinoma of solid basal cells with follicular differentiation and 10 TB tissues. The diagnosis of all samples was confirmed morphologically with hematoxylin and eosin. One-micron-thick sections were cut from each sample and analyzed semiquantitatively by immunohistochemistry (IHC). Differences in staining between BCC and TB were analyzed by Chi-square test. Results: Two of 10 TB cases were positive for Ki-67 versus 10 of 10 BCC samples. Cytokeratins 6 was expressed in 1 of 10 TB samples and in all BCC tissues. Staining with clone 34BE12 generated signals in all lesions at various intensities. Conclusion: The diagnosis between TBs and BCCs must be made histologically, because the treatment of BCC is radical and can compromise aesthetics and function, even for experienced pathologists. Because their morphological diagnosis is difficult, the histopathology results must be supported by an IHC panel.
1 December 2017 in Anais Brasileiros de Dermatologia
Pemphigus is part of a group of blistering diseases that affect the skin and mucous membranes. Based on its autoimmune origin, autoantibodies develop in pemphigus that are directed toward cell surface components of keratinocytes. However, some data cannot be explained, such as the lack of a relationship between autoantibody levels and the severity of clinical manifestations, treatment resistance, the presence of inflammatory infiltrates and the potential occurrence of apoptosis as determinants of vesicle formation. To examine the presence of apoptosis in pemphigus vulgaris by TUNEL technique. In this cross-sectional study, we selected 15 paraffin-embedded tissues from subjects who were diagnosed with pemphigus vulgaris by hematoxylin and eosin staining. The samples were subjected to TUNEL assay and examined under an Olympus BX61 fluorescence microscope. Positivity was categorized dichotomously, and the statistical analysis was performed using the X2 test. Positivity was observed in basal layer cells in 14 (93.3%) cases. In 13 (86.7%) of the positive cases, we noted espinosum and granular layers that formed the blister roof, and in 12 cases (80%), positive acantholytic cells were observed. TUNEL positivity was observed in pemphigus vulgaris, implicating apoptosis in the pathophysiology of this condition, which can help guide the development of apoptotic blockers as therapeutics.