RESUMEN
BACKGROUND: Grover disease is a clinicopathologic entity characterized by acantholysis. The histologic changes typically occupy circumscribed foci, therefore early stages could go unnoticed and be misdiagnosed. OBJECTIVE: To report on early histopathologic changes in Grover disease. MATERIAL AND METHODS: We analyzed 22 cases of Grover disease histologically diagnosed at Wake Forest University School of Medicine, NC, between 2000 and 2009. Early changes were defined as elongation of rete ridges and mild focal acantholysis. RESULTS: Six cases (27%) showed elongation of the rete ridges with focal acantholysis. Mild spongiosis was seen in 4 cases. Superficial perivascular inflammatory infiltrate was found in all cases, 5 of which showed eosinophils. CONCLUSIONS: These findings may represent a diagnostic clue in cases of early Grover disease, if clinical correlation is made.
Asunto(s)
Acantólisis/patología , Ictiosis/patología , Queratinocitos/patología , Piel/patología , Acantólisis/inmunología , Anciano , Biopsia , Eosinófilos/inmunología , Eosinófilos/patología , Femenino , Humanos , Ictiosis/inmunología , Linfocitos/inmunología , Linfocitos/patología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Piel/inmunologíaRESUMEN
BACKGROUND: The value of dermatologists as consultants is increasing. OBJECTIVE: To evaluate the activity of dermatologists as inpatient consultants. METHODS: Retrospective study of consultations to Dermatology of inpatients, visits per consultation, referral service, procedures performed, delay until visit and diagnoses based on ICD-9. RESULTS: 3,144 requests generated 4,824 visits, 200 biopsies, 107 cultures and other procedures. The mean delay between request and visit was 0.75 days. The requesting service was recorded in 3,097 cases: 21.5% by Internal Medicine, 11.4% by Pediatrics, 8.3% by Neurology and 6.2% by the Infectious Diseases Unit. Follow-up was recommended in 12.4% by the Dermatology Service and in 8% by a dermatologist. Reliable diagnoses were recorded for 2,832 consultations. The most frequent diagnostic groups were diseases of the skin and subcutaneous tissue (ICD-9: 680-709) in 58%, infectious and parasitic diseases (ICD-9: 001-139) in 20%, and neoplasm (ICD-9: 140-239) in 5.7%. The most frequent diagnoses were contact dermatitis (ICD-9: 692.X) in 8.9%, drug reactions (ICD-9: 693.0) in 7.4%, candidiasis (ICD-9:112.X) in 7.1% and seborrheic dermatitis (ICD-9: 690) in 5.3%. CONCLUSIONS: Most diagnoses were of a specific cutaneous disease and the dermatologist would be in the best position to evaluate those that inpatients acquire.