Adult-onset erythrokeratodermia variabilis (EKV) triggered by pregnancy and crash dieting: A rare case report.

Erythrokeratodermia variabilis (EKV) is a rare inherited genodermatosis characterised by migratory and erythematous patches changing over the course of hours to days and fixed keratotic plaques. The disease begins mostly at birth or within the first year of life; it very rarely starts after childhood. We present here a sporadic case with adult onset EKV that was aggravated by pregnancy with spontaneous resolution, and later on, after crash diet more persistent patches and plaques appeared with no spontaneous resolution. The patient showed excellent response to systemic retinoids.

PD-L1 and CD8+ T cell evaluation in breast cancers and their correlation with clinicopathological parameters.

OBJECTIVE: To determine the immunohistochemical expression of Programmed cell Death Ligand 1 and intratumoural cluster of differentiation-8-positive T lymphocyte count in primary breast cancer cases, and to ascertain their association with different clinicopathological parameters. Methods: The cross-sectional study was conducted at the Pakistan Navy Station Shifa Hospital, Karachi, from January 2020 to December 2021, and comprised patients of breast cancer regardless of age. Representative tissue blocks, both prospective and from the 2019 institutional archives, were exposed to immunohistochemical staining with Programmed cell Death Ligand 1 and intratumoural cluster of differentiation-8-positive T lymphocyte antibodies. Pathological and clinical records were used for assessing clinicopathological parameters. Data was analysed using SPSS 23. RESULTS: Of the 70 women with mean age 52.04±12.54 years, 30(42.9%) expressed high Programmed cell Death Ligand 1 positivity, and 55(78.6%) revealed low intratumoural cluster of differentiation-8-positive T lymphocyte count, while 23 (32.9%), had both Programmed cell Death Ligand 1 high positivity and low intratumoural cluster of differentiation-8-positive T lymphocyte count. The association between Programmed cell Death Ligand 1 and intratumoural cluster of differentiation- 8-positive T lymphocytes was not significant (p=0.813). A strong significant association was observed between Programmed cell Death Ligand 1 expression and progesterone receptor negative status (p=0.008). No significant association was observed with any other clinicopathological parameter. CONCLUSIONS: Programmed cell Death Ligand 1 high positivity and low intratumoural cluster of differentiation-8-positive T lymphocyte count were together observed in one-third of the breast cancer cases. A strong significant association existed between Programmed cell Death Ligand 1 high positivity and progesterone receptor negative status.

Basaloid follicular hamartoma syndrome: acquired sporadic variant with hypothyroidism, hypohidrosis and alopecia, a rare case.

Basaloid follicular hamartoma is a rare benign malformation of hair follicles, characterised clinically as generalised or localised multiple brown papules mostly on face, scalp and trunk. It may be congenital or acquired with or without any associated disease. Histologically it is composed of epithelial proliferation of basaloid cells with radial disposition enclosed in a fibrous stroma. It is of important consideration because it can be mistaken for basal cell carcinoma both clinically and histologically. Here we report the case of a 51-year-old female with acquired, generalised basaloid follicular hamartomas associated with alopecia, hypothyroidism and hypohidrosis which is an extremely rare disease.

CD 10 expression intensity in various grades and stages of urothelial carcinoma of urinary bladder.

OBJECTIVE: To evaluate CD10 expression in urothelial carcinoma of the urinary bladder and the association of immunohistochemical (IHC) CD10 expression intensity with grade and stage. STUDY DESIGN: Descriptive cross-sectional analytical study. PLACE AND DURATION OF STUDY: Armed Forces Institute of Pathology, Rawalpindi, from January to December 2011. METHODOLOGY: Fifty consecutive cases of urothelial bladder carcinomas, obtained through transurethral resections, were included in this study. Hematoxylin-eosin (HE) stained sections from each case were re-evaluated histopathologically according to WHO 2004 grading system. The TNM system was used for pathologic staging. On selected slides IHC CD10 marker was applied and a semiquantitative scoring for its expression based on the percentage of positive cells and intensity was performed. Data was entered and analysed on SPSS version 17. Fisher's exact test was used to compare grades, stages of urothelial carcinoma with CD 10 expression and age groups. P < 0.05 was taken as level of significance. RESULTS: Urothelial carcinoma was more common in males. The male to female ratio was 9:1. The older patients > 50 years had higher grade and stage as compared to the younger patients. All cases of high grade urothelial carcinoma showed higher positivity for CD 10. Twenty cases (86.95%) of high grade urothelial carcinoma were positive with +2 immunostaining while 3 cases (13.04 %) were positive with +1 staining. None of the tumors of stage pTa was positive for CD 10 expression. Of all patients with stage pT 1 tumor, 1 case (5.3%) was CD 10 negative and 17 cases (89.9%) were CD 10 positive having +1 staining with 5 - 50% staining and 1 case (5.3%) had +2 staining with more then 50% expression. Out of all patients with stage pT 2, no tumor was CD 10 negative, 3 (13.6%) patients were CD 10 positive with +1 staining and 19 (86.4%) with stage pT 2 tumor had stained positive with +2 staining. CONCLUSION: CD 10 expression was greater in high grade and invasive urothelial carcinomas; it may be associated with tumor progression in bladder cancer pathogenesis.