RESUMO
A woman in her 60s presented with oral lichen planus on hands and cheeks since childhood and also present in her parent and sibling. What is your diagnosis?
Assuntos
Líquen Plano Bucal , Humanos , Feminino , Líquen Plano Bucal/patologia , Líquen Plano Bucal/diagnóstico , Pessoa de Meia-Idade , Hiperpigmentação/patologia , Hiperpigmentação/diagnóstico , Hiperpigmentação/etiologiaRESUMO
ABSTRACT: Eccrine squamous syringometaplasia (ESS) has been associated with several conditions including morphea, linear scleroderma, and burns. It is yet to be reported in lichen sclerosus et atrophicus (LSA). We describe a bullous LSA plaque on the forearm of a woman with pre-existing genital LSA and vitiligo. Besides the histopathological findings of bullous LSA, numerous small irregular squamoid structures were present in the mid and upper dermis always above the normal eccrine glands. The histopathology, periodic acid-Schiff stain, and positive immunostains for P63, low molecular weight keratins 8&18, epithelial membrane antigen, and carcinoembryonic antigen supported the diagnosis of ESS. The pathogenesis of ESS in LSA may be related to ischemia, inflammation, and fibrosis.
Assuntos
Carcinoma de Células Escamosas , Líquen Escleroso e Atrófico , Esclerodermia Localizada , Carcinoma de Células Escamosas/complicações , Feminino , Humanos , Líquen Escleroso e Atrófico/complicações , Líquen Escleroso e Atrófico/patologia , Metaplasia , Esclerodermia Localizada/complicações , Esclerodermia Localizada/patologia , Coloração e RotulagemAssuntos
Tumor Glômico/cirurgia , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Paraganglioma Extrassuprarrenal/cirurgia , Adulto , Tumor Glômico/diagnóstico , Tumor Glômico/patologia , Humanos , Terapia a Laser/instrumentação , Masculino , Paraganglioma Extrassuprarrenal/diagnóstico , Paraganglioma Extrassuprarrenal/patologia , Pele/patologia , Pele/efeitos da radiação , Resultado do TratamentoRESUMO
BACKGROUND: Periodic acid-Schiff (PAS) staining of nail clippings is an adjunct diagnostic tool for onychomycosis. OBJECTIVE: To detect histopathological findings as clues to the presence of PAS-positive (+) fungal elements in nail clippings. METHODS: Four hundred sixteen consecutive nail clippings suspected of onychomycosis were stained with hematoxylin and eosin, and with PAS stains. All cases were studied histopathologically. The clinical files of the cases with neutrophils were reviewed. RESULTS: PAS+ staining for fungi were demonstrated in 159 (38%) of the nail clippings. Neutrophils, parakeratosis, plasma globules, and bacteria were observed in 43 (27%), 108 (67%), 80 (50%), and 80 (50%) of the PAS+ cases, respectively, and in 17 (6%), 109 (41%), 84 (32%) and 140 (54%) of the PAS- cases, respectively (P < 0.01). Neutrophils showed by far the highest specificity (93%), although with low sensitivity (27%) for the presence of PAS+ fungi. Among the 43 PAS+ and 17 PAS- specimens with neutrophils, only 1 (2.3%) and 3 (17%) had overt psoriasis, respectively. CONCLUSION: Neutrophils in nail clippings may serve as a clue for onychomycosis. PAS staining with neutrophils is not necessarily associated with psoriasis.