RESUMO
Differential diagnosis of palmoplantar non-pustular psoriasis and chronic allergic contact dermatitis (ACD) and the combination of these conditions, termed "eczema in psoriatico" (EIP), is difficult, especially in cases of isolated involvement. A blind re-evaluation of 63 archived formalin-fixed palmoplantar samples, previously diagnosed clinically as either psoriasis or chronic ACD, was performed. Samples were allocated to histopathological diagnoses of psoriasis, contact dermatitis or EIP. Immunohistological stainings were performed for better characterization. Immunochemistry of EIP revealed features that overlapped contemporarily with psoriasis (cytokeratin 17 (CK17), Ki67, interleukin (IL)-8, IL-17, IL-23) and with ACD (CD1a, major histocompatibility complex (MHC) class I, MHC class II, epidermal T-cell subsets). Surprisingly, a significantly much higher number of dermal CD8+ T cells was found in EIP than in ACD and psoriasis. In conclusion, this study provides insight into the immunohistological differentiation of palmoplantar psoriasis, chronic ACD and EIP.
Assuntos
Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/metabolismo , Interleucinas/metabolismo , Psoríase/diagnóstico , Psoríase/metabolismo , Antígenos CD1/metabolismo , Linfócitos T CD8-Positivos/patologia , Doença Crônica , Dermatite Alérgica de Contato/complicações , Dermatite Alérgica de Contato/patologia , Diagnóstico Diferencial , Proteínas Filagrinas , Antígenos de Histocompatibilidade Classe I/metabolismo , Antígenos de Histocompatibilidade Classe II/metabolismo , Humanos , Imunoglobulina E/sangue , Imuno-Histoquímica , Proteínas de Filamentos Intermediários/metabolismo , Queratina-17/metabolismo , Antígeno Ki-67/metabolismo , Contagem de Linfócitos , Psoríase/complicações , Psoríase/patologia , Subpopulações de Linfócitos T/patologiaRESUMO
Varicella has the highest contagiosity index of all viral diseases. We report an endemic outbreak of varicella among 4 Indian students in Magdeburg in November and December 2008. An initially severe course was observed in three of these patients with a negative vaccination status. Large vesicular skin lesions with a diameter of up to 8 mm were found in all patients. Molecular genetic tests revealed African/Indian clade 5 in 2 patients, although the European clades (i.e., clade 1 and 3) are the most common in Germany, accounting for 85 %. All patients recovered without any complications after administration of intravenous aciclovir at a dosage of 10 mg per kg body weight. Although isolated cases of varicella are not notifiable according to the German Protection against Infection Act, endemic outbreaks must be reported to the appropriate health surveillance authorities.
Assuntos
Varicela/diagnóstico , Varicela/virologia , Surtos de Doenças/prevenção & controle , Emigração e Imigração , Herpesvirus Humano 3/isolamento & purificação , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Varicela/tratamento farmacológico , Alemanha , Herpesvirus Humano 3/genética , Humanos , Índia , Resultado do TratamentoAssuntos
Traumatismos do Braço/complicações , Queimaduras/complicações , Diagnóstico Tardio , Granuloma/patologia , Úlcera Cutânea/microbiologia , Infecções Cutâneas Estafilocócicas/microbiologia , Infecções Cutâneas Estafilocócicas/patologia , Adulto , Biópsia por Agulha , Doença Crônica , Clindamicina/uso terapêutico , Quimioterapia Combinada , Seguimentos , Granuloma/microbiologia , Granuloma/terapia , Humanos , Iloprosta/uso terapêutico , Imuno-Histoquímica , Escala de Gravidade do Ferimento , Masculino , Medição de Risco , Índice de Gravidade de Doença , Úlcera Cutânea/patologia , Infecções Cutâneas Estafilocócicas/terapia , Staphylococcus aureus/isolamento & purificação , Resultado do TratamentoRESUMO
Varicella-zoster virus (VZV), the cause of varicella and zoster, is divided into five major clades and four provisional clades, the latter of which have been rarely reported worldwide to date. We present a varicella outbreak by the provisional clade VI within an Indian couple in Germany returning from a trip to Amsterdam. To the best of our knowledge, this is the first case of varicella by the VZV clade VI described in Germany, but the disease was acquired in The Netherlands.