Fine needle aspiration cytology in leprosy.

BACKGROUND: Laboratory diagnosis of leprosy by slit skin smear and skin biopsy is simple but both techniques have their own limitations. Slit skin smear is negative in paucibacillary cases whereas skin biopsy is an invasive technique. Fine needle aspiration cytology (FNAC) from skin lesions in leprosy with subsequent staining with May-Grunwald-Giemsa (MGG) stain has been found useful. AIM: To evaluate the possible role of cytology in classifying leprosy patients. METHODS: Seventy-five untreated cases of leprosy attending the outpatient department were evaluated. Smears were taken from their skin lesions and stained using the MGG technique. Skin biopsy was also done from the lesions, which was compared with cytology smears. RESULTS: A correlation of clinical features with FNAC was noticed in 87.5% of TT, 92.1% of BT, 81% of BL, and 66% of LL cases. Correlation of clinical with histopathological diagnoses revealed 12.5% specificity in TT leprosy, 55.3% in BT, 52.4% in BL and 50% in LL, and 100% in neuritic and histoid leprosy cases. Both correlations were found to be statistically significant by paired t test analysis. Thus, it was possible to distinguish the tuberculoid types by the presence of epithelioid cells and the lepromatous types by the presence of lymphocytes and foamy macrophages. CONCLUSION: FNAC may be used to categorize the patients into paucibacillary and multibacillary types, but is not a very sensitive tool to classify the patients across the Ridley-Jopling spectrum.

Universal acquired melanosis (Carbon baby).

We report a 3-year-old girl born with fair complexion which became darker. The color change was insidious in onset at the age of 5 months, asymptomatic and progressive involving the entire body surface. Histopathology revealed increased pigmentation of the epidermal basal layer. Universal acquired melanosis is a rare form of hypermelanosis which was synonymously referred to as "Carbon baby". This is a rare presentation with only one earlier case report.

Kindler syndrome.

Kindler syndrome is a rare autosomal recessive disorder associated with skin fragility. It is characterized by blistering in infancy, photosensitivity and progressive poikiloderma. The syndrome involves the skin and mucous membrane with radiological changes. The genetic defect has been identified on the short arm of chromosome 20. This report describes an 18-year-old patient with classical features like blistering and photosensitivity in childhood and the subsequent development of poikiloderma. The differential diagnosis of Kindler syndrome includes diseases like Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. Our patient had classical cutaneous features of Kindler syndrome with phimosis as a complication.

MDT-MB therapy in paucibacillary leprosy: a clinicopathological assessment.

BACKGROUND: The World Health Organization recommends treatment regimens for paucibacillary (PB) and multibacillary (MB) leprosy, which differ in their duration and components. Hence accurate classification of the disease is required. To overcome difficulties in classification Uniform Multi Drug Therapy (U-MDT) has been recommended. AIM : To evaluate the benefit of adding clofazimine to paucibacillary regimens in leprosy patients by measuring clinical and histological resolution. METHODS: Forty-four paucibacillary patients were included in the study. Twenty-two patients were given MDT-PB regimen and the remaining MDT-MB regimen for six months . Skin biopsies were done before the commencement and at the end of treatment. Clinical and histological resolutions were measured according to the standard criteria a laid down. The results were analyzed using Fishers' test and Crammers' V test. RESULTS: Clinical improvement was observed in 90.9% in the MB group as compared to 27.3% in the PB group. Regression in the nerve swelling was observed in 70% in the MB group and in 37.5% in the PB group while histological resolution was observed in 72.8% and 54.5% respectively. CONCLUSIONS: Addition of clofazimine helps to resolve leprosy lesions both clinically and histologically, thus justifying the concept of Uniform MDT regimen for all patients.

Scleromyxedema with subclinical myositis.

A 49-year-old farmer presented with papules on the face, arms, chest and back associated with sclerosis. Histopathology and PAS stain confirmed the clinical diagnosis of scleromyxedema. He also had elevated CPK levels due to myopathy. Screening for internal malignancy was negative.

Esophageal carcinoma with spread to mesenteric and iliac lymph nodes.

Carcinoma of the esophagus can metastasize to unusual sites. We report a patient with esophageal carcinoma with retrograde spread to the mesenteric and iliac lymph nodes from celiac nodes, demonstrated by magnetic resonance imaging and confirmed by FNAC.

Effect of hexachlorocyclohexane on hsp26 expression in transgenic Drosophila melanogaster.

Hexachlorocyclohexane (HCH) at different concentrations (0.5 to 5.0 ng/ml) mixed with food was fed to third instar larvae of hsp26-lacZ transgenic Drosophila for 2 hr and hsp26 gene expression was examined by beta-galactosidase staining. Puffing in salivary gland polytene chromosomes was also studied. Brain and midgut of larvae showed dark blue staining at 2.0 and 5.0 ng/ml of HCH. Absence of induced puffing at 67B and 84D in the salivary gland polytene chromosomes indicated that these glands are not affected. The study suggests presence of the vulnerable sites in larvae to the higher concentrations of HCH.

Histopathological and lipid changes in experimental colon cancer: effect of coconut kernal (Cocos nucifera Linn.) and (Capsicum annum Linn.) red chilli powder.

Influence of coconut kernal and red chilli on the metabolism of lipids was studied in animals given 1,2-dimethylhydrazine (DMH). The average weight gain by the animals in the coconut kernal group was more than DMH and chilli treated groups. The concentration of cholesterol showed a decrease and phospholipids an increase in most of the tissues studied, of the kernal groups. The cholesterol-phospholipid ratio was found to be increased in most of the tissues of all experimental groups, when compared to control animals. HMG CoA reductase activity decreased in the high fat and most of the tissues of the kernal + DMH, kernal + chilli and kernal + chilli + DMH groups, while it increased in the DMH, chilli and chilli + DMH groups. Histopathological studies showed that coconut kernal supplemented animals had fewer papillae, lesser infiltration into the submucosa and lesser changes in the cytoplasm with decreased mitotic figures. Coconut kernal, thus reduced the mutagenic and carcinogenic effect of chilli and DMH respectively.

Role of redchilli (Capsaicin) in the formation of colonic carcinoma.

The effect of feeding redchilli (Capsaicin) powder on the histopathological changes occurring in the colonic mucosa was studied in rats. These animals were compared with those treated with a colonic carcinogen 1,2-dimethylhydrazine (DMH). Animals fed with redchilli, dimethylhydrazine, dimethylhydrazine plus redchilli powder showed polyp and dysplasia, malignant tumour and malignant tumour with transitional area of dysplasia.

Effect of anaesthetic ether on lipid peroxidation and superoxide dismutase isozymes of young and adult rat brain.

Changes in lipid peroxidation and superoxide dismutase level in rat brain due to single exposure to diethyl ether (anaesthetic) were studied in 100 and 300 day old rats. Enhancement of superoxide dismutase activity was more pronounced in young rat brain, while the reverse was the case with lipid peroxidation. The neurotoxic effects of diethyl ether may involve active oxygen species and superoxide dismutase activity increases as a defensive adaptation.