The present study demonstrates that a combination of lumboventricular lavage and mechanical head motion reduces vasospasm on TCD ultrasonography, the incidence of DIND, and secondary infarctions on CT and improves clinical outcome. No obvious effect could be found on the rate of angiographic vasospasm.
Despite available vaccination, measles is one of the leading causes of death among young children in developing countries. In clinical practice, the spectrum of differential diagnoses of morbilliform exanthemas associated with fever is wide, and it can be hard to differentiate from other infectious eruptions, especially in adults or in atypical courses in immunocompromised patients. The goal of our study was to identify characteristic histomorphological and immunohistochemical patterns of measles exanthema through the study of 13 skin biopsy specimens obtained from 13 patients with this disease and a review of cases in the literature. Histopathological features of measles exanthema are quite distinctive and characterized by a combination of multinucleated keratinocytes, and individual and clustered necrotic keratinocytes in the epidermis with pronounced folliculosebaceous as well as acrosyringeal involvement. Immunohistochemical staining of skin biopsies with anti-measles virus (MeV) nucleoprotein and anti-MeV phosphoprotein can be of great value in confirming the diagnosis of measles. Both methods can serve as quick additional diagnostic tools for prompt implementation of quarantine measures and for providing medical assistance, even in patients in whom the clinician did not consider measles as a differential diagnosis of the rash due to the rarity of the disease in a putatively vaccinated community.
SummaryDermatopathology is an indispensable tool in the diagnostic workup of inflammatory and neoplastic lesions. For the dermatologist in everyday clinical practice, basic knowledge of dermatopathology is highly valuable, as it allows for proper classification and interpretation of histological findings, as well as their correlation with the clinical picture (especially in case of inflammatory skin diseases). Such basic understanding is also important with regard to selecting the appropriate biopsy technique, thus increasing the overall diagnostic quality. The present article describes the diagnostic approaches taken by dermatopathologists in the histological workup of inflammatory skin diseases. The basic principles of this workup are highlighted on the basis of key histological patterns. Published in an upcoming issue, the second part of this article will address the histological characteristics of the most common skin tumors.
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