Background: Leprosy continues to be a predominant public health problem in India despite rapid strides made for its prevention, detection and treatment since ages. As leprosy can occur in any form due to immunological status of the patient, its clinico-pathological correlation gains more importance. Aim: The present research was undertaken to ascertain the importance of skin biopsy in detecting and diagnosing difficult cases where clinical diagnosis alone is not sufficient and a clinico-pathological correlation study in leprosy assumes greater significance. Method: This was a hospital based prospective study conducted in 60 cases of clinically diagnosed, newly untreated or suspected cases of leprosy for two years among patients attending OPD Department of Dermatology and whose skin biopsies were processed in the department of Pathology with Haematoxylin & Eosin stain along with special stain (Fite Faraco) to ascertain clinico-pathological correlation in leprosy cases. Results: A total of 60 cases were studied. Out of them 71.7% were males and 28.3% females. Majority of them 31.7% belonged to the age group of 21-30 years and children were least affected. Clinico-histopathological classification concordance was noted maximum in LL (80%) followed by BT (77.2%), TT (76.4%), BL (75%), BB (71.4%) and least in IL (60%). Overall concordance between clinical and histopathological diagnosis observed in our study was 75%. Conclusion: Diagnosing and treating leprosy solely on clinical basis still poses a problem while histopathology helps in making a definite diagnosis. This study shows a good correlation among clinical and histopathological findings in skin biopsy.
Background: Erythroderma or exfoliative dermatitis is an inflammatory disorder characterized by erythema and scaling in the body involving more than 90% of the body surface. Underlying etiologies which lead to erythroderma are commonly psoriasis (23%), spongiotic dermatitis (16%), drug hypersensitivity reactions (15%) and cutaneous T cell lymphoma (16%). Aims: The aim of our study was to find out the histopathologically erythroderma cases and to evaluate the clinicopathological correlation of such cases. Methods: Skin biopsies of 60 erythroderma cases were received in the department of Pathology. The samples were processed, stained and examined under light microscope. Results: Erythroderma was more common in males (60%) with male to female ratio 1.5:1. Mean age of incidence was 43.3 years. Majority of the cases were acute in onset (51.67%) with shortest duration of 5 days. Pre-existing dermatoses was responsible in 68.33% cases with maximum cases being psoriasis in 33.33% and eczema in 31.67%. Drug induced erythroderma was seen in 16.67% cases. Winter was the aggravating season in 48.14% patients especially in psoriasis. Systemic features such as fever, tachycardia, etc were reported in 76.67% cases. Scales were seen in 83.33% cases and nail changes in 68.33%. Out of 60 cases, 49 cases (81.67%) had positive clinicopathological correlation with best correlation seen in psoriatic erythroderma. P value is<0.001 with strong clinical significance. Conclusion: Erythroderma has many overlapping features which made the identification of underlying disease quiet challenging sometimes. Therefore thorough clinical examination and patients' detailed history along with microscopic findings is essential to rule out all the differential diagnosis.
Context:Pruritic papular eruption (PPE) is a chronic eruption of papular and pruritic lesions of unknown etiology, symmetrically distributed over trunk and extremities. These are common cutaneous manifestations in HIV patients. It is an important cause of HIV-related morbidity. PPE can be the first marker of HIV. Their etiology, histopathological findings, and associated factors vary from region to region. There are no clear data available on the etiology, exact spectrum of the condition, histopathological findings, or treatment of PPE.Aims:The study is aimed at documenting the etiology, CD4 count, and its histopathological correlation in HIV-infected patients.Settings and Design:An observational study conducted in Government Medical College, Patiala.Subjects and Methods:Two-year data regarding history, HIV status, cluster of differentiation 4 (CD4) cell count, and skin biopsy of clinically suspected PPE patients with known HIV status were analyzed.Statistical Analysis Used:All the results were then statistically analyzed. Categorical data were analyzed by Chi-square test, and one-way Spearman's rho test was used for multiple group comparison.Results:Data of 50 eligible patients were analyzed. The majority of the patients were female (between 21 and 50 years of age). The most common histopathological patterns were of papular urticaria, scabies, and drug reaction, and the others less common PPE were polymorphic light eruption and eosinophilic folliculitis. Patients with papular urticaria (32%) had significantly lower mean CD4 counts (157 cells/mm3), while in scabies, the mean CD4 count (376 cells/mm3) was higher.Conclusions:We conclude that histopathology helps in specifying the pattern of PPE and its etiology. It can be a marker of advanced HIV infection. Thus, correlation between the histopathology, clinical diagnosis, and CD4 counts helps to know the disease process.
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