Pub Date : 2022-01-01DOI: 10.4103/ijdpdd.ijdpdd_60_21
Abhishek S. Patokar, Gaurav H. Khandait, Nitin C Chaudhari, S. Khatu
Graham-Little-Piccardi-Lassueur syndrome is a rare variant of lichen planopilaris. It is characterized by multifocal, patchy, cicatricial alopecia of the scalp, noncicatricial alopecia of axilla and pubic region, and keratotic follicular papules involving the trunk and extremities. Trichoscopy shows perifollicular erythema, tubular perifollicular scales, fibrotic white dots, and hair casts along the hair shafts. We are reporting this rare syndrome in a 26-year-old pregnant woman with concomitant oral lichen planus and lichen planus pigmentosus. This case is unique as no previous report of coexistence of these variants of lichen planus has been published.
graham - little - piccard - lassueur综合征是一种罕见的扁平苔藓变异体。其特征为头皮多灶性斑状瘢痕性脱发，腋窝和阴部非瘢痕性脱发，以及累及躯干和四肢的角化性毛囊丘疹。毛镜检查显示毛囊周围红斑、管状毛囊周围鳞片、纤维化白点和沿毛轴的毛模。我们报告这一罕见的综合征，在26岁的孕妇合并口腔扁平苔藓和扁平苔藓色素。这种情况是独特的，因为以前没有报道共存的这些变体的扁平苔藓已发表。
{"title":"Graham-Little-Piccardi-Lassueur syndrome—A rare case report with concomitant lichen planus pigmentosus and oral lichen planus in a pregnant female","authors":"Abhishek S. Patokar, Gaurav H. Khandait, Nitin C Chaudhari, S. Khatu","doi":"10.4103/ijdpdd.ijdpdd_60_21","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_60_21","url":null,"abstract":"Graham-Little-Piccardi-Lassueur syndrome is a rare variant of lichen planopilaris. It is characterized by multifocal, patchy, cicatricial alopecia of the scalp, noncicatricial alopecia of axilla and pubic region, and keratotic follicular papules involving the trunk and extremities. Trichoscopy shows perifollicular erythema, tubular perifollicular scales, fibrotic white dots, and hair casts along the hair shafts. We are reporting this rare syndrome in a 26-year-old pregnant woman with concomitant oral lichen planus and lichen planus pigmentosus. This case is unique as no previous report of coexistence of these variants of lichen planus has been published.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117258659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/ijdpdd.ijdpdd_22_21
V. Mysore, Anuradha Jindal
Vasculitis comprises a diverse group of disorders with varying clinical, histopathological, and immunofluorescence findings arising due to an array of underlying pathogenic mechanisms. These varying reactions are primarily a reflection of complex interplay of different cells, vessels, and stroma. There are several controversies and differences of opinions in the diagnostic criteria, classifications, and terminologies. This article deals with different concepts and controversies in the subject, and also attempts to provide an algorithmic approach for the histopathological diagnosis.
{"title":"Histopathology of vasculitis: Classification, controversies, and concepts","authors":"V. Mysore, Anuradha Jindal","doi":"10.4103/ijdpdd.ijdpdd_22_21","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_22_21","url":null,"abstract":"Vasculitis comprises a diverse group of disorders with varying clinical, histopathological, and immunofluorescence findings arising due to an array of underlying pathogenic mechanisms. These varying reactions are primarily a reflection of complex interplay of different cells, vessels, and stroma. There are several controversies and differences of opinions in the diagnostic criteria, classifications, and terminologies. This article deals with different concepts and controversies in the subject, and also attempts to provide an algorithmic approach for the histopathological diagnosis.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"442 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132932485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/ijdpdd.ijdpdd_19_21
S. Rani, A. Chitkara, P. Sharma, Saket Sinha, Preeti Sharma
Objective: Women with diffuse hair loss need to be screened for possible causes or factors responsible for increased hair shedding and also to exclude factors that can increase hair shedding and aggravate the disease. Material and Methods: A prospective cross-sectional study of 40 cases (18–45years) of diffuse hair loss and 40 healthy females were included. The diagnosis was based on the detailed history, clinical examination to rule out pattern hair loss, and hair pull test. Complete hemogram, serum ferritin, vitamin D, and thyroid function tests (T3, T4, thyroid-stimulating hormone [TSH]) along with all routine investigations were determined for each participant. A diet history of vegetarians and non-vegetarians was also taken. Results: On screening, serum ferritin in cases ranged from 3.92 to 104 ng/mL with a mean of 22.36±23.10 ng/mL and that in controls ranged from 5.5 to115 ng/mL with a mean of 29.97±45.72 ng/mL. The serum ferritin level in cases was lower, at a cut-off value of 10 ng/mL, which is statistically significant (p= 0.027). For those with serum ferritin level >10 ng/mL, the mean concentration of hemoglobin was 11.65 ± 0.79 gm%, whereas for the <10 ng/mL serum ferritin level, the mean concentration of hemoglobin was 11 ± 1.1 gm% with a significant statistical difference (p= 0.027). The serum level of vitamin D in cases ranged from 8 to 57.4 IU/dL with a mean of 20.24±11.98 IU/dL while that in controls ranged from 11.1 to 42.6 IU/dL with a mean of 22.42±9.29 IU/dL, which was statistically significant difference (p= 0.003). We found no association of thyroid dysfunction with diffuse hair loss. On dietary evaluation, significant statistical association among vegetarians (67.5% cases and 40% controls) and non-vegetarians (32.5% cases and 60% controls) was observed (p= 0.024); however, we could not find any statistical significant association of diet with ferritin and vitamin D. Conclusion: Low ferritin and vitamin D may contribute to diffuse hair loss.
{"title":"An analytical study of serum ferritin, vitamin D, and thyroid function in females with diffuse hair loss","authors":"S. Rani, A. Chitkara, P. Sharma, Saket Sinha, Preeti Sharma","doi":"10.4103/ijdpdd.ijdpdd_19_21","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_19_21","url":null,"abstract":"Objective: Women with diffuse hair loss need to be screened for possible causes or factors responsible for increased hair shedding and also to exclude factors that can increase hair shedding and aggravate the disease. Material and Methods: A prospective cross-sectional study of 40 cases (18–45years) of diffuse hair loss and 40 healthy females were included. The diagnosis was based on the detailed history, clinical examination to rule out pattern hair loss, and hair pull test. Complete hemogram, serum ferritin, vitamin D, and thyroid function tests (T3, T4, thyroid-stimulating hormone [TSH]) along with all routine investigations were determined for each participant. A diet history of vegetarians and non-vegetarians was also taken. Results: On screening, serum ferritin in cases ranged from 3.92 to 104 ng/mL with a mean of 22.36±23.10 ng/mL and that in controls ranged from 5.5 to115 ng/mL with a mean of 29.97±45.72 ng/mL. The serum ferritin level in cases was lower, at a cut-off value of 10 ng/mL, which is statistically significant (p= 0.027). For those with serum ferritin level >10 ng/mL, the mean concentration of hemoglobin was 11.65 ± 0.79 gm%, whereas for the <10 ng/mL serum ferritin level, the mean concentration of hemoglobin was 11 ± 1.1 gm% with a significant statistical difference (p= 0.027). The serum level of vitamin D in cases ranged from 8 to 57.4 IU/dL with a mean of 20.24±11.98 IU/dL while that in controls ranged from 11.1 to 42.6 IU/dL with a mean of 22.42±9.29 IU/dL, which was statistically significant difference (p= 0.003). We found no association of thyroid dysfunction with diffuse hair loss. On dietary evaluation, significant statistical association among vegetarians (67.5% cases and 40% controls) and non-vegetarians (32.5% cases and 60% controls) was observed (p= 0.024); however, we could not find any statistical significant association of diet with ferritin and vitamin D. Conclusion: Low ferritin and vitamin D may contribute to diffuse hair loss.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"208 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121454328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/ijdpdd.ijdpdd_5_21
B. Devi, M. Celine, Sandhya George, P. Shanimole, S. Varghese
{"title":"Chromoblastomycosis: A clinico-investigative study of 42 cases","authors":"B. Devi, M. Celine, Sandhya George, P. Shanimole, S. Varghese","doi":"10.4103/ijdpdd.ijdpdd_5_21","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_5_21","url":null,"abstract":"","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"302 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133802682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/ijdpdd.ijdpdd_61_21
S. Mahajan, Yallappa Kabbannavar, Surender Singh
Porokeratotic adnexal ostial nevus is a rare nevoid condition, with a characteristic histological feature of coronoid lamella involving the acrosyringium and the hair follicle. Here we report a case of an 11-year-old female child presented with multiple hyperpigmented and hyperkeratotic papules present over the posterior aspect of right lower extremities along Blaschko’s lines.
{"title":"Linear Porokeratotic Adnexal Ostial Nevus with Dermoscopic Features","authors":"S. Mahajan, Yallappa Kabbannavar, Surender Singh","doi":"10.4103/ijdpdd.ijdpdd_61_21","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_61_21","url":null,"abstract":"Porokeratotic adnexal ostial nevus is a rare nevoid condition, with a characteristic histological feature of coronoid lamella involving the acrosyringium and the hair follicle. Here we report a case of an 11-year-old female child presented with multiple hyperpigmented and hyperkeratotic papules present over the posterior aspect of right lower extremities along Blaschko’s lines.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127410387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/ijdpdd.ijdpdd_82_21
Dhanraj Gitte, S. Ghate, R. Dhurat, Suraj Pai
Dermatofibroma is one of the most common dermal dermatologic tumors. In its classic variant, a dermatofibroma is easily recognized by dermatologists; however, studies have identified numerous variants of the dermatofibroma that do not present with a classic clinical picture. Aneurysmal fibrous histiocytoma, one of these variants, is not easily recognized because of its rarity and potentially malignant appearance. Microscopically, aneurysmal fibrous histiocytoma displays some similarities to a classic dermatofibroma along with distinguishing characteristics, such as blood-filled pseudovascular spaces. Aneurysmal fibrous histiocytoma is a benign lesion with a risk for recurrence if not adequately excised. In this case, we present this rare histological variant of dermatofibroma that stimulates clinically other malignant lesions.
{"title":"Histopathological aneurysmal variant of dermatofibroma—A rare entity known for malignant appearance and recurrence","authors":"Dhanraj Gitte, S. Ghate, R. Dhurat, Suraj Pai","doi":"10.4103/ijdpdd.ijdpdd_82_21","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_82_21","url":null,"abstract":"Dermatofibroma is one of the most common dermal dermatologic tumors. In its classic variant, a dermatofibroma is easily recognized by dermatologists; however, studies have identified numerous variants of the dermatofibroma that do not present with a classic clinical picture. Aneurysmal fibrous histiocytoma, one of these variants, is not easily recognized because of its rarity and potentially malignant appearance. Microscopically, aneurysmal fibrous histiocytoma displays some similarities to a classic dermatofibroma along with distinguishing characteristics, such as blood-filled pseudovascular spaces. Aneurysmal fibrous histiocytoma is a benign lesion with a risk for recurrence if not adequately excised. In this case, we present this rare histological variant of dermatofibroma that stimulates clinically other malignant lesions.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125806725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ijdpdd.ijdpdd_113_20
S. Arora, R. Pal, Devinder Suhag, R. Dabas, Gulhima Arora, S. Chand
Context: Diagnosis of superficial mycoses in clinically doubtful cases relies on demonstration of fungal elements on a 10% potassium hydroxide (KOH) slide mount which takes 30 min to 2 h. Rapid results will lead to reduced time to diagnosis. Aims: A comparative study of conventional 10% KOH wet mount against the cellophane strip method without a mounting medium under bright-field and phase-contrast microscopy was aimed to determine the comparative efficacy of these methods in demonstrating fungal elements of superficial mycoses. Settings and Design: The study was conducted at a skin center of a tertiary care hospital between November 2019 and January 2020. Material and Methods: One hundred and fifty consecutive clinically suspect cases of superficial cutaneous mycoses were examined. Skin scrapings for 10% KOH were collected with a blunt scalpel on one slide and examined half hour later. A cellophane strip collection of squames stuck onto another slide and examined directly by bright-field and phase-contrast microscopy. Statistical Analysis Used: Descriptive and inferential statistical analysis was carried out in the present study using SPSS 22.0, and R environment version 3.2.2 was used for the analysis of the data. Chi-square/Fisher’s exact test was used to find the significance of study parameters on categorical scale between two or more groups, nonparametric setting for qualitative data analysis. Fisher’s exact test was used when samples were very small. Results: The mean percentage positivity for fungal hyphae as seen on KOH mount was 76%, for cellophane tape 97.33%, and under phase-contrast microscopy 97.33%. Pityriasis versicolor was detected by all three methods (100%). Tinea corporis had the least positive result on KOH mount. Conclusion: Cellophane strip method without a mounting medium adequately demonstrates fungal elements on light microscopy.
{"title":"KOH wet mount versus cellophane strip without mounting medium for rapid diagnosis in superficial mycoses","authors":"S. Arora, R. Pal, Devinder Suhag, R. Dabas, Gulhima Arora, S. Chand","doi":"10.4103/ijdpdd.ijdpdd_113_20","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_113_20","url":null,"abstract":"Context: Diagnosis of superficial mycoses in clinically doubtful cases relies on demonstration of fungal elements on a 10% potassium hydroxide (KOH) slide mount which takes 30 min to 2 h. Rapid results will lead to reduced time to diagnosis. Aims: A comparative study of conventional 10% KOH wet mount against the cellophane strip method without a mounting medium under bright-field and phase-contrast microscopy was aimed to determine the comparative efficacy of these methods in demonstrating fungal elements of superficial mycoses. Settings and Design: The study was conducted at a skin center of a tertiary care hospital between November 2019 and January 2020. Material and Methods: One hundred and fifty consecutive clinically suspect cases of superficial cutaneous mycoses were examined. Skin scrapings for 10% KOH were collected with a blunt scalpel on one slide and examined half hour later. A cellophane strip collection of squames stuck onto another slide and examined directly by bright-field and phase-contrast microscopy. Statistical Analysis Used: Descriptive and inferential statistical analysis was carried out in the present study using SPSS 22.0, and R environment version 3.2.2 was used for the analysis of the data. Chi-square/Fisher’s exact test was used to find the significance of study parameters on categorical scale between two or more groups, nonparametric setting for qualitative data analysis. Fisher’s exact test was used when samples were very small. Results: The mean percentage positivity for fungal hyphae as seen on KOH mount was 76%, for cellophane tape 97.33%, and under phase-contrast microscopy 97.33%. Pityriasis versicolor was detected by all three methods (100%). Tinea corporis had the least positive result on KOH mount. Conclusion: Cellophane strip method without a mounting medium adequately demonstrates fungal elements on light microscopy.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123665225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ijdpdd.ijdpdd_76_20
S. Arora, R. Dabas, Eeshaan Ranjan, Aradhana Rout
Cutaneous metastasis of carcinoma cervix is quite uncommon, with a reported incidence of 0.1%–4.4%, with zosteriform or dermatomal distribution being a rare presentation. Although zosteriform cutaneous metastases have been reported with other malignancies, namely lung carcinoma, breast carcinoma, and malignant melanoma, there are no reports of dermatomal cutaneous metastases with adenocarcinoma cervix. We report a case of adenocarcinoma cervix who developed cutaneous metastases in an unusual dermatomal distribution mimicking herpes zoster.
{"title":"Cutaneous metastases in a case of adenocarcinoma cervix with atypical presentation","authors":"S. Arora, R. Dabas, Eeshaan Ranjan, Aradhana Rout","doi":"10.4103/ijdpdd.ijdpdd_76_20","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_76_20","url":null,"abstract":"Cutaneous metastasis of carcinoma cervix is quite uncommon, with a reported incidence of 0.1%–4.4%, with zosteriform or dermatomal distribution being a rare presentation. Although zosteriform cutaneous metastases have been reported with other malignancies, namely lung carcinoma, breast carcinoma, and malignant melanoma, there are no reports of dermatomal cutaneous metastases with adenocarcinoma cervix. We report a case of adenocarcinoma cervix who developed cutaneous metastases in an unusual dermatomal distribution mimicking herpes zoster.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128826279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ijdpdd.ijdpdd_97_20
Shobhna Sharma, D. Goel, Paritosh Gupta
Primitive neuroectodermal tumors (PNET)/Ewing sarcomas (ES) are a group of malignant tumors composed of small round cells of neuroectodermal origin, that affect soft tissue and bone, primarily in children and young adults. About 10%–20% of all cases are extraskeletal, out of which primary cutaneous and superficial cases are rare. We report a case of primary cutaneous PNET/ES in a 57-year-old diabetic man without osseous or other extraskeletal involvement. Differential diagnosis of this rare entity includes other cutaneous malignant round cell tumors such as lymphoma, melanoma, malignant glomus tumor, Merkel cell carcinoma, and malignant cutaneous adnexal neoplasms. The correct diagnosis is important for managing these chemosensitive tumors, which can be achieved with the help of special stains and immunohistochemistry. This case report aims to increase the awareness about rarer clinical presentation of this rare entity with emphasis on histomorphological differential diagnosis.
{"title":"Primary cutaneous primitive neuroectodermal tumor/Ewing sarcoma: A rare case with an unusual presentation","authors":"Shobhna Sharma, D. Goel, Paritosh Gupta","doi":"10.4103/ijdpdd.ijdpdd_97_20","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_97_20","url":null,"abstract":"Primitive neuroectodermal tumors (PNET)/Ewing sarcomas (ES) are a group of malignant tumors composed of small round cells of neuroectodermal origin, that affect soft tissue and bone, primarily in children and young adults. About 10%–20% of all cases are extraskeletal, out of which primary cutaneous and superficial cases are rare. We report a case of primary cutaneous PNET/ES in a 57-year-old diabetic man without osseous or other extraskeletal involvement. Differential diagnosis of this rare entity includes other cutaneous malignant round cell tumors such as lymphoma, melanoma, malignant glomus tumor, Merkel cell carcinoma, and malignant cutaneous adnexal neoplasms. The correct diagnosis is important for managing these chemosensitive tumors, which can be achieved with the help of special stains and immunohistochemistry. This case report aims to increase the awareness about rarer clinical presentation of this rare entity with emphasis on histomorphological differential diagnosis.","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131194933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.4103/ijdpdd.ijdpdd_94_20
M. Gautam, Nidhi Shah, Prachi Bhattar, N. Nadkarni, S. Patil
Context: Onychomycosis (OM) is a commonly encountered problem in clinical practice, which needs to be differentiated from other causes of dystrophic nails as its treatment is long-term and may have potential side effects. Routinely used laboratory tests like direct microscopy with potassium hydroxide (KOH) and fungal culture (FC) show inconsistent sensitivity. Hence, newer methods of diagnosis are required. Aim: This study aims to compare the efficacy of KOH mount, fungal culture, and histopathology of nail clippings with periodic acid–Schiff stain for the diagnosis of onychomycosis. Settings and Design: This was a cross-sectional study conducted in the Dermatology Outpatient Department of a tertiary care center in Navi Mumbai from September 2013 to September 2014. Subjects and Methods: A total of 102 patients with clinically suspected OM were included in the study and evaluated for the following three methods: KOH mount, FC, and HP/PAS stain. To determine the efficacy and performance characteristics of each test, FC was chosen as the gold standard for statistical analysis. Statistical Analysis Used: Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each test. Association among the study group was assessed with the help of Chi-square test. Results: Of the 102 patients, direct microscopy with KOH mount was positive in 47, FC in 30, and HP/PAS in 71 patients. Ninety-one out of the 102 patients had at least one of the three diagnostic tests positive. Using this as the denominator, KOH mount, culture, and HP/PAS had sensitivities of 51.64%, 32.96%, and 78.02%, respectively. Diagnostic sensitivity increased to 89.38% when both KOH and HP/PAS were combined.For calculation of specificity of KOH and HP/PAS, we used FC as the gold standard because it gives precise identification of the pathogen. Specificity for KOH and HP/PAS was 59.7% and 34.7%, respectively. It increased to 73.7% if both KOH and HP/PAS were positive. Conclusion: Using PAS on nail scraping can yield higher diagnostic sensitivity with no loss of specificity and hence can be considered as the method of choice for the diagnosis of OM. Accuracy of diagnosis can be increased by combining the two tests (KOH and HP/PAS) instead of one test (HP/PAS).
{"title":"Comparative evaluation of potassium hydroxide mount, fungal culture, and histopathology of nail clipping with periodic acid–Schiff stain in the diagnosis of onychomycosis","authors":"M. Gautam, Nidhi Shah, Prachi Bhattar, N. Nadkarni, S. Patil","doi":"10.4103/ijdpdd.ijdpdd_94_20","DOIUrl":"https://doi.org/10.4103/ijdpdd.ijdpdd_94_20","url":null,"abstract":"Context: Onychomycosis (OM) is a commonly encountered problem in clinical practice, which needs to be differentiated from other causes of dystrophic nails as its treatment is long-term and may have potential side effects. Routinely used laboratory tests like direct microscopy with potassium hydroxide (KOH) and fungal culture (FC) show inconsistent sensitivity. Hence, newer methods of diagnosis are required. Aim: This study aims to compare the efficacy of KOH mount, fungal culture, and histopathology of nail clippings with periodic acid–Schiff stain for the diagnosis of onychomycosis. Settings and Design: This was a cross-sectional study conducted in the Dermatology Outpatient Department of a tertiary care center in Navi Mumbai from September 2013 to September 2014. Subjects and Methods: A total of 102 patients with clinically suspected OM were included in the study and evaluated for the following three methods: KOH mount, FC, and HP/PAS stain. To determine the efficacy and performance characteristics of each test, FC was chosen as the gold standard for statistical analysis. Statistical Analysis Used: Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each test. Association among the study group was assessed with the help of Chi-square test. Results: Of the 102 patients, direct microscopy with KOH mount was positive in 47, FC in 30, and HP/PAS in 71 patients. Ninety-one out of the 102 patients had at least one of the three diagnostic tests positive. Using this as the denominator, KOH mount, culture, and HP/PAS had sensitivities of 51.64%, 32.96%, and 78.02%, respectively. Diagnostic sensitivity increased to 89.38% when both KOH and HP/PAS were combined.For calculation of specificity of KOH and HP/PAS, we used FC as the gold standard because it gives precise identification of the pathogen. Specificity for KOH and HP/PAS was 59.7% and 34.7%, respectively. It increased to 73.7% if both KOH and HP/PAS were positive. Conclusion: Using PAS on nail scraping can yield higher diagnostic sensitivity with no loss of specificity and hence can be considered as the method of choice for the diagnosis of OM. Accuracy of diagnosis can be increased by combining the two tests (KOH and HP/PAS) instead of one test (HP/PAS).","PeriodicalId":423971,"journal":{"name":"Indian Journal of Dermatopathology and Diagnostic Dermatology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125655081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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