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At least 1,189 records · Page 66Linked to original sources
PubMed1998

Histological and immunocytochemical studies of human psoriatic lesions transplanted onto SCID mice.

To investigate the pathology of psoriasis, we developed an animal model for this disease using severe combined immunodeficiency (SCID) mice. These mice possess neither B nor T Lymphocytes so that both cellular and humoral immunities are impaired. For the in vivo study of psoriasis, human psoriatic skin was grafted on SCID mice. Long-term morphological and immunohistochemical changes in the grafted skin ware examined for up to 22 weeks after transplantation. The human skin graft were generally well maintained during this period, but the histological and immunohistochemical findings characteristic of psoriasis, except for acanthosis and hyperkeratosis, gradually disappeared as lymphocytic infiltration of the psoriatic lesions declined.

Adult↗
PubMed2003

Benign tumors of the esophagus: radiologic evaluation.

Benign tumors of the esophagus can be classified as mucosal or submucosal in origin. The most common mucosal lesions include squamous papillomas, adenomas arising in Barrett's mucosa, inflammatory esophagogastric polyps, and glycogenic acanthosis. These benign mucosal lesions can often be diagnosed on double-contrast esophagrams based on their characteristic radiographic findings. Major submucosal or intramural lesions include leiomyomas, leiomyomatosis, fibrovascular polyps, granular cell tumors, and duplication cysts. Despite their infrequency, these lesions also can often be diagnosed on esophagography and/or CT based on their characteristic radiographic findings. The purpose of this article is to review in some detail the radiographic features of these various benign tumors of the esophagus.

Adenoma↗
PubMed2000

Are trends in diabetes incidence changing for minority children?

PURPOSE: To contrast incidence rates and time trends of typical type 1 diabetes with non-autoimmune insulin-resistant type 2 diabetes in minority children (Early 2).METHODS: A population based registry of all insulin treated African-American and Hispanic children residing in Chicago, aged 0-17 years at onset, diagnosed between 1985-1994 provided data. Medical records were reviewed and abstracted (N = 739), and a subset of patients were interviewed (n = 195). Based on these data sources, cases were assigned to the early type 2 category if one or more of the following variables were present: notation of "atypical" or "possible type 2" diabetes in the medical record; obesity (defined as BMI >/= 27 (kg/m(2))) or acanthosis nigricans noted at diagnosis; a report by the patient of going off insulin six months after initial diagnosis without developing diabetic ketoacidosis; or reporting the use of oral hypoglycemic agents with or without insulin. The Chi-square test for homogeneity was used to determine differences between proportions of groups. Time trend analysis of incidence was done using regression models with the Poisson distribution.RESULTS: The 10-year average annual incidence rate was 10.3 per 100,000 population for typical type 1 diabetes (n = 565) and 3.2 per 100,000 for those with characteristics of early 2 diabetes (n = 174). Over the ten year interval the incidence rate remained static for typical type 1 diabetes. In the early 2 group there was a 9.0% average annual percent increase over the ten year interval (p < 0.01).CONCLUSIONS: The trends in incidence rates vary between typical type and early 2 diabetes. We hypothesize that this is associated with the increasing rate of obesity and a lack of physical activity in young people.

Journal Article↗
PubMed1999

Actinic cheilitis: a review of 152 cases.

OBJECTIVE: The purpose of this study was to determine whether any clinical or histopathologic variables are associated with the severity of epithelial change in lesions of actinic cheilitis. STUDY DESIGN: A total of 152 acceptable cases of actinic cheilitis were identified from 66,067 cases accessioned from February 1989 to June 1998. For each case, the clinical information supplied by the submitting practitioner at the time of the biopsy and 8 histopathologic variables were evaluated. RESULTS: The following 5 histopathologic variables were positively correlated with an increased degree of epithelial change: acanthosis, basophilic change within the connective tissue, the presence of inflammation within the connective tissue, perivascular inflammation, and thickness of the keratin layer. None of the clinical variables was associated with an increased degree of epithelial change. CONCLUSIONS: The presence of any of the aforementioned histopathologic changes should prompt a close evaluation of the lesion for the presence of either epithelial dysplasia or carcinoma.

Age Factors↗
PubMed2003

Hyperinsulinemic diseases of civilization: more than just Syndrome X.

Compensatory hyperinsulinemia stemming from peripheral insulin resistance is a well-recognized metabolic disturbance that is at the root cause of diseases and maladies of Syndrome X (hypertension, type 2 diabetes, dyslipidemia, coronary artery disease, obesity, abnormal glucose tolerance). Abnormalities of fibrinolysis and hyperuricemia also appear to be members of the cluster of illnesses comprising Syndrome X. Insulin is a well-established growth-promoting hormone, and recent evidence indicates that hyperinsulinemia causes a shift in a number of endocrine pathways that may favor unregulated tissue growth leading to additional illnesses. Specifically, hyperinsulinemia elevates serum concentrations of free insulin-like growth factor-1 (IGF-1) and androgens, while simultaneously reducing insulin-like growth factor-binding protein 3 (IGFBP-3) and sex hormone-binding globulin (SHBG). Since IGFBP-3 is a ligand for the nuclear retinoid X receptor alpha, insulin-mediated reductions in IGFBP-3 may also influence transcription of anti-proliferative genes normally activated by the body's endogenous retinoids. These endocrine shifts alter cellular proliferation and growth in a variety of tissues, the clinical course of which may promote acne, early menarche, certain epithelial cell carcinomas, increased stature, myopia, cutaneous papillomas (skin tags), acanthosis nigricans, polycystic ovary syndrome (PCOS) and male vertex balding. Consequently, these illnesses and conditions may, in part, have hyperinsulinemia at their root cause and therefore should be classified among the diseases of Syndrome X.

Civilization↗
PubMed2005

Classification of diabetes in young adults: new concepts for an old disease.

As clinicians, we are faced to difficult situations in young diabetic patients. The prevalence of type 2 diabetes increases in these patients due to a rising incidence of obesity. We present two clinical observations which both illustrate the insufficiencies of the present classifications. Modern tools are now available for diagnosis such as anti-GAD65 and IA-2 antibodies, genetic tools to investigate for specific mutations, but quantitative means of beta cell mass are lacking. Clinical examination is still accurate to identify type 1 or type 2 diabetes, MODY and mitochondrial diabetes. Weight curve, lesions of acanthosis nigricans, criteria of metabolic syndrome, history of diabetes are critical factors. This problematic has important consequences in our daily practice: the right choice for rapid and good metabolic control.

Adult↗
PubMed2001

Shammah-induced oral leukoplakia-like lesions.

A Shammah-induced oral leukoplakia-like lesion is described in a 44-year-old Algerian patient, who used this specific chewing tobacco since 33 years. The extended white lesion was located to the right mandibular vestibule and had a homogeneous appearance. Shammah is a chewing tobacco consisting of powdered tobacco leaves with carbonate of lime and other substances. It has been associated with oral cancer in Saudi Arabia. Histologically, acanthosis, hyperortho- and parakeratosis were seen. The spinous cell layer showed large pale staining epithelial cells with pycnotic nuclei. Atypia was not observed, however, an increase in mitotic activity was apparent. The subepithelial infiltrate was mild. Electron microscopy showed changes in the basal membrane with interruptions, duplications and triplications. Follow-up of the patient for 2 years revealed that, whenever, the patient changed the location of application, the white lesion regressed or disappeared within 4-6 weeks. Due to the composition of Shammah, the lesion induced has features of a mucosal burn. In contrast to other smokeless tobacco variants, Shammah seems to cause changes which, according to the small number of reports, may transform into oral cancer. As such, Shammah-induced oral leukoplakia-like lesions may be considered precancerous.

Adult↗
PubMed2003

Molecular and cellular bases of syndromic craniosynostoses.

Premature fusion of cranial sutures underlies the clinical condition of 'craniosynostosis', a common human disorder that occurs in both nonsyndromic and syndromic forms. The subgroup of syndromic craniosynostoses usually associates limb abnormalities and facial dysmorphism to skull distortion. Over the past decade, some of the genes causing these phenotypes have been identified. Among these, the gene encoding FGFR2, one of four members of the fibroblast growth factor receptor(FGFR) family, has been shown to account for several severe conditions including Apert, Pfeiffer, Crouzon, Beare-Stevenson and Jackson-Weiss syndromes. Two other FGFRs, FGFR1 and FGFR3, also account for craniosynostoses of variable severity [Pfeiffer, Crouzon with acanthosis nigricans (a pre-malignant skin disorder), and Muenke syndromes]. By contrast,Saethre-Chotzen syndrome and craniosynostosis (Boston-type) arise from mutations in the Twist and muscle segment homeobox 2 (MSX2) transcription factors, respectively. Whereas most FGFR mutations are likely to cause ligand independent activation of the receptor, leading to an upregulation of signaling pathways, mutations in the basic helix-loop-helix (bHLH) transcription factor Twist appear to induce loss of protein function. This review will summarise and discuss some of the cellular and molecular mechanisms involved in normal and abnormal craniofacial development, focusing on the possible interactions between the different factors controlling membranous ossification.

Craniofacial Abnormalities↗
PubMed1997

Unusual observations in the histology of Pityriasis versicolor.

Histological studies were carried out on 25 patients with various morphological types of pityriasis vesicolor. In addition to the usual features, acanthosis nigricans-like picture in papular lesions, dilated blood vessels in erythematous lesions were observed. In sections stained with Periodic acid Schiff's stain (PAS) absence of granular layer in areas of close approximation of filaments to the stratum malpighii and presence of only mycelia in the vicinity of acrosyringium were found unusual, interesting and are new findings to our knowledge.

Adult↗
PubMed2001

Dermatophilus congolensis infection in goats in Tanzania.

When goats in Eastern Tanzania were screened for skin diseases, Dermatophilus congolensis was isolated from the skin lesions in 8 of 484 animals examined. In one severely affected case, the disease was also characterized by histological studies (Gram stain, Giemsa stain and routine HE studies) and electron microscopy. The histological picture was characterized by hyperkeratosis, parakeratosis, acanthosis, folliculitis and an inflammatory cellular reaction involving the epidermis. Gram stain and Giemsa stain revealed longitudinal and transverse branching filaments in the deeper layers of the epidermis. Ultrastructural studies demonstrated D. congolensis in various morphological forms, ranging from filamentous to tuber-shaped structures, mixed with numerous coccoid bodies of variable size. In some instances, the organisms were geometrically arranged in parallel rows of beading and were present in and among the degenerated epithelial cells. Several host cells showed degenerative changes. Ticks present on the goats were Amblyomma variegatum, Rhipicephalus evertsi, Rhipicephalus pravus and Boophilus sp. The clinical signs, pathological lesions, diagnosis, epidemiology and pathogenesis of the disease are discussed.

Actinomycetales↗
PubMed2001

Ultrastructural and biosynthetic characteristics of epidermal cells in patients with psoriasis treated with antiproliferative drugs.

Biopsy specimens from patients with psoriasis treated with antiproliferative drugs (methotrexate, etretinate) were analyzed. Acanthosis and papillomatosis of the epidermis and inflammatory reaction of the derma decreased. A tendency to normalization of epidermocyte ultrastructure with regeneration of tonofilaments and normal keratinization was noted. An important role in the morphogenesis of this process belongs to interrelationships of two competitive types of biosynthesis, DNA and RNA synthesis, providing epidermocyte proliferation and intracellular regeneration, respectively. Structural and functional composition optimal for the epidermis is formed under conditions of complex treatment with antiproliferative drugs combined with photochemotherapy.

Biopsy↗
PubMed2004

Psoriasis associated with opisthorchiasis under conditions of anthelmintic therapy.

Biopsy specimens from patients with psoriasis concomitant with chronic opisthorchiasis were examined. Severe clinical course of combined disease was associated with degenerative changes in epidermocytes, keratinization disorders, and diffuse inflammatory cell infiltration of the derma. Combined therapy including anthelmintic agents produced a positive effect: decreased the degree of acanthosis, increased intracellular regeneration of epidermocytes, and suppressed inflammatory reaction of the derma and hyperplasia of immunocompetent cells. These data attested to an important role of opisthorchiasis in the pathogenesis of psoriatic disease.

Anthelmintics↗
PubMed2005

Basic concepts of the bovine teat canal.

The bovine teat canal is highly specialized in its unique function of preventing both leakage of milk and entry of bacteria and thereby plays a major role in the defence of the udder against mastitis. The teat canal is a longitudinally folded cylinder-shaped body opening, covered with approximately the same type of epithelia as the normal skin and surrounded with a net-like integrated musculoelastic system facilitating its opening and closure. During milking, dead, flattened, enucleated squamae (cellular detritus) are sloughed from the teat canal surface and are continually replaced by inner cells differentiating outwards. The epidermis is characterized by a polarized pattern of epithelial growth and differentiation, with a single layer of proliferating keratinocytes and multiple overlying differentiated layers. Morphologically, the cells transit from the basal layers on the basement membrane of the dermis through stratum corneum before they finally end up as the keratin of the teat canal. The majority of the epidermal protein synthesizing machinery is devoted to making keratin. This is reflected in the fact that keratins are the major structural proteins, constituting up to 85% of a fully differentiated keratinocyte. Epidermal keratin is a 40-70 kDa alpha-helical coiled-coil dimer of the intermediate filament family that, among other marker proteins, characterizes each stage of keratinocyte differentiation. Studies of skin fragility disorders show that the primary role of keratins in epidermal cells is to reinforce them so that they do not lyse upon physical pressure and to provide cells with subtly different properties of resistance and plasticity to equip the epithelial cells for the physical stress of each particular body site. Epithelial cell specialization for function also depends, however, on the lipid composition and organization and on the epidermal architecture. Epidermal architecture depends on epidermal turnover time, which in turn depends on cell number as well as the proliferative condition. Both in vitro and in vivo studies have implicated calcium as a major modulator of epidermal differentiation. Calcium is a factor known to enhance differentiation and promote expression of the differentiation-specific keratin genes. In animals and humans, both topical and systemic retinoids produce acanthosis, hypergranulosis and a relative (but not absolute) decrease in the thickness of the stratum corneum. Despite a high degree of epithelial specialization, we expect a somewhat similar immunological functional importance in the teat canal epithelia as in other stratified squamous keratinized type epithelia.

Animals↗
PubMed2000

Identification of three novel mutations in the insulin receptor gene in type A insulin resistant patients.

Type A insulin resistance syndrome is characterized by the association of ovarian hyperandrogenism, acanthosis nigricans, and severe insulin resistance. We have identified three novel mutant alleles of the insulin receptor gene in 3 patients with type A syndrome, a severe form of insulin resistance. Two of the patients were sisters (A1, A2), 1 of them was a compound heterozygote for a mutation at the 3'-splice acceptor site of intron 21 (AG-->AA), and a missense mutation Val140Leu in exon 2. Her sister was a simple heterozygote for the 3'-splice acceptor mutation. The third patient (A3) was heterozygous for the missense mutation Ala1028Val in exon 17, in the consensus sequence for ATP binding.

Adolescent↗
PubMed2002

Exostosis following a free gingival graft.

BACKGROUND: There have been few cases reported of exostoses following a free gingival graft. In 1980, a free gingival graft was placed on the facial level of 33-34, developing over the years a significant enlargement. In 1999, since the patient felt progressively uncomfortable with the enlarged area, its surgical reduction was proposed. METHOD: Under local anesthesia, the hard tissue developed under the previously-grafted area, was significantly reduced. The specimen, together with a fragment of the covering soft tissue, was sent for histological analysis. RESULTS: The surgical wound healed uneventfully, and the patient was satisfied with the results. The histology showed the presence of mature bone surrounded by a dense connective tissue, whereas the gingival tissue showed acanthosis and fibrosis. CONCLUSION: The development of exostoses following a free gingival graft can be considered an unpredictable, albeit infrequent side-effect of this procedure. The fact that most of these exostoses appear in the cuspid-premolar area, deserves further consideration.

Adult↗
PubMed2000

Cutaneous infections due to nontuberculous mycobacteria: histopathological review of 28 cases. Comparative study between lesions observed in immunosuppressed patients and normal hosts.

To evaluate the histopathological features observed in patients with cutaneous infections due to nontuberculous mycobacteria (NTM) and to compare the histopathological patterns observed in immunosuppressed patients and normal hosts. Twenty-eight biopsy specimens corresponding to 27 patients with cutaneous infections due to NTM were reviewed. Eighteen biopsies corresponded to normal hosts (14 Mycobacterium marinum, 2 Mycobacterium chelonae, 1 Mycobacterium terrae and 1 Mycobacterium gordonae) and 10 biopsy specimens were obtained from 9 immunosuppressed patients (3 Mycobacterium chelonae, one of which had two biopsies, 1 Mycobacterium abscessus, 2 Mycobacterium kansasii, 1 Mycobacterium marinum, 1 Mycobacterium avium complex and 1 Mycobacterium simiae). A panel of histopathological features was evaluated by two independent observers in each biopsy specimen. Epidermal changes (acanthosis, pseudoepitheliomatous hyperplasia, exocytosis) were mainly observed in M. marinum infections. In immunosuppressed patients the infiltrate tended to be deeper, involving the subcutaneous tissue (100%) with a more diffuse distribution and constant abscess formation. A marked granulomatous inflammatory reaction was observed in 83% of immunocompetent and in 60% of immunosuppressed patients. In immunosuppressed patients a relationship between the chronic evolution of the disease and granuloma formation was demonstrated. A diffuse infiltrate of histiocytes with occasionally foamy appearance was noted in three biopsy specimens from three patients with AIDS. Acute and chronic panniculitis was detected in 8 biopsy specimens. In one biopsy (M. chelonae) an acute suppurative folliculitis was observed. Different histopathological patterns can be noted in biopsy specimens from cutaneous nontuberculous mycobacterial infections. The evolution of the disease and the immunologic status of the host may explain this spectrum of morphological changes. Tuberculoid, palisading and sarcoid-like granulomas, a diffuse infiltrate of histiocytic foamy cells, acute and chronic panniculitis, non-specific chronic inflammation, cutaneous abscesses, suppurative granulomas and necrotizing folliculitis can be detected. Suppurative granulomas are the most characteristic feature in skin biopsy specimens from cutaneous NTM infections. Some histopathological patterns seem more prevalent in immunosuppressed patients.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Pagetoid dyskeratosis of the prepuce. An incidental histologic finding resembling extramammary Paget's disease.

BACKGROUND: Pale cells resembling those of paget's disease have been seen as an incidental finding within the epidermis in a variety of benign papules most commonly located in intertriginous areas. This lesion, called pagetoid dyskeratosis, is considered a reactive process in which a small part of the normal population of keratinocytes is induced to proliferate. Among the inductors friction is suspected. As far as we know, these cells have not been reported in the penis. METHODS: Here we describe the location of the lesion in the foreskin and the incidence of this lesion in a group of 281 unselected patients surgically treated for phimosis. In selected cases histochemical staining and immunohistochemical studies were performed. RESULTS: Pagetoid dyskeratosis was found in 105 cases (37.4%) but only in 5 cases (1.8%) the lesion was conspicuous. The cells of pagetoid dyskeratosis show an immunohistochemical profile different from the surrounding keratinocytes characterized by premature keratinization. Pagetoid dyskeratosis cells must be distinguished from the artefactual clear cells of the epidermis, from reactive melanocytes, and from pale-cell acanthosis. In cases in which pagetoid dyskeratosis shows a florid expression there is a hazard of overdiagnosis to the patient. The main differential diagnosis includes extramammary Paget's disease, pagetoid squamous cell carcinoma in situ, epidermotropic metastasis, superficial spreading malignant melanoma, clear cell papulosis, and penile koilocytoses. CONCLUSIONS: The pathologist should be familiar with the histologic features of pagetoid dyskeratosis in the foreskin in order to avoid misdiagnosis and unnecessary treatment. Routine histologic study is usually sufficient to identify the lesion.

Adolescent↗
PubMed2002

Acantholytic dyskeratotic epidermal nevus: a rare histopathologic feature.

BACKGROUND: Epidermal nevus is a congenital malformation of the epidermis consisting of verrucoid scaly plaques on the skin, often in a linear fashion. Different histologic features have been seen and, at times, acantholytic dyskeratosis has been observed. We report a new case of acantholytic dyskeratotic epidermal nevus. CASE REPORT: A 3-year-old girl presented, since birth, asymptomatic keratotic scaly lesions on the left hemithorax and left arm that followed Blaschko's lines. HISTOLOGY: Biopsies revealed acanthosis, papillomatosis, hyperkeratosis and focal areas of suprabasal clefting with acantholysis, as well as individual dyskeratotic cells (corps ronds et grains) in the upper layers of the epidermis. In the literature, this histologic feature has been reported twice. Generalized or localized Darier's disease are well-established clinical entities with characteristic histologic features of acantholytic dyskeratosis. Because of the linear clinical appearance and the onset at birth or early childhood, the lesions should be regarded as epidermal nevi and not linear Darier's disease. CONCLUSION: We report here an additional case of dyskeratotic epidermal nevus, which is a rare histopathologic feature.

Acantholysis↗