Immunohistological Analysis of In Situ Expression of Mycobacterial Antigens in Skin Lesions of Leprosy Patients Across the Histopathological Spectrum

A comparative study was carried out on common and agile frogs ( Rana temporaria and R. dalmatina) naturally infected with ranid herpesvirus 3 (RaHV3) and common toads ( Bufo bufo) naturally infected with bufonid herpesvirus 1 (BfHV1) to investigate common pathogenetic pathways and molecular mechanisms based on macroscopic, microscopic, and ultrastructural pathology as well as evaluation of gene expression. Careful examination of the tissue changes, supported by in situ hybridization, at different stages of development in 6 frogs and 14 toads revealed that the skin lesions are likely transient, and part of a tissue cycle necessary for viral replication in the infected hosts. Transcriptomic analysis, carried out on 2 naturally infected and 2 naïve common frogs ( Rana temporaria) and 2 naturally infected and 2 naïve common toads ( Bufo bufo), revealed altered expression of genes involved in signaling and cell remodeling in diseased animals. Finally, virus transcriptomics revealed that both RaHV3 and BfHV1 had relatively high expression of a putative immunomodulating gene predicted to encode a decoy receptor for tumor necrosis factor in the skin of the infected hosts. Thus, the comparable lesions in infected frogs and toads appear to reflect a concerted epidermal and viral cycle, with presumptive involvement of signaling and gene remodeling host and immunomodulatory viral genes.

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Risk factors for physical disability in patients with leprosy disease in Yunnan, China: Evidence from a retrospective observational study

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009923 ◽

2021 ◽

Vol 15 (11) ◽

pp. e0009923

Author(s):

Xiaohua Chen ◽

Hong-bing Liu ◽

Tie-Jun Shui ◽

Shun Zha

Keyword(s):

Risk Factors ◽

Physical Disability ◽

Physical Disabilities ◽

Delayed Diagnosis ◽

Skin Lesions ◽

Nerve Damage ◽

Advanced Age ◽

Han Ethnicity ◽

Leprosy Patients ◽

Male Sex

Background Leprosy is potentially debilitating. The risk factors related to physical disabilities associated with leprosy disease in Yunnan, China was not clear. Methodology/Principal findings We studied 10644 newly detected leprosy patients from Yunnan, China, from 1990 to 2019. Factors associated with Grade 1 (G1D) and Grade 2 (G2D) physical disabilities or overall physical disabilities (combined G1D and G2D) associated with leprosy were analyzed using multinomial and ordinal logistic regression analyses. The following factors were associated with the development of physical disability in these patients with leprosy: delayed diagnosis [odds ratio (OR): 5.652, 4.399, and 2.275; 95% confidence intervals (CIs): 4.516–7.073, 3.714–5.212, and 2.063–2.509; for ≥ 10, 5–10 y, and 2–5 years, respectively], nerve damage (OR: 3.474 and 2.428; 95% CI: 2.843–4.244, and 1.959–3.008; for 2 and 1 damaged nerves, respectively), WHO classification of PB (OR: 1.759; 95% CI: 1.341–2.307), Ridley-Jopling classification (OR: 1.479, 1.438, 1.522 and 1.239; 95% CI: 1.052–2.079, 1.075–1.923, 1.261–1.838, and 1.072–1.431; for TT, BT, BB, and BL when compared with LL, respectively), advanced age (OR: 1.472 and 2.053; 95% CI: 1.106–1.960 and 1.498–2.814; for 15–59 and over 60 years old, respectively), zero skin lesions (OR: 1.916; 95% CI: 1.522–2.413), leprosy reaction (OR: 1.528; 95% CI: 1.195–1.952), rural occupation (OR: 1.364; 95% CI: 1.128–1.650), Han ethnicity (OR: 1.268; 95% CI: 1.159–1.386), and male sex (OR: 1.128; 95% CI: 1.024–1.243). Conclusions Delayed diagnosis, nerve damage, no skin lesions, WHO and Ridley-Jopling classifications, leprosy reactions, advanced age, rural occupation, Han ethnicity, and male sex were associated with disability in leprosy patients. Identifying risk factors could help to prevent physical disability.

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Pediatric Acute Promyelocytic Leukemia

Annals of Hematology & Oncology ◽

10.26420/annhematoloncol.2021.1374 ◽

2021 ◽

Vol 8 (11) ◽

Author(s):

Campos Davó E ◽

◽

Verdú Belmar J ◽

Garzó Moreno A ◽

de Paz Andrés F ◽

...

Keyword(s):

Blood Smear ◽

Peripheral Blood Smear ◽

International Normalized Ratio ◽

Skin Lesions ◽

Pediatric Emergency ◽

Promyelocytic Leukemia ◽

Pediatric Emergency Department ◽

Laboratory Results ◽

Wbc Count

A previously healthy 4-year-old boy presented to the pediatric emergency department with high fever, headache, asthenia and neutropenia. The fever started two days prior along with the appearance of purple skin lesions. Laboratory results were as follows: White Blood Cell (WBC) count of 44.2 × 109 hemoglobin 62g/L; hematocrit 18.9%, platelet count 30 × 109/l, international normalized ratio (INR) 1.06, lactate dehydrogenase (LDH) 479u/l, creatinine 37μmol/l. Peripheral blood smear demonstrated: 80% of abnormal promyelocytes with bilobar nuclei and cytoplasmic granules; some contained multiple Auer rods. Immunophenotyping demonstrates CD13, CD33, CD117, and myeloperoxidase positivity with a high side-scatter. Fluorescence in situ hybridization revealed the t(15;17) (q22;q21.1) (PML-RARA) (Figure 1 and 2).

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Does Shave Biopsy Accurately Predict the Final Breslow Depth of Primary Cutaneous Melanoma?

The American Surgeon ◽

10.1177/000313480907500503 ◽

2009 ◽

Vol 75 (5) ◽

pp. 369-373 ◽

Cited By ~ 5

Author(s):

Phillip Moore ◽

Jon Hundley ◽

Jennifer Hundley ◽

Edward A. Levine ◽

Phillip Williford ◽

...

Keyword(s):

Retrospective Review ◽

Residual Disease ◽

Tumor Stage ◽

Skin Lesions ◽

Tumor Depth ◽

Primary Cutaneous Melanoma ◽

Tumor Registry ◽

Melanoma In Situ ◽

Additional Surgery

Shave biopsy (SB) is used for the diagnosis of suspicious skin lesions, including melanoma. Its accuracy for melanoma has not been confirmed. We examined our experience with SB to determine its ability to predict true Breslow depth (BD). We performed a retrospective review of the tumor registry for all patients diagnosed with melanoma by SB from 1995 to 2004. Site and depth of lesion, tumor stage, correlation of BD between SB and wide local excision (WLE), and changes in surgical management due to discordance were examined. Melanoma-in-situ was defined as a depth of 0 for this analysis. One hundred thirty-nine patients were diagnosed with melanoma by SB. Pathology after WLE were as follows: 54 (39%) patients had no residual disease, 67 (48%) had a BD equal to or less than the SB, and 18 (13%) had a thicker BD compared with the SB. For these 18 patients, the median BD by SB and WLE was 1.1 mm (range 0-6.5) and 3.5 mm (range 0.5-20.5), respectively ( P = 0.0017). Upstaging of final BD from SB to WLE was significantly associated with increasing tumor depth and higher stage of melanoma ( P < 0.0001). Only seven of the 139 patients (5%) required further surgery because of the increased depth of the WLE. SB underestimated the final BD of melanoma in 13 per cent of patients, but changed the management of few patients. SB is a valuable tool for practitioners in the diagnosis of melanoma. Nevertheless, patients diagnosed with melanoma by SB should be counseled about the rare need for additional surgery.

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Significance of Histopathology in Leprosy Patients with 1–5 Skin Lesions with Relevance to Therapy

Journal of Laboratory Physicians ◽

10.4103/0974-2727.78557 ◽

2011 ◽

Vol 3 (01) ◽

pp. 021-024 ◽

Cited By ~ 1

Author(s):

S Veena ◽

Prakash Kumar ◽

Shashikala P. ◽

Gurubasavaraj H. ◽

H R Chandrasekhar ◽

...

Keyword(s):

Drug Therapy ◽

Skin Lesion ◽

Skin Lesions ◽

Clinicopathological Correlation ◽

Adequate Treatment ◽

Duration Of Therapy ◽

Tuberculoid Leprosy ◽

Leprosy Patients ◽

Skin Biopsies ◽

Severity Of The Disease

ABSTRACT Background: Patients with 1-5 skin lesions are clinically categorized as paucibacillary for treatment purposes. For betterment and adequate treatment of patients, this grouping needs further study. Aim: To study a group of leprosy patients with 1-5 skin lesions, compare clinical details with histopathological findings and bacteriological status of the skin to evaluate the relevance of this grouping. Materials and Methods: Two-year study involving 31 patients of leprosy with 1-5 skin lesions was included in this study. A number of skin lesions were recorded. Skin biopsies were taken in all patients. The biopsies were evaluated for the type of pathology and acid fast bacilli (AFB) status. Results: Of 31 patients, 19 (61.2%) had single skin lesion, 7 (22.5%) had two lesions, 4 (12.9%) had three lesions, and only one (3.22%) had four lesions, there were no patients with five lesions. Of the 31 patients, 30 (96.7%) were clinically diagnosed as borderline tuberculoid and one patient (3.22%) has tuberculoid leprosy. Skin smears were negative for AFB in all patients. The histological diagnoses were: TT 1 (3.22%), BT 24 (77.41%), and IL 6 (19.2%). AFB were found in 2 (6.45%) out of 31 skin biopsies. Clinicopathological correlation was 76.6% in the BT group. Conclusion: Tissue biopsy findings in 1-5 skin lesions which were not considered relevant for treatment purposes until now should be given a status in the categorization and assessment of severity of the disease. The significance of finding of AFB and histopathology of multibacillary (MB) type of leprosy in tissue biopsies, in patients grouped as PB should be resolved so that patients could be given the drug therapy and duration of therapy they warrant.

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Distinctive Dermatoscopic Features of Acral Lentiginous Melanoma in Situ from Plantar Melanocytic Nevi and Their Histopathologic Correlation

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347549800200404 ◽

1998 ◽

Vol 2 (4) ◽

pp. 199-204 ◽

Cited By ~ 20

Author(s):

Yasuhiro Kawabata ◽

Kunihiko Tamaki

Keyword(s):

Skin Lesions ◽

Melanocytic Nevus ◽

Entire Surface ◽

Acral Lentiginous Melanoma ◽

Melanocytic Nevi ◽

Melanoma In Situ ◽

Technical Advances ◽

Surface Profiles ◽

Histopathologic Findings

Background: An acral lentiginous melanoma in situ on the sole is often difficult to differentiate with the naked eye from an acquired plantar melanocytic nevus. Recent technical advances in epiluminescence microscopy have contributed to the differentiation of these two pigmented skin lesions. Objective: In this study, the correlation between dermatoscopic and histopathologic findings of acral lentiginous melanoma in situ on the sole are compared to those of acquired plantar melanocytic nevi. Methods: Three acral lentiginous melanomas in situ on the sole, and two cases of acral lentiginous melanoma were compared with 50 acquired plantar melanocytic nevi by means of dermatoscopy and histopathology. Results: The dermatoscopic surface profiles of acquired melanocytic nevi were composed of linear pigmentation accentuated mainly on the sulcus superficialis. Histologically, some areas of the sulcus superficialis corresponded to rete ridges of the epidermis, and nests of nevus cells were also often located there. In contrast, the acral lentiginous melanomas in situ showed diffuse, irregularly shaped pigmentation distributed in a disorderly fashion over the entire surface. Histologically, isolated areas of proliferation and small nest formations of atypical melanocytes were irregularly distributed in the epidermis. Conclusion: A distinctive dermatoscopic feature of acral lentiginous melanoma in situ is diffuse and irregular pigmentation over the entire surface of the lesion. This feature is helpful for differentiating acral lentiginous melanoma in situ from acquired plantar melanocytic nevi.

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Powerful Bactericidal Activity of Moxifloxacin in Human Leprosy

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01162-07 ◽

2008 ◽

Vol 52 (9) ◽

pp. 3113-3117 ◽

Cited By ~ 24

Author(s):

Fe Eleanor F. Pardillo ◽

Jasmin Burgos ◽

Tranquilino T. Fajardo ◽

Eduardo Dela Cruz ◽

Rodolfo M. Abalos ◽

...

Keyword(s):

Clinical Trial ◽

Side Effects ◽

Bactericidal Activity ◽

Mycobacterium Leprae ◽

Skin Lesions ◽

Definite Improvement ◽

Highly Effective ◽

Leprosy Patients ◽

Multibacillary Leprosy

ABSTRACT In a clinical trial of moxifloxacin in eight multibacillary leprosy patients, moxifloxacin proved highly effective. In all trial patients, a single 400-mg dose of moxifloxacin resulted in significant killing (P ≤ 0.006) of Mycobacterium leprae, ranging from 82% to 99%, with a mean of 91%. In all instances, no viable bacilli were detected with an additional 3 weeks of daily therapy, this observed rapid bactericidal activity being matched previously only by rifampin. On moxifloxacin therapy, skin lesions cleared exceedingly rapidly with definite improvement observed consistently after eight doses and progressive resolution continuing for the 56 days of the trial. Side effects, toxicities, and laboratory abnormalities were mild, not requiring discontinuation of therapy.

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Successful treatment of multifocal pedal Prototheca wickerhamii infection in a feline immunodeficiency virus-positive cat with multiple Bowenoid in situ carcinomas containing papillomaviral DNA sequences

Journal of Feline Medicine and Surgery Open Reports ◽

10.1177/2055116916688590 ◽

2017 ◽

Vol 3 (1) ◽

pp. 205511691668859 ◽

Cited By ~ 1

Author(s):

Allan E Kessell ◽

Derek McNair ◽

John S Munday ◽

Richard Savory ◽

Catriona Halliday ◽

...

Keyword(s):

Dna Sequences ◽

Feline Immunodeficiency Virus ◽

Skin Lesions ◽

En Bloc Resection ◽

Bloc Resection ◽

En Bloc ◽

First Case ◽

Immunodeficiency Virus ◽

Prototheca Wickerhamii

Case summary A 16-year-old, castrated male, feline immunodeficiency virus (FIV)-positive, domestic shorthair cat developed multiple skin lesions. Most of these were Bowenoid carcinoma in situ and contained DNA sequences consistent with Felis catus papillomavirus type 2. Two additional lesions that developed in the skin and subcutaneous tissues between the digital and carpal pads on the left forelimb and right hindlimb were shown by cytology, histology and culture to be caused by Prototheca wickerhamii. These lesions failed to improve in response to systemic therapy treatment with itraconazole, but excision by sharp en bloc resection with follow-up oral itraconazole therapy proved curative for one lesion, although the other lesion recurred, necessitating a second surgery. Relevance and novel information This is only the second reported case of feline protothecosis from Australia and the first case that has been cultured and identified to the species level. Also of great interest was the presence of multiple papillomavirus-associated neoplastic lesions, which may have afforded a portal of entry for the algal pathogen and the cat’s positive FIV status; the latter might have impacted on both viral and algal pathogenesis by effects on immunocompetence.

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