Background: Prurigo pigmentosa (PP) is a rare inflammatory disease of the skin typified by recurrent, pruritic erythematous macules and papules that resolve leaving behind net like pigmentation. Objective: PP is diagn...Background: Prurigo pigmentosa (PP) is a rare inflammatory disease of the skin typified by recurrent, pruritic erythematous macules and papules that resolve leaving behind net like pigmentation. Objective: PP is diagnosed most commonly in Japanese women. Preponderance of the disease in other ethnic populations has yet to be identified. Methods: We conducted a clinicopathologic case study in 4 Iranian women. Results:The clinical diagnosis of PP was confirmed by typical histopathologicfindings, elucidating the morphologic spectrum of the disease. Limitations: The small number of patients in this study is a limitation. Conclusion: We suspect that PP may have a proclivity in the Iranian population.展开更多
Background: Cutaneous leishmaniasis (CL) is rare in Northern Europe and may be overlooked because colleagues have little experience with it. Objectives: To identify manifestations of CL that may escape diagnosis. Meth...Background: Cutaneous leishmaniasis (CL) is rare in Northern Europe and may be overlooked because colleagues have little experience with it. Objectives: To identify manifestations of CL that may escape diagnosis. Methods: Correlation of clinical diagnosis and histopathological findings in 28 biopsy specimens taken from 19 patients with CL confirmed by polymerase chain reaction (PCR) specific for Leishmania. Results: In only one patient was the clinical diagnosis CL; other diagnoses included: malignant epithelial neoplasms (5), follicular cyst (2), atypical mycobacteriosis (1), sarcoidosis (2) and lymphoma (1). Lesions were single (15) or few (4) nodules predominantly situated on the extremities or face (16). Histopathological findings were diagnostic of CL in only 10 cases. In nine cases Leishmania was not identified microscopically; histopathological diagnoses were: granulomatous dermatitis (6), lupoid rosacea (1), foreign body granuloma (1) and granuloma annulare (1). Unaltered epidermis (9), nodular infiltrates (5), numerous multinucleated histiocytes (3), palisaded granulomas with fibrinoid centres (2), sarcoidal granulomas (4) and elastophagocytosis (1) misled the histopathologists in these cases. Conclusions: CL seems often to be misdiagnosed clinically in countries where it is not endemic. Histopathologically, CL may be misinterpreted as sarcoidosis, foreign body granuloma, lupoid rosacea and granuloma annulare, especially when Leishmania is not seen microscopically. We suggest that in Northern Europe, PCR for Leishmania-specific DNA should be performed routinely in any granulomatous dermatitis presenting as a single or few nodules on the extremities or face, even when a diagnosis of CL was not considered by the referring clinician.展开更多
文摘Background: Prurigo pigmentosa (PP) is a rare inflammatory disease of the skin typified by recurrent, pruritic erythematous macules and papules that resolve leaving behind net like pigmentation. Objective: PP is diagnosed most commonly in Japanese women. Preponderance of the disease in other ethnic populations has yet to be identified. Methods: We conducted a clinicopathologic case study in 4 Iranian women. Results:The clinical diagnosis of PP was confirmed by typical histopathologicfindings, elucidating the morphologic spectrum of the disease. Limitations: The small number of patients in this study is a limitation. Conclusion: We suspect that PP may have a proclivity in the Iranian population.
文摘Background: Cutaneous leishmaniasis (CL) is rare in Northern Europe and may be overlooked because colleagues have little experience with it. Objectives: To identify manifestations of CL that may escape diagnosis. Methods: Correlation of clinical diagnosis and histopathological findings in 28 biopsy specimens taken from 19 patients with CL confirmed by polymerase chain reaction (PCR) specific for Leishmania. Results: In only one patient was the clinical diagnosis CL; other diagnoses included: malignant epithelial neoplasms (5), follicular cyst (2), atypical mycobacteriosis (1), sarcoidosis (2) and lymphoma (1). Lesions were single (15) or few (4) nodules predominantly situated on the extremities or face (16). Histopathological findings were diagnostic of CL in only 10 cases. In nine cases Leishmania was not identified microscopically; histopathological diagnoses were: granulomatous dermatitis (6), lupoid rosacea (1), foreign body granuloma (1) and granuloma annulare (1). Unaltered epidermis (9), nodular infiltrates (5), numerous multinucleated histiocytes (3), palisaded granulomas with fibrinoid centres (2), sarcoidal granulomas (4) and elastophagocytosis (1) misled the histopathologists in these cases. Conclusions: CL seems often to be misdiagnosed clinically in countries where it is not endemic. Histopathologically, CL may be misinterpreted as sarcoidosis, foreign body granuloma, lupoid rosacea and granuloma annulare, especially when Leishmania is not seen microscopically. We suggest that in Northern Europe, PCR for Leishmania-specific DNA should be performed routinely in any granulomatous dermatitis presenting as a single or few nodules on the extremities or face, even when a diagnosis of CL was not considered by the referring clinician.
