Acanthosis nigricans (AN) is a fairly common dermatosis characterized by hyperpigmented velvety plaques, having a predilection for the intertriginous areas. We herein present a case of unilateral ...nevoid acanthosis nigricans over the left lateral chest, in an adult male. The rarity of documentation of this entity in the world literature prompted us to report the case.
This report presents three cases where the rK39 strip test failed to diagnose two cases of post-kala-azar dermal leishmaniasis and one case of visceral leishmaniasis. However, a strong clinical ...suspicion prompted further evaluation by polymerase chain reaction (PCR), which established the etiology. The present case series highlights the usefulness of PCR in the diagnosis of leishmaniasis.
Appendageal skin tumors (ATs) are those neoplasms that differentiate toward/arise from pilosebaceous apparatus, apocrine, or eccrine sweat glands. Pilosebaceous apparatus are concentrated in ...head-neck area; thus it is expected that ATs would account for a major fraction of skin tumors over this site.
This study aims at finding the clinico-histopathological correlation in cases ATs in head-neck region among attendees of dermatology OPD.
Cross-sectional descriptive study, conducted over 1-year period. All clinically suspected cases of ATs were evaluated and subjected to histopathological examination. Confirmed cases of ATs were finally analyzed.
Among twenty eight thousand four hundred sixty six new patients attending OPD, 30 suspected cases of ATs underwent histopathological examination. Histopathology was confirmatory in only 23 (76.67%) cases. Out of 23, syringoma were found in 9 (39.13%), trichoepithelioma in 6 (26.08%), syringocystadenoma papilliferum in 4 (17.39%), sebaceous gland hyperplasia in 3 (13.04%), and vellous hair cyst in 1 (4.34 %). Females (65.21%) outnumbered males (34.78%) in our study population.
ATs of head-neck region constitute a meager population (0.08%) attending dermatology OPD, and were more common among young population. Often it is over-diagnosed clinically thus necessitating histological confirmation. Young females being cosmetically more conscious are more eager to seek advice for this condition.
The high level of functional diversity and plasticity in monocytes/macrophages has been defined within in vitro systems as M1 (classically activated), M2 (alternatively activated) and deactivated ...macrophages, of which the latter two subtypes are associated with suppression of cell mediated immunity, that confers susceptibility to intracellular infection. Although the Leishmania parasite modulates macrophage functions to ensure its survival, what remains an unanswered yet pertinent question is whether these macrophages are deactivated or alternatively activated. This study aimed to characterize the functional plasticity and polarization of monocytes/macrophages and delineate their importance in the immunopathogenesis of Post kala-azar dermal leishmaniasis (PKDL), a chronic dermatosis of human leishmaniasis. Monocytes from PKDL patients showed a decreased expression of TLR-2/4, along with an attenuated generation of reactive oxidative/nitrosative species. At disease presentation, an increased mRNA expression of classical M2 markers CD206, ARG1 and PPARG in monocytes and lesional macrophages indicated M2 polarization of macrophages which was corroborated by increased expression of CD206 and arginase-1. Furthermore, altered vitamin D signaling was a key feature in PKDL, as disease presentation was associated with raised plasma levels of monohydroxylated vitamin D3 and vitamin D3- associated genes, features of M2 polarization. Taken together, in PKDL, monocyte/macrophage subsets appear to be alternatively activated, a phenotype that might sustain disease chronicity. Importantly, repolarization of these monocytes to M1 by antileishmanial drugs suggests that switching from M2 to M1 phenotype might represent a therapeutic opportunity, worthy of future pharmacological consideration.
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