Search

Byline: Anwita. Sinha, Arun. Hegde, Prateek. Kinra, Shekhar. Neema, Anchit. Singh Sir, Drug-induced lupus erythematosus (DILE) constitutes 10% of all systemic lupus erythematosus (SLE) cases. DILE manifests with typical cutaneous [...]

Classic Toxic Epidermal Necrolysis (TEN) in Lupus Erythematosus (LE) is rare and that caused by oxcarbazepine is even rarer. It can be triggered/induced by various insults, the most prominent being drugs. Herein, we describe a young female, a diagnosed case of LE with lupus nephritis, with recent-onset central nervous system vasculitis (incidentally detected on neuroimaging while she was being evaluated for a recent-onset behavioural change), who within a month of exposure to the drug developed an extensive exfoliating skin rash with mucosal lesions, which on histopathological evaluation showed TEN in LE, triggered by Oxcarbazepine, which was commenced for seizure prophylaxis. She was managed with pulse methylprednisolone, followed by intravenous immunoglobulin (IVIg), after which she made a satisfactory recovery. It is highlighted that TEN in LE patterns must be recognized in an emergency and Acute Syndrome of Apoptotic Panepidermolysis (ASAP) concept applied promptly without awaiting diagnoses. Further, many common drugs possibly trigger this pathology making the rara-avis not rare anymore! [ABSTRACT FROM AUTHOR]

DRESS is a potentially life-threatening severe cutaneous adverse reaction (SCAR). Historically, it was most frequently linked with phenytoin and was initially described as phenytoin hypersensitivity syndrome; however, it was later found to be caused by various other medications, with the commonest been aromatic anticonvulsants, allopurinol and sulfonamides. The severity of this entity is related to systemic involvement, which can result in multiorgan failure and death. The diagnosis of DRESS, especially in the early stages, remains challenging and elusive due to its heterogeneous clinical presentation and the complex course of the disease with different patterns depending on the causal drug. The most important step in the management of DRESS is early diagnosis and immediate cessation of the suspected offending drug along with oral steroids or immunosuppressants to control the disease. We describe the varying presentation and management of six adults with DRESS from a tertiary care hospital, observed over a two-year period with a brief review of the literature. [ABSTRACT FROM AUTHOR]

Epidermodysplasia verruciformis (EDV) is a rare, autosomal recessive, genetic disorder of immune dysregulation characterized by increased susceptibility to cutaneous human papilloma virus infections. It was first described by Lewandowsky and Lutz in 1922 as a form of epidermal nevus. Its association with skin cancers was proposed by Sullivan and Ellis in 1939. Initial lesions often occur in childhood and are of two types; lifelong eruptions of pityriasis versicolor like lesions and flat wart like papules. The latter is characterized by malignant transformation in 35%–50% of patients especially after 40–50 years of age. Bowen disease is the most common tumor followed by invasive squamous cell carcinoma, however, metastasis is rarely encountered. [ABSTRACT FROM AUTHOR]

Byline: Rajesh. Verma, Biju. Vasudevan, Prateek. Kinra, P. Vijendran, Ambresh. Badad, Vikram. Singh Sir, Lichen planus (LP) is a chronic inflammatory dermatosis involving mucocutaneous surfaces and nails. The world-wide prevalence [...]

Inflammatory lesions may sometimes show intense tracer uptake and mimic neoplastic lesions on (18) F-fluoro-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). We report one such false positive case on FDG PET/CT, where septic pulmonary emboli (SPE) mimicked pulmonary metastases. A 45-year-old man with stomach cancer had an indwelling central venous catheter (CVC) in situ while on neoadjuvant chemotherapy. He underwent FDG PET/CT scan for response assessment and the images revealed multiple, intensely FDG avid, peripheral, lung nodules with feeding vessels, which were suspicious for pulmonary metastases. A day later, the patient developed fever with chills and his blood culture showed bacterial growth (Enterobacter cloacae). A provisional diagnosis of SPE from an infected CVC was made. Chemotherapy was withheld, CVC removed, and the catheter tip was sent for bacterial culture. Following a 4-week course of antibiotic treatment, the patient became afebrile. Culture from the CVC tip grew the same organism, as was seen earlier in the patient's blood culture, thus pin-pointing the source of infection in our case. Diagnosis of SPE was clinched when follow-up CT chest done after completion of antibiotic course showed complete resolution of the lung lesions. [ABSTRACT FROM AUTHOR]

Background: Vasculogenic mimicry (VM) is the ability of cancer stem cells of aggressive phenotype to mimic embryonic vascular network by forming channels lined by tumor cells, thereby, promoting tumor growth. These channels are periodic acid-schiff positive and CD34 negative and have been associated with tumor invasion, metastasis, and poor prognosis. It is a promising target for developing novel anticancer therapeutics and contributes to personalized medicine., Aim: Our study aims to look for an association of vasculogenic mimicry marker (VMM) with the aggressiveness of colorectal carcinomas (CRCs)., Settings and Design: All retrospective and prospective cases of colorectal adenocarcinomas received over period of five years, from 2017 to 2021 were included in this study and a case-control study was planned., Materials and Methods: The study population was divided into two comparison groups based on TNM staging (a) those with non-aggressive tumors (controls; TNM stage I and II) and (b) those with aggressive tumors (cases; TNM stage III and IV). A total of 36 controls and 27 cases were studied. Hematoxylin and eosin stain, PAS, and CD34 immunohistochemistry were conducted. PAS positivity with negative CD34 in the same case was designated as VMM positive. VMM status was correlated with tumor stage, grade, and other pathological markers of prognosis., Statistical Analysis: The Chi-square test was used to find an association between the aggressiveness of CRCs and VM positivity. The P value < 0.05 was considered to be significant., Results: It was found that VMM was significantly associated with the aggressiveness of CRCs., Conclusion: VMM is a promising marker for its clinical utility in day-to-day routine IHC studies and its positivity correlates with tumor aggressiveness., (Copyright © 2024 Copyright: © 2024 Indian Journal of Pathology and Microbiology.)

Competing Interests: There are no conflicts of interest.