The Correlations between Clinical Features, Dermoscopic and Histopathological Findings, and Treatment Outcomes of Patients with Pitted Keratolysis

Background. Pitted keratolysis (PK) is a superficial bacterial infection diagnosed mainly by clinical manifestations. Current data on its dermoscopic and histopathological findings, and the correlation of those findings, are limited. Objectives. To evaluate the clinical manifestations, dermoscopic, and histopathological findings of PK and to determine the correlations. Methods. Forty naval cadets with PK and five cadets with normal feet were enrolled this cohort study and provided informed consent. Dermoscopy was independently applied and evaluated by 2 dermatologists. Shave biopsies were performed on 37 patients with PK. Results. Pits were the most common dermoscopic finding (88.1%). The dermoscope had more sensitivity for the detection of PK than the naked eye examinations. Apart from the pits and the presence of bacteria, the most common histopathological finding for PK was color alteration of keratin. The presence of bacteria correlated with interrupted dermatoglyphic lines and the color alteration of keratin. Moreover, the presence of bacteria at the base of pits was related to worse treatment outcomes. Conclusions. Dermoscopy is a useful tool for PK diagnosis. Color alteration of keratin is another histopathological finding for PK. The presence of bacteria is associated with worse treatment outcomes.

Histopathology diagnosis in women who underwent a hysterectomy for a benign condition.

Objectives: To determine frequency of histopathological diagnosis in women who underwent hysterectomy for benign condition in tertiary care hospital. Study Design: Retrospective study. Setting: Department of Gynecology and Obstetrics, CMH Nowshera. Period: 6 months (July 2018 December 2019). Material & Methods: Data of all hysterectomies underwent in last 3 years was reviewed. Ethical approval was taken from ethical review board. Patients undergone hysterectomy with benign condition were included in study. Data was analyzed using SPSS version 24. Chi-square and correlation test was performed. P value ≤0.05 was considered significant. Results: Total 430 cases were included in study. Mean age of women was 37.1 years± 8.2 SD. Most common complaints was irregular bleeding 123(28.6%) following dysmenorrhea 78(18.1%). Most common histopathological finding was adenomyosis 214(49.8%), following leiomyoma 66(15.3%). Histopathological findings were significantly associated parity (p=0.000), type of hysterectomy (p=0.000), marital status (p=0.000) and occupation (p=0.000). Significant correlation between clinical diagnosis and histopathological finding was found (r= 0.7, p=0.00). Conclusion: Hysterectomy is most common surgical modality in gynecology. Adenomyosis is most common histopathological finding in patients undergone hysterectomy for benign condition. All hysterectomy specimens should be subjected to pre-operative and post-operative histopathological examination for accurate diagnosis and management in benign conditions.

Gastric carcinoma metastasis to the palatine tonsil – case report

<b>Aim:</b> The aim of the study is to present a rare case of metastatic tumor localized in pharyngeal tonsil being the first symptom of gastric carcinoma. <br><b>Case report:</b> Retrospective analysis of medical documentation was performed. A 44-years-old men was referred to the Department presenting a complaint of enlarged right pharyngeal tonsil. The mass was not painful. Patient reported tobacco smoking (20/day) for many years. In the intraoral examination a 2 cm right palatine tonsil was present. There was a slight asymmetry between tonsils. Local lymph nodes were not enlarged. FNAC was performed stating suspicion of carcinoma. Patient was qualified for the tonsillectomy under general anesthesia. Histopathological finding was adenocarcinoma (G2) infiltration. Due to no correlation of clinical presentation and histopathological finding PET-CT examination was performed revealing massive gastric infiltration, tumor of the left adrenal gland, increased 18-FDG uptake in epigastrial and para-aortic lymph nodes. Gastroscopy and biopsy was performed. Histopathological material confirmed adenocarcinoma presenting the same immunotype as tonsillar. Patient was qualified for paliative treatment. He died 6 weeks after stating the diagnosis. Metastases to the pharyngeal tonsils constitute rare disease entities. Mostly the primary site is localized in the region of head and neck. In our case the metastatic tumor of the right tonsil was the first sign of the gastric cancer.

Primary tonsillar tuberculosis: a forgotten clinical identity

Primary tonsillar tuberculosis is an uncommon entity and a diagnostic challenge. Misdiagnosis can be prevented with early professional para-clinical finding. The true diagnosis is often delayed and infection management depends on recognizing disease patterns and early laboratory documentation. This rare clinical caseation granuloma with positive clinical symptoms, negative results of radiology/laboratory and alone based on histopathological finding without any Mycobacterium particle indicates the role of an accurate laboratory/pathology finding for urgent medical intervention treatment and lifesaving of patients, particularly in immunocompromised group.

Toxicologic Pathology Forum*: Opinion on Designation of Adverse and Nonadverse Histopathological Findings in Toxicity Studies: The Pathologist’s Dilemma

In this opinion piece, we discuss some proposed principles for designating adversity and nonadversity of histopathological changes. The suggested approach categorizes the classes of findings noted in toxicity studies with illustrations and examples and suggests adversity or nonadversity for each class, in the authors’ opinions, with rationales. Although the suggestions and examples offered in this opinion piece are generally in agreement with Society of Toxicologic Pathology best practices guideline on adversity, the authors suggest and highlight occasional divergences and differences of opinion. This is because making an adversity call is a complex and challenging topic that is difficult to simplify. Some of the challenges in deciding on adversity are discussed, especially those related to making an adversity call on a histopathological finding in isolation, based on the nature and extent of severity. The authors demonstrate some of these situations with examples. Finally, the authors suggest, in contrast to the guidelines, occasional use of a separate category for findings that are less easily classified. [Box: see text]