scholarly journals Study of Various Vesiculobullous Lesions Using Tzanck Smear

2020 ◽  
Vol 7 (6) ◽  
pp. A301-305
Author(s):  
Sanchit Singhal ◽  
Hemalata M
Keyword(s):  
Early Diagnosis ◽  
Bullous Pemphigoid ◽  
Viral Infections ◽  
Pemphigus Vulgaris ◽  
Giant Cells ◽  
Pemphigus Foliaceus ◽  
Dermoepidermal Junction ◽  
Non Invasive ◽  
Histopathological Correlation ◽  
Invasive Method

Background: The vesiculobullous reaction pattern is characterized by the presence of vesicles or bullae within the epidermis or at the dermoepidermal junction. Despite some having characteristic presentations, it’s difficult to make a definite diagnosis clinically. Hence, cytological evaluation is required for reliable and early diagnosis. Objectives of the study are to determine the incidence of various vesiculobullous lesions and evaluate cytology as a tool for early diagnosis of vesiculobullous lesions. Methods: For Tzanck smears fresh vesicle or bulla was selected and incised with scalpel, reflecting the roof of bulla. Base of the blister scraped gently and material spread on a glass slide. These smears were stained with MGG (air dried), Pap and H&E stains (fixed).Skin punch biopsies from the bullae were subjected to routine fixation, processing, sectioning and staining. Results: A total of 62 Tzanck smears were done for vesiculobullous lesions of skin of which 29 had histopathological correlation. Herpes constituted the most common vesiculobullous disorder (42%) followed by bullous pemphigoid (27.4%) and pemphigus vulgaris (19.3%). Most patients were in the age group 61- 70 years. The M:F ratio of 1:1.38 showing female preponderance. Tzanck smears showed acantholytic cells in pemphigus group, eosinophils in bullous pemphigoid and multinucleate giant cells in viral blisters. Histopathology showed intraepidermal acantholysis in pemphigus vulgaris, subcorneal blister in pemphigus foliaceus and subepidermal in bullous pemphigoid. Conclusion: Cytohistopathological correlation showed an overall sensitivity of 79%. Tzanck smear showed 96% sensitivity for viral infections. Tzanck smear is a quick, non-invasive method for the early diagnosis of vesiculobullous disorders.

AI-Provided Instant Differential Diagnosis of Pemphigus Vulgaris and Bullous Pemphigoid: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Xiaoyu He ◽  
Juan Su ◽  
Guangyu Wang ◽  
Kang Zhang ◽  
Navarini Alexander ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Early Diagnosis ◽  
Image Classification ◽  
Bullous Pemphigoid ◽  
Skin Diseases ◽  
Pemphigus Vulgaris ◽  
Classification Model ◽  
Clinical Image ◽  
Clinical Images ◽  
Multimodal Classification

BACKGROUND Pemphigus vulgaris (PV) and bullous pemphigoid (BP) are two rare but severe inflammatory dermatoses. Due to the regional lack of trained dermatologists, many patients with these two diseases are misdiagnosed and therefore incorrectly treated. An artificial intelligence diagnosis framework would be highly adaptable for the early diagnosis of these two diseases. OBJECTIVE Design and evaluate an artificial intelligence diagnosis framework for PV and BP. METHODS The work was conducted on a dermatological dataset consisting of 17,735 clinical images and 346 patient metadata of bullous dermatoses. A two-stage diagnosis framework was designed, where the first stage trained a clinical image classification model to classify bullous dermatoses from five common skin diseases and normal skin and the second stage developed a multimodal classification model of clinical images and patient metadata to further differentiate PV and BP. RESULTS The clinical image classification model and the multimodal classification model achieved an area under the receiver operating characteristic curve (AUROC) of 0.998 and 0.942, respectively. On the independent test set of 20 PV and 20 BP cases, our multimodal classification model (sensitivity: 0.85, specificity: 0.95) performed better than the average of 27 junior dermatologists (sensitivity: 0.68, specificity: 0.78) and comparable to the average of 69 senior dermatologists (sensitivity: 0.80, specificity: 0.87). CONCLUSIONS Our diagnosis framework based on clinical images and patient metadata achieved expert-level identification of PV and BP, and is potential to be an effective tool for dermatologists in remote areas in the early diagnosis of these two diseases.

The Central Slip Tenodesis Test for Early Diagnosis of Potential Boutonnière Deformities

1994 ◽  
Vol 19 (1) ◽  
pp. 88-90 ◽  
Author(s):  
P. J. SMITH ◽  
D. A. ROSS
Keyword(s):  
Early Diagnosis ◽  
Conservative Management ◽  
Primary Defect ◽  
Non Invasive ◽  
Boutonniere Deformity ◽  
Invasive Method ◽  
Central Slip ◽  
Boutonnière Deformity

Disruption of the central slip is the primary defect leading to boutonnière deformity. In the closed injury early diagnosis of this lesion is rarely achieved due to the limitations of current methods and difficulties encountered in assessing a painful finger. We describe a simple, non-invasive method of diagnosis which can be carried out on all patients and with minimal discomfort. This test is also beneficial in monitoring the progress of conservative management of central slip disruption.

scholarly journals Development of a Non-Invasive Method, Multiplex Methylation Specific PCR (MMSP), for Early Diagnosis of Nasopharyngeal Carcinoma

PLoS ONE ◽  
2012 ◽  
Vol 7 (11) ◽  
pp. e45908 ◽  
Author(s):  
Zhe Zhang ◽  
Di Sun ◽  
Susanna Hilda Hutajulu ◽  
Imran Nawaz ◽  
Do Nguyen Van ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Early Diagnosis ◽  
Non Invasive ◽  
Methylation Specific Pcr ◽  
Specific Pcr ◽  
Invasive Method

scholarly journals Non-invasive method for early diagnosis of herpes simplex encephalitis.

1988 ◽  
Vol 63 (12) ◽  
pp. 1470-1473 ◽  
Author(s):  
N Hanada ◽  
S Kido ◽  
M Terashima ◽  
K Nishikawa ◽  
T Morishima
Keyword(s):  
Herpes Simplex ◽  
Early Diagnosis ◽  
Herpes Simplex Encephalitis ◽  
Non Invasive ◽  
Invasive Method

scholarly journals Heart Rate Variability as a Prospective Predictor of Early COVID-19 Symptoms

2021 ◽  
Author(s):  
Alexey Ponomarev ◽  
Konstantin Tyapochkin ◽  
Ekaterina Surkova ◽  
Evgeniya Smorodnikova ◽  
Pavel Pravdin
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Viral Infections ◽  
Group Analysis ◽  
Interval Data ◽  
Time Interval ◽  
Individual Level ◽  
Non Invasive ◽  
Invasive Method ◽  
The Individual

Heart rate variability (HRV) is the fluctuation in the time interval between consecutive heartbeats, the measurement of which is a non-invasive method for assessing the autonomic status. The autonomic nervous system plays an important role in physiological situations, and in various pathological processes such as in cardiovascular diseases and viral infections. This study examined the cardiac autonomic responses, as measured by HRV before, after, and during coronavirus disease. In this study, we used beat interval data extracted from the Welltory app from 14 eligible subjects (9 men and 5 women) with a mean age (SD) of 44 (8.7) years. HRV analysis was performed through an assessment of time-domain indices (SDNN and RMSSD). Group analysis did not reveal any statistical difference between HRV metrics before, during, and after COVID-19. However, HRV at the individual level showed a statistically significant individual change during COVID-19 in some users. These data further support the usefulness of using individual-level HRV tracking for the detection of early diseases inclusive of COVID-19.

scholarly journals Detection of circulating anti-skin antibodies by indirect immunofluorescence and by ELISA: a comparative systematic review and meta-analysis

2020 ◽  
Vol 58 (10) ◽  
pp. 1623-1633
Author(s):  
Otto Van de gaer ◽  
Petra de Haes ◽  
Xavier Bossuyt
Keyword(s):  
Bullous Pemphigoid ◽  
Indirect Immunofluorescence ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Pemphigus Vulgaris ◽  
Pemphigus Foliaceus ◽  
Bullous Pemphigoid Antigen ◽  
Autoimmune Bullous Diseases ◽  
Pubmed Database

AbstractBackgroundBoth enzyme-linked immunosorbent assays (ELISAs) and indirect immunofluorescence (IIF) are available for the diagnosis of autoimmune bullous diseases (AIBD). Many studies have reported on the performance of ELISAs and concluded that ELISAs could replace IIF. This study compares the diagnostic accuracy of ELISA and IIF for the detection of autoantibodies to desmoglein 1 (DSG1), desmoglein 3 (DSG3), bullous pemphigoid antigen 2 (BP180) and bullous pemphigoid antigen 1 (BP230) to support the diagnosis of pemphigus vulgaris (PV), pemphigus foliaceus (PF) and bullous pemphigoid (BP).MethodsA literature search was performed in the PubMed database. The meta-analysis was performed using summary values and a bivariate random effect model.ResultsThe five included studies on PV did not demonstrate significant differences between IIF and DSG3-ELISA (sensitivity 82.3% vs. 81.6%, p = 0.9284; specificity 95.6% vs. 93.9%, p = 0.5318; diagnostic odds ratio [DOR] 101.60 vs. 67.760, p = 0.6206). The three included studies on PF did not demonstrate significant differences between IIF and DSG1-ELISA (sensitivity 80.6% vs. 83.1%, p = 0.8501; specificity 97.5% vs. 93.9%, p = 0.3614; DOR 160.72 vs. 75.615, p = 0.5381). The eight included studies on BP showed that BP230-ELISA differed significantly from both IIF on monkey esophagus (MO) and BP180-ELISA with regard to DOR (11.384 vs. 68.349, p = 0.0008; 11.384 vs. 41.699, p = 0.0125, respectively)ConclusionsOur meta-analysis shows that ELISA performs as well as IIF for diagnosing PV, PF and BP.

scholarly journals Bullous Skin Diseases: Classical Types of Autoimmune Diseases

Scientifica ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Jan Damoiseaux
Keyword(s):  
Autoimmune Diseases ◽  
Bullous Pemphigoid ◽  
Oral Mucosa ◽  
Skin Diseases ◽  
Pemphigus Vulgaris ◽  
Pemphigus Foliaceus ◽  
Blister Formation ◽  
Koch’S Postulates ◽  
Bullous Skin Diseases ◽  
Koch's Postulates

The prototypic bullous skin diseases, pemphigus vulgaris, pemphigus foliaceus, and bullous pemphigoid, are characterized by the blister formation in the skin and/or oral mucosa in combination with circulating and deposited autoantibodies reactive with (hemi)desmosomes. Koch’s postulates, adapted for autoimmune diseases, were applied on these skin diseases. It appears that all adapted Koch’s postulates are fulfilled, and, therefore, these bullous skin diseases are to be considered classical autoimmune diseases within the wide and expanding spectrum of autoimmune diseases.

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