The study of epidemiological, clinical, histopathological and dermoscopic features of lichen planus

<p class="abstract"><strong>Background:</strong> Lichen planus (LP) is a common papulosquamous condition seen by the dermatologists. It can involve the skin, mucous mebranes, hair and nails. There are many subtypes of LP with various clinical, histopathological and dermoscopic features. In this study we intended to study the epidemiological, clinical, histopathological and dermoscopic features of LP.</p><p class="abstract"><strong>Methods:</strong> A total of 73 patients of LP, above the age of 18 years who qualified the inclusion and exclusion criteria were included in the study. A proforma of epidemiological details was noted, clinical and dermoscopic examination of the lesions were done. The punch biopsy specimens of cutaneous lesions were subjected to histopathological examination and the findings noted.</p><p class="abstract"><strong>Results:</strong> Out of the 73 patients included in the study, 44 were males and 29 females with a ratio of 1.51:1. Classic LP was the commonest type of LP. Wickham’s striae (WS) was the most typical and commonest dermoscopic feature of cutaneous LP except lichen planus pigmentosus. Hyperkeratosis, hypergranulosis, acanthosis, band shaped lymphocytic infiltrate, melanophages, basal cell degeneration and saw tooth shaped rete ridges were the significant histopathological features.</p><p class="abstract"><strong>Conclusions:</strong> LP is more common in young adults and shows a male preponderance. WS is the most important diagnostic feature seen on dermoscopy of all the cutaneous types of LP excluding LPP. Interface dermatitis with a band of lymphocytic infiltrates and dermal melanophages is a notable feature of histopathology of LP.</p>

Taxonomic revision of the genus Cabassous McMurtrie, 1831 (Cingulata: Chlamyphoridae), with revalidation of Cabassous squamicaudis (Lund, 1845)

Cabassous comprises armadillos lacking a full osteoderm cover in the tail, justifying its common name naked-tailed armadillos. In the only taxonomic revision of the genus, in 1980, four living species were recognized, including a polytypic taxon with two subspecies. Recent studies have questioned this classification, but a comprehensive taxonomic review is lacking. Here, we revise the taxonomy of the genus Cabassous using complementary morphological approaches and clarify the geographical limits of naked-tailed armadillo species. Based on qualitative and quantitative analyses, we recognize five living species: C. centralis, C. chacoensis, C. squamicaudis, C. unicinctus, and C. tatouay. Most of the species can be easily differentiated using external or cranial traits, except C. centralis and C. unicinctus, which share several morphological features. The scutes pattern on the cephalic shield is an important diagnostic feature in naked-tailed armadillos and can be easily applied in field studies. Cabassous squamicaudis and C. unicinctus were previously treated as subspecies but we show they have conspicuous diagnostic traits, without mixture of characters even in closer contact. Cabassous species can be classified as open-dwellers (C. chacoensis and C. squamicaudis), forest-dwellers (C. centralis and C. unicinctus), or of more generalist habits (C. tatouay). We designate a lectotype for C. unicinctus to preserve its long-term nomenclature use.

Long-Term Variability in Immunofluorescence Titer of Antibodies to Nuclear Antigens Observed in Clinical Laboratory Proficiency Testing Surveys

Context.— Presence of antibodies to nuclear antigens (ANAs) above a threshold titer is an important diagnostic feature of several autoimmune diseases, yet titers reported vary between laboratories. Proficiency survey results can help clarify factors contributing to the variability. Objective.— To determine the contribution of HEp-2 ANA kits from different manufacturers to the variation in titers, and assess whether the differences between kits are consistent over the long term. Design.— HEp-2 ANA titers reported by laboratories participating in the external quality assessment proficiency testing surveys conducted by the College of American Pathologists between 2008 and 2018 were analyzed. The ANA titers reported for each specimen were ranked according to the kits being used by testing laboratories, and the statistical significance of the differences was determined. Results.— The ANA titer results were strongly influenced by the HEp-2 ANA kit used (P &lt; .001). During the 11 years studied, the rank order of the ANA titer for each kit relative to the other kits was remarkably consistent. The rank of ANA titer for individual ANA patterns observed for each kit was similar to the overall rank of that kit. Conclusions.— Variability in ANA titers was strongly associated with the kits used, and the differences between kits were quite consistent during the 11 years studied. Because the variability is not random, it has the potential to be managed by harmonizing kits, which could lead to improved consistency in reporting ANA titers.

Zenker’s diverticulum: a rare clinical condition with unusual oral manifestation

Oral mucosa exhibit clinical manifestations of a variety of systemic conditions and can serve as an indicator of overall health of an individual. Various systemic conditions like autoimmune, endocrine and haematological disorders can present with oral mucosal lesions, which can serve as an important diagnostic feature. These oral lesions can vary from oral ulceration, bleeding gums, xerostomia, chronic glossitis, to erosion and sensitivity of teeth. It is important that a clinician must be aware of the oral presentations of systemic conditions, so that timely diagnosis can be made and the necessary treatment is executed. This paper presents an unusual case of severe oral mucosal ulcerations and dysphagia in an elderly patient diagnosed with Zenker’s diverticulum. Patient was relieved of all oral symptoms once the underlying gastrointestinal tract pathology was diagnosed and surgically corrected.

Variable utility of mosaic attenuation to distinguish fibrotic hypersensitivity pneumonitis from idiopathic pulmonary fibrosis

BackgroundMosaic attenuation on computed tomography (CT) has been identified in international guidelines as an important diagnostic feature of fibrotic hypersensitivity pneumonitis (FHP) as opposed to idiopathic pulmonary fibrosis (IPF). However, mosaic attenuation comprises several different radiological signs (low-density lobules, preserved lobules, air trapping and the so-called “headcheese sign”) which may have differing diagnostic utility. Furthermore, the extent of mosaic attenuation required to distinguish these two diagnoses is uncertain and thresholds of mosaic attenuation from international guidelines have not been validated.MethodsInspiratory and expiratory CT scans were evaluated by two readers in 102 patients (IPF n=57; FHP n=45) using a semiquantitative scoring system for mosaic attenuation. Findings were validated in an external cohort from a secondary referral institution (IPF n=34; FHP n=28).ResultsLow-density lobules and air trapping were a frequent finding in IPF, present in up to 51% of patients. A requirement for increasing extent of low-density lobules and air trapping based on guidelines (American Thoracic Society and Fleischner Society) was associated with increased specificity for the diagnosis of FHP (0.96 and 0.98, respectively) but reduced sensitivity (0.16 and 0.20, respectively). The headcheese sign was found to be highly specific (0.93) and moderately sensitive (0.49) for a high-confidence diagnosis of FHP. The high specificity of the headcheese sign was maintained in the validation cohort and when patients with other CT features of FHP were excluded.ConclusionMosaic attenuation is a frequent finding in IPF. However, the headcheese sign can be confidently considered as being inconsistent with a diagnosis of IPF and specific for FHP.

Effect of Men Infertility on Serum Creatine ‎Kinase Activity ‎

mThe present study was carried out on 60 patientsm with male factor infertility comparedmwith 60 healthy controls, their ages ranged betweenn20-56 years in Maternity and Childhood Teaching Hilla Hospital and in a biochemistry laboratory of Pharmacy college of Babylon university, between Junem2014 – Junuary 2015. The purpose of this study is to investigate CK activity, serum creatine,mcreatinine levels and semen parametersmin infertile men only ,infertile with DM, smoking ifertile,nand hypertention with infertile patients. The present resultsbshowed a statistically significant deferences (p<0.05) in creatine kinasehactivity, creatine and seminal characteristics while nonmsignificant in creatinine and in Abnormal sperm morphology % . There were statistically significant deferences betweenkthe biochemical and seminal parameters inodiabetes , hypertension and smoking patients and tomcontrol group at a p valuem(P<0.05). There were no observed significantkdifferences in creatinine and Abnormal sperm morphology % of smokerskcompared to control group (P>0.05). The same resultskwere obtained in diabetic and hypertensionkwhen compared tojcontrol group (P<0.05). Our resultsjindicated that thejdiabetes , hypertension and smoking reducelserum CK creatinine and semen parameters inkmale infertility . Enzymetic activity of CK inkserum is a biochemical marker in determining infertility and this biochemicalkmarker will represents an important diagnostic feature withmseminal parameters in the future.

Cross Sectional Imaging of Solitary Lesions of the Neurocranium

Background Although a wide range of processes along the neurocranium are of a benign nature, there are often difficulties in the differential diagnosis. Method In the review CT/MRI scans of the head were evaluated retrospectively regarding solitary lesions along the neurocranium. The majority of the lesions were histologically proven. Results The purpose of the review is to present typical pathologies of the neurocranium and provide a systematic overview based on 12 entities, their locations, prevalence and radiological characteristics. Conclusion Processes, which primarily originate from the neurocranium have to be differentiated from secondary processes infiltrating the neurocranium. For this important diagnostic feature, MRI is typically essential, while the definitive diagnosis is often made on the basis of the medical history and the typical appearance on computer tomography. Key Points Citation Format

The genus Parmelina (Parmeliaceae) in the Russian Caucasus

The present study provides a brief survey of the genus Parmelina in the Russian Caucasus (Western Transcaucasia, Western, Central and Eastern Caucasus) with a special emphasis on species distribution. The study area is located in the largest nature reserves of the Russian Caucasus — Kavkazskiy, Utrish, Severo-Osetinskiy, Erzi. This paper contributes to a better understanding of the genus in the Caucasus, focusing mainly on the author’s collections in different regions of the Northern Caucasus in 2008–2016. Four species have been identified from the Russian Caucasus — Parmelina carporrhizans, P. pastillifera, P. quercina and P. tiliacea. Notes on their morphology, anatomy, ecology and distribution are based on data obtained from a study of ca. 20 specimens of each species. The presence of whitish macules on the upper surface of P. carporrhizans (after Clerc, Truong, 2008) as an important diagnostic feature was shown. The Caucasian material shows the differences in size and proportions of ascospores, size and shape of pycnoconidia between critical species P. carporrhizans and P. quercina. An identification key for Caucasian Parmelina species is composed for the first time and can be used for central regions of Russia.

Biometric features and content of phenolic compounds of roseroot (Rhodiola rosea L.)

Roseroot (<em>Rhodiola rosea</em> L.) belongs to important herbs in folk medicine of Scandinavia, Russia, Mongolia, and China. Its therapeutic usage is mainly associated with the adaptogenic properties of this species. Roseroot is characterized by high morphological, phytochemical, and genetic differentiation. The aim of the present work was to determine the biometric and phytochemical co-variability of this taxon. Samples of <em>Rh. rosea</em> were collected from 4-year-old experimental field cultivation established by rhizome division in western Poland. For each plant, the biometric measurements of the clumps, shoots, leaves, and rhizomes with roots were carried out. In the underground plant parts (raw material), the contents of the main active compounds (phenylpropanoids, phenylethanoids, phenolic acids, and catechins) were determined by the HPLC-DAD method. <em>K</em>-means clustering analysis showed three well-separated plant groups of <em>Rh. rosea</em> that differed significantly in the level of most of the investigated components. It was interesting that in the raw material with a high content of phenylethanoids, a low level of phenyl­propanoids was found, and vice versa. These chemical groups clearly differed in luxuriance of plants, too. The important diagnostic feature was also the degree of leaf serration. The morphological and phytochemical co-variability of roseroot was confirmed by the correlations detected between some active compounds (especially catechins and rosavin) and biometric traits describing the size and serration of leaves, the size of clumps and shoots as well as the weight of the raw material.

Utility of an abbreviated version of the executive and social cognition battery in the detection of executive deficits in early behavioral variant frontotemporal dementia patients

The detection of executive deficits in early behavioral variant frontotemporal dementia (bvFTD) is crucial, as impairments in the executive domain constitute an important diagnostic feature of the newly proposed diagnostic criteria for bvFTD. Our group has recently demonstrated that classical executive tests fail to detect the executive deficits of a subgroup of early bvFTD patients. When administered an executive and social cognition battery (ESCB) that includes tasks that mimic everyday scenarios (e.g., affective decision-making, planning and organization, theory of mind), however, the performance of those bvFTD patients differed significantly from that of controls. One limitation of the ESCB is its lengthy nature (approximately 90 min). For this reason, the present study analyzes the usefulness of alternative shorter versions of this battery. We propose one particular two-task combination that demands approximately 30 min for its administration and scoring, and which presents similar discriminatory accuracy as that of the complete ESCB, while maintaining its significantly superior capacity to detect subtle executive deficits in bvFTD patients relative to classical executive tests. We suggest that, in clinical settings where tools, time, or human resources are scarce, this abbreviated ESCB may be useful in the detection of subtle yet impairing executive impairments of patients with bvFTD. (JINS, 2010,16, 687–694.)