Cutaneous pseudolymphoma is a benign, reactive lymphoproliferative disorder that can clinically and histologically mimic cutaneous lymphoma. There are many potential causes of cutaneous pseudolymphoma, including infections, drugs, neoplasms, and other dermatological conditions. Correct diagnosis is important to avoid unnecessary treatment, as cutaneous pseudolymphoma will often resolve spontaneously.
This document discusses cutaneous pseudolymphoma (CPL). It was first described in 1891 and has been called by various names over time. Pseudolymphoma clinically and sometimes histologically mimics lymphoma, but has benign behavior and does not meet criteria for malignant lymphoma. It is characterized by lymphocytic infiltration in the skin in response to stimuli. CPL is classified into types depending on the predominant cell type (B cell vs T cell) and location of infiltration (nodular vs stripe-like). While CPL has no associated mortality, localized variants can cause minor symptoms. Treatment involves excision, corticosteroids, radiation therapy, and immunosuppressants depending on the subtype.
For undergradutes
Revise structure of lymph node and spleen
Classify non-neoplastic lesions
Various histological patterns
Etiologies of each lesion / pattern
Basic Pathological Reactions of the Skin - Dr Zainab Almossalliaskadermatologist
This document summarizes the basic pathological reactions of the skin. It describes the different tissue compartments that make up the skin, including the epidermis, dermal-epidermal junction, papillary dermis, deep dermis, and subcutaneous tissue. It then discusses various pathological processes that can disturb the structure and function of these compartments, such as disturbances in epidermal cell kinetics, differentiation, and cohesion. Specific diseases are provided as clinical correlations for each pathological reaction described. The summary focuses on providing a high-level overview of the key tissue compartments involved and some examples of related pathological processes and diseases.
Subspecialty of dermatology and pathology focused on performing and interpreting tests on human tissue samples to provide scientific data and consultative opinions to referring clinicians
Erythema dyschromicum perstans (EDP), also known as ashy dermatosis, is a chronic skin condition first described in El Salvador characterized by gray-blue hyperpigmented patches. It is most common in Latin America and Asia and affects darker-skinned individuals more often than lighter-skinned ones. While the cause is unknown, it is considered a variant of lichen planus actinicus. Clofazimine is the most effective treatment, as it masks the dyschromias and has anti-inflammatory effects. EDP has a benign course, though it can cause cosmetic complaints.
This document provides information on mastocytosis, a rare condition characterized by too many mast cells in the skin and other tissues. It discusses the epidemiology, pathogenesis, classification, clinical spectrum, clinical features, investigations and treatment of both cutaneous mastocytosis (CM) and systemic mastocytosis (SM). CM typically presents in children as skin lesions like urticaria pigmentosa while SM presents in adults and can involve internal organs. Diagnosis involves skin biopsy for CM and additional tests for SM. Treatment focuses on avoiding triggers and using antihistamines, steroids and newer targeted therapies depending on severity.
This document discusses cutaneous pseudolymphoma (CPL). It was first described in 1891 and has been called by various names over time. Pseudolymphoma clinically and sometimes histologically mimics lymphoma, but has benign behavior and does not meet criteria for malignant lymphoma. It is characterized by lymphocytic infiltration in the skin in response to stimuli. CPL is classified into types depending on the predominant cell type (B cell vs T cell) and location of infiltration (nodular vs stripe-like). While CPL has no associated mortality, localized variants can cause minor symptoms. Treatment involves excision, corticosteroids, radiation therapy, and immunosuppressants depending on the subtype.
For undergradutes
Revise structure of lymph node and spleen
Classify non-neoplastic lesions
Various histological patterns
Etiologies of each lesion / pattern
Basic Pathological Reactions of the Skin - Dr Zainab Almossalliaskadermatologist
This document summarizes the basic pathological reactions of the skin. It describes the different tissue compartments that make up the skin, including the epidermis, dermal-epidermal junction, papillary dermis, deep dermis, and subcutaneous tissue. It then discusses various pathological processes that can disturb the structure and function of these compartments, such as disturbances in epidermal cell kinetics, differentiation, and cohesion. Specific diseases are provided as clinical correlations for each pathological reaction described. The summary focuses on providing a high-level overview of the key tissue compartments involved and some examples of related pathological processes and diseases.
Subspecialty of dermatology and pathology focused on performing and interpreting tests on human tissue samples to provide scientific data and consultative opinions to referring clinicians
Erythema dyschromicum perstans (EDP), also known as ashy dermatosis, is a chronic skin condition first described in El Salvador characterized by gray-blue hyperpigmented patches. It is most common in Latin America and Asia and affects darker-skinned individuals more often than lighter-skinned ones. While the cause is unknown, it is considered a variant of lichen planus actinicus. Clofazimine is the most effective treatment, as it masks the dyschromias and has anti-inflammatory effects. EDP has a benign course, though it can cause cosmetic complaints.
This document provides information on mastocytosis, a rare condition characterized by too many mast cells in the skin and other tissues. It discusses the epidemiology, pathogenesis, classification, clinical spectrum, clinical features, investigations and treatment of both cutaneous mastocytosis (CM) and systemic mastocytosis (SM). CM typically presents in children as skin lesions like urticaria pigmentosa while SM presents in adults and can involve internal organs. Diagnosis involves skin biopsy for CM and additional tests for SM. Treatment focuses on avoiding triggers and using antihistamines, steroids and newer targeted therapies depending on severity.
This document provides definitions and descriptions of terms related to normal skin anatomy and pathology. It begins with labeling diagrams of normal skin structures from the macroscopic to microscopic level. It then covers various skin conditions including pigmentation disorders, benign and malignant epidermal and dermal tumors, dermatoses, bullae, appendage disorders, panniculitis, and infections/infestations. For each condition, it lists key characteristics and histologic findings to aid in identification and diagnosis.
This document discusses various premalignant lesions of the skin. It begins by describing the normal architecture of the skin, including the different layers of the epidermis. It then discusses several specific premalignant lesions in more detail, including actinic keratosis, oral leukoplakia, Bowen's disease, erythroplasia of Queyrat, and Bowenoid papulosis. It also briefly mentions arsenical keratosis, Marjolin's ulcer, Paget's disease, extramammary Paget's disease, and xeroderma pigmentosum. For each condition, it provides information on clinical presentation, histopathology, causative factors, and risk of progression to
This document provides an overview of mast cells, mast cell activation disorders, and mastocytosis. It discusses the development, mediators, and receptors of mast cells. It also covers the epidemiology, pathogenesis, classification, clinical features, diagnosis, and treatment of mast cell activation disorders and mastocytosis. Key points include that mast cells develop from bone marrow stem cells and require stem cell factor for survival, and that mastocytosis is rare and commonly involves the skin and gastrointestinal system.
Chronic actinic dermatitis is a long-term inflammatory skin disorder caused by sun exposure that presents as itchy eczematous patches on light exposed areas. It can develop from pre-existing conditions like eczema or photosensitivity due to drugs. The pathogenesis involves CD8+ T cells causing a delayed hypersensitivity reaction when normal skin proteins are altered by UV light. Diagnosis is based on clinical examination, reduced skin sensitivity to UV light on testing, and histology showing chronic eczema. Treatment focuses on absolute sun protection and topical or oral immunosuppressants depending on severity.
Cysts with a lining of stratified squamous epithelium: Epidermoid cyst
Milium
Trichilemmal cyst
Vellus hair cyst
Steatocystoma
Dermoid cyst
Cysts lined with non-stratified squamous epithelium: Hidrocystoma, Eccrine or Apocrine
Cysts without an epithelial lining: Mucocele
Digital mucous cyst
Ganglion
The document discusses various histopathological techniques for demonstrating fungi in tissue sections. It covers staining methods like Gomori's methenamine silver, PAS, Gridley stain, mucicarmine, Alcian blue, Gram's stain and Ziehl-Neelsen stain. It describes diagnosing different fungal infections based on the morphological appearance of fungi in tissue like Blastomycosis, Cryptococcosis, Aspergillosis and Mucormycosis. Special stains help identify fungi but histopathology should be used along with culture for definitive diagnosis.
various cutaneous lymphomas though having low incidence but need to be diagnosed accurately. they can be mimiced by many non neoplastic conditions of skin. so discussing both T and B cell lymphomas
This document summarizes various immune-mediated bullous lesions of the skin. It describes the different types of blisters and levels at which they can form. The main categories discussed are pemphigus, which involves acantholysis, and subepidermal blistering diseases. Within pemphigus, it describes Pemphigus vulgaris, Pemphigus foliaceus, IgA pemphigus and Paraneoplastic pemphigus. It details the target antigens, histopathology, direct immunofluorescence findings and clinical features of each. For subepidermal blistering, it outlines the structure of the epidermal basement membrane zone and the target antigens in bullous pe
Actinic keratoses: Erythematous scaly lesions on sun-damaged skin & considered “precancerous” lesions that have the potential to progress into invasive SCC.
Bowen’s disease: SCC in situ It has the potential to progress to invasive SCC.
Leukoplakia: Leukoplakia refers to a white patch or plaque on the oral mucosa that cannot be wiped off and cannot be characterized clinically or pathologically as any other disease.
This document discusses the histology and classification of non-neoplastic lymphadenopathy. It begins by describing the histology of lymph nodes, including the capsule, cortex, paracortex, and medulla. Guidelines for examining lymph nodes through grossing, fixation, sectioning and staining are provided. Non-neoplastic lymphadenopathy is classified into lymphadenitides caused by various infectious agents like viruses, bacteria, mycobacteria, fungi and protozoa, and lymphadenopathies associated with clinical syndromes. Specific conditions are then discussed in detail, including their etiology, clinical features, histopathology, special staining, and differential diagnosis.
This document discusses various non-neoplastic and neoplastic conditions that can cause lymphadenopathy. It focuses on filariasis as a cause of non-neoplastic lymphadenopathy. Filarial parasites can infect the lymphatics and lymph nodes, causing inflammation and blockage. On pathology, the lymph nodes show an intense inflammatory reaction around dead or dying larvae with eosinophils and multinucleated giant cells. Rarely, microfilaria can be seen embedded in the lymph node tissue. The document emphasizes that a diligent search is needed to identify the parasite and make an accurate diagnosis.
Special stains in dermato pathology - final copyariva zhagan
This document provides an overview of various special stains used in dermatopathology. It begins by explaining what stains are and their uses, such as enhancing contrast and examining tissues. It then describes the major categories of stains including those for carbohydrates, lipids, microorganisms, connective tissues, and minerals. Specific stains are also outlined, like PAS for glycogen and fungi, Masson's Trichrome for collagen, and Gram staining for bacteria identification. The document concludes by stating several stains used for visualizing structures like mast cells, amyloid, and various microbes under the microscope.
This document provides an overview of immunofluorescence (IF) techniques used in dermatology. IF can be used to directly detect antigens in tissue or indirectly detect circulating antibodies in serum. It involves using fluorescently-labeled antibodies that bind to target antigens, which are then viewed under a fluorescence microscope. Direct IF is used to detect in vivo antigen deposition in skin biopsies, while indirect IF detects circulating antibodies in serum. Modifications include antigen mapping to determine structural protein localization in epidermolysis bullosa, and salt split skin techniques to differentiate subepidermal bullous disorders. IF plays a key role in diagnosing immunobullous diseases and providing insight into the pathogenic mechanisms of various skin conditions.
This document provides information on endoscopic gastrointestinal biopsies and their interpretation. It discusses endoscopy techniques and tools used to visualize the gastrointestinal tract and obtain biopsies. Key points include types of endoscopes, handling of biopsy specimens, processing for histological examination, common indications for endoscopy of the upper gastrointestinal tract, and histological findings and interpretations for conditions of the esophagus and stomach, including chronic gastritis, Helicobacter pylori infection, Barrett's esophagus, and polypoid lesions.
Histoid leprosy is a rare form of multibacillary leprosy characterized by cutaneous or subcutaneous nodules and plaques with a unique histopathology and bacterial morphology. It occurs in patients with reduced cell-mediated immunity and irregular or inadequate treatment for leprosy. Lesions most commonly appear on the back, buttocks, face and extremities as firm, dome-shaped papules. Histopathology shows numerous thin, spindle-shaped histiocytes forming bands and whorls containing large numbers of acid-fast bacilli. Treatment involves multidrug therapy with rifampicin, clofazimine and dapsone over an extended period of at least two years.
The document discusses various types of melanocytic lesions of the skin except melanoma. It describes:
1. Benign pigmented lesions arising from epidermal melanocytes such as freckles, solar lentigines, and melanotic macules.
2. Lesions arising from dermal melanocytes including Mongolian spots, nevi of Ota and Ito, and blue nevi.
3. Benign tumors arising from nevus cells including congenital and acquired nevi, and special variants like Spitz nevi, balloon cell nevi, and dysplastic nevi.
This document discusses primary cutaneous lymphomas, which are a type of non-Hodgkin lymphoma that primarily involves the skin. It notes that primary cutaneous lymphomas can be of either T-cell or B-cell origin. Mycosis fungoides, a type of cutaneous T-cell lymphoma, is then discussed in detail. It accounts for about half of all primary cutaneous lymphomas. The document outlines the clinical features, classification, diagnostic evaluation, staging, and treatment approaches for mycosis fungoides.
This document defines and describes various skin diseases and conditions through macroscopic and microscopic definitions. It discusses acute inflammatory dermatoses such as urticaria, acute eczematous dermatitis, erythema multiforme, erythema nodosum, and erythema induratum. It also covers chronic inflammatory dermatoses like psoriasis, lichen planus, lupus erythematosus, and acne vulgaris. For each condition, it provides details on presentation, histology, and clinical features.
This document provides definitions and descriptions of terms related to normal skin anatomy and pathology. It begins with labeling diagrams of normal skin structures from the macroscopic to microscopic level. It then covers various skin conditions including pigmentation disorders, benign and malignant epidermal and dermal tumors, dermatoses, bullae, appendage disorders, panniculitis, and infections/infestations. For each condition, it lists key characteristics and histologic findings to aid in identification and diagnosis.
This document discusses various premalignant lesions of the skin. It begins by describing the normal architecture of the skin, including the different layers of the epidermis. It then discusses several specific premalignant lesions in more detail, including actinic keratosis, oral leukoplakia, Bowen's disease, erythroplasia of Queyrat, and Bowenoid papulosis. It also briefly mentions arsenical keratosis, Marjolin's ulcer, Paget's disease, extramammary Paget's disease, and xeroderma pigmentosum. For each condition, it provides information on clinical presentation, histopathology, causative factors, and risk of progression to
This document provides an overview of mast cells, mast cell activation disorders, and mastocytosis. It discusses the development, mediators, and receptors of mast cells. It also covers the epidemiology, pathogenesis, classification, clinical features, diagnosis, and treatment of mast cell activation disorders and mastocytosis. Key points include that mast cells develop from bone marrow stem cells and require stem cell factor for survival, and that mastocytosis is rare and commonly involves the skin and gastrointestinal system.
Chronic actinic dermatitis is a long-term inflammatory skin disorder caused by sun exposure that presents as itchy eczematous patches on light exposed areas. It can develop from pre-existing conditions like eczema or photosensitivity due to drugs. The pathogenesis involves CD8+ T cells causing a delayed hypersensitivity reaction when normal skin proteins are altered by UV light. Diagnosis is based on clinical examination, reduced skin sensitivity to UV light on testing, and histology showing chronic eczema. Treatment focuses on absolute sun protection and topical or oral immunosuppressants depending on severity.
Cysts with a lining of stratified squamous epithelium: Epidermoid cyst
Milium
Trichilemmal cyst
Vellus hair cyst
Steatocystoma
Dermoid cyst
Cysts lined with non-stratified squamous epithelium: Hidrocystoma, Eccrine or Apocrine
Cysts without an epithelial lining: Mucocele
Digital mucous cyst
Ganglion
The document discusses various histopathological techniques for demonstrating fungi in tissue sections. It covers staining methods like Gomori's methenamine silver, PAS, Gridley stain, mucicarmine, Alcian blue, Gram's stain and Ziehl-Neelsen stain. It describes diagnosing different fungal infections based on the morphological appearance of fungi in tissue like Blastomycosis, Cryptococcosis, Aspergillosis and Mucormycosis. Special stains help identify fungi but histopathology should be used along with culture for definitive diagnosis.
various cutaneous lymphomas though having low incidence but need to be diagnosed accurately. they can be mimiced by many non neoplastic conditions of skin. so discussing both T and B cell lymphomas
This document summarizes various immune-mediated bullous lesions of the skin. It describes the different types of blisters and levels at which they can form. The main categories discussed are pemphigus, which involves acantholysis, and subepidermal blistering diseases. Within pemphigus, it describes Pemphigus vulgaris, Pemphigus foliaceus, IgA pemphigus and Paraneoplastic pemphigus. It details the target antigens, histopathology, direct immunofluorescence findings and clinical features of each. For subepidermal blistering, it outlines the structure of the epidermal basement membrane zone and the target antigens in bullous pe
Actinic keratoses: Erythematous scaly lesions on sun-damaged skin & considered “precancerous” lesions that have the potential to progress into invasive SCC.
Bowen’s disease: SCC in situ It has the potential to progress to invasive SCC.
Leukoplakia: Leukoplakia refers to a white patch or plaque on the oral mucosa that cannot be wiped off and cannot be characterized clinically or pathologically as any other disease.
This document discusses the histology and classification of non-neoplastic lymphadenopathy. It begins by describing the histology of lymph nodes, including the capsule, cortex, paracortex, and medulla. Guidelines for examining lymph nodes through grossing, fixation, sectioning and staining are provided. Non-neoplastic lymphadenopathy is classified into lymphadenitides caused by various infectious agents like viruses, bacteria, mycobacteria, fungi and protozoa, and lymphadenopathies associated with clinical syndromes. Specific conditions are then discussed in detail, including their etiology, clinical features, histopathology, special staining, and differential diagnosis.
This document discusses various non-neoplastic and neoplastic conditions that can cause lymphadenopathy. It focuses on filariasis as a cause of non-neoplastic lymphadenopathy. Filarial parasites can infect the lymphatics and lymph nodes, causing inflammation and blockage. On pathology, the lymph nodes show an intense inflammatory reaction around dead or dying larvae with eosinophils and multinucleated giant cells. Rarely, microfilaria can be seen embedded in the lymph node tissue. The document emphasizes that a diligent search is needed to identify the parasite and make an accurate diagnosis.
Special stains in dermato pathology - final copyariva zhagan
This document provides an overview of various special stains used in dermatopathology. It begins by explaining what stains are and their uses, such as enhancing contrast and examining tissues. It then describes the major categories of stains including those for carbohydrates, lipids, microorganisms, connective tissues, and minerals. Specific stains are also outlined, like PAS for glycogen and fungi, Masson's Trichrome for collagen, and Gram staining for bacteria identification. The document concludes by stating several stains used for visualizing structures like mast cells, amyloid, and various microbes under the microscope.
This document provides an overview of immunofluorescence (IF) techniques used in dermatology. IF can be used to directly detect antigens in tissue or indirectly detect circulating antibodies in serum. It involves using fluorescently-labeled antibodies that bind to target antigens, which are then viewed under a fluorescence microscope. Direct IF is used to detect in vivo antigen deposition in skin biopsies, while indirect IF detects circulating antibodies in serum. Modifications include antigen mapping to determine structural protein localization in epidermolysis bullosa, and salt split skin techniques to differentiate subepidermal bullous disorders. IF plays a key role in diagnosing immunobullous diseases and providing insight into the pathogenic mechanisms of various skin conditions.
This document provides information on endoscopic gastrointestinal biopsies and their interpretation. It discusses endoscopy techniques and tools used to visualize the gastrointestinal tract and obtain biopsies. Key points include types of endoscopes, handling of biopsy specimens, processing for histological examination, common indications for endoscopy of the upper gastrointestinal tract, and histological findings and interpretations for conditions of the esophagus and stomach, including chronic gastritis, Helicobacter pylori infection, Barrett's esophagus, and polypoid lesions.
Histoid leprosy is a rare form of multibacillary leprosy characterized by cutaneous or subcutaneous nodules and plaques with a unique histopathology and bacterial morphology. It occurs in patients with reduced cell-mediated immunity and irregular or inadequate treatment for leprosy. Lesions most commonly appear on the back, buttocks, face and extremities as firm, dome-shaped papules. Histopathology shows numerous thin, spindle-shaped histiocytes forming bands and whorls containing large numbers of acid-fast bacilli. Treatment involves multidrug therapy with rifampicin, clofazimine and dapsone over an extended period of at least two years.
The document discusses various types of melanocytic lesions of the skin except melanoma. It describes:
1. Benign pigmented lesions arising from epidermal melanocytes such as freckles, solar lentigines, and melanotic macules.
2. Lesions arising from dermal melanocytes including Mongolian spots, nevi of Ota and Ito, and blue nevi.
3. Benign tumors arising from nevus cells including congenital and acquired nevi, and special variants like Spitz nevi, balloon cell nevi, and dysplastic nevi.
This document discusses primary cutaneous lymphomas, which are a type of non-Hodgkin lymphoma that primarily involves the skin. It notes that primary cutaneous lymphomas can be of either T-cell or B-cell origin. Mycosis fungoides, a type of cutaneous T-cell lymphoma, is then discussed in detail. It accounts for about half of all primary cutaneous lymphomas. The document outlines the clinical features, classification, diagnostic evaluation, staging, and treatment approaches for mycosis fungoides.
This document defines and describes various skin diseases and conditions through macroscopic and microscopic definitions. It discusses acute inflammatory dermatoses such as urticaria, acute eczematous dermatitis, erythema multiforme, erythema nodosum, and erythema induratum. It also covers chronic inflammatory dermatoses like psoriasis, lichen planus, lupus erythematosus, and acne vulgaris. For each condition, it provides details on presentation, histology, and clinical features.
A comprehensive review of Cutaneous Lymphomas - both B-Cell and T-Cell with latest treatment strategies. Target audience are oncologists, dermatologists, oncology physicians, dermatology and oncology fellows
This document discusses different types of panniculitis, which is inflammation of subcutaneous fat. It begins by describing the normal morphology of subcutaneous fat and its limited responses to injury, which include fat necrosis. It then covers the different forms of panniculitis, including septal and lobular panniculitis associated with vascular disorders. Specific conditions are discussed like pancreatic panniculitis, lupus panniculitis, and those associated with vasculitis. Later sections focus on different histopathological presentations, stages of lesions, and conditions that can present similarly to calciphylaxis. In summary, the document provides an overview of the classification, causes, histology, and presentations
The document summarizes two cases of Kimura disease seen on CT and MR imaging. In Case 1, the lesion showed slightly high intensity on T2-weighted MR and low to intermediate intensity on T1-weighted images. It enhanced intermediately. In Case 2, the lesion showed very high intensity on T2-weighted images and marked enhancement on gadolinium-enhanced T1-weighted images. Kimura disease typically presents as an asymptomatic mass and lymphadenopathy in the head and neck region, especially the parotid and submandibular glands, in Asian patients in their second to third decades of life.
Delsym is launching a new 12-hour tablet formulation of their cough medicine. The campaign will promote the tablets' extended release feature that suppresses coughs for 12 hours and target busy, on-the-go consumers. Delsym will create various marketing materials including banner ads, packaging, magazine ads, and brochures that emphasize the tablets' convenience and position Delsym as the #1 recommended cough suppressant brand. The goal is to transform Delsym into the leading cough suppressant brand with the new tablet launch.
Final version histologic intepretation of bxs for dermatitisMarco Fusaro
This document provides an overview of interpreting pathology reports for dermatitis biopsies. It discusses biopsy techniques, terminology used in dermatopathology reports, and patterns seen in common types of dermatitis. Key points include that punch biopsies are preferred over shave biopsies for dermatitis. Common tissue reaction patterns seen include spongiotic, lichenoid, psoriasiform, and granulomatous inflammation. The cellular composition and location of the inflammatory infiltrate provides clues to different diagnoses. Clinical history is essential for dermatopathologists to accurately interpret biopsies.
This document summarizes various diagnostic tests for drug allergies, including immediate and delayed reaction tests. It describes skin prick tests and intradermal skin tests for immediate reactions, which are sensitive but skin prick tests are simpler. It also discusses IgE drug allergy tests and basophil activation tests. For delayed reactions, it covers lymphocyte transformation tests, patch tests, and drug challenges. Patch tests are frequently positive for certain drug eruptions while lymphocyte transformation and basophil activation tests have limited sensitivity.
SMi’s 3rd annual conference
Immunogenicity
13th and 14th June 2016, Holiday In Kensington Forum, London, UK.
Immunogenicity of an antigen is frequently encountered in the context of vaccine development, an area of intense interest currently due to the emergence or re-emergence of infectious pathogens with the potential for worldwide spread. With the global vaccine market expected to reach $84.44 billion by 2022, now is the time engage with industry experts to addresses the real challenges with immunogenicity including assay assessment, the role of aggregation, the introduction of nanobodies and many more!
For further information or to register please visit the event website www.immuno.co.uk or contact Matthew Apps on +44 (0) 207 827 6093 or mapps@smi-online.co.uk
This document summarizes the histopathological features of Kikuchi-Fujimoto Disease (KFD). KFD is characterized by a necrotizing lymphadenitis without neutrophil infiltration, distinguishing it from other diseases that involve lymph nodes. The histopathology of KFD evolves through three stages - proliferative, necrotizing, and xanthomatous - though sequential biopsies are needed to confirm this progression. While the necrotizing form is most common, the stages may represent differences in disease progression or host response. Overall, the document outlines the distinctive pathological features of KFD.
The document discusses allergies, providing statistics showing that 55% of people have allergies and 33% develop one food allergy. It then discusses common food allergies like shellfish, milk, peanuts, wheat and eggs. It also discusses skin conditions like atopic dermatitis and contact dermatitis. Other sections cover signs and symptoms of allergies, causes of allergies including genetic and environmental factors, treatments, prevention methods, and allergy tests. It notes allergies can affect daily life through disrupted sleep and limited activities.
This document discusses psoriasis and scabies. Psoriasis is a chronic inflammatory skin disorder characterized by thickened, scaly plaques that affects 1.5-3% of the population worldwide. Scabies is a contagious skin infection caused by the mite Sarcoptes scabiei that causes intense itching. Treatment for psoriasis includes topical therapies like corticosteroids and vitamin D analogues, phototherapy, and systemic immunosuppressants. Scabies is transmitted through direct skin contact and presents as a pimple-like rash and sores from scratching.
Siguiente seminario habla de las ultimas pautas de cáncer gástrico en Venezuela. Es realizado por LOUWIS PEREZ, estudiante de la Universidad Experimental Romulo Gallegos (UNERG)de la República Bolivariana de Venezuela, cursante de 5 to año de Medicina, en el Hospital "Victorino Santaella Ruiz".
The Future of Allergy and Clinical Immunology Prof. G. Walter Canonica - Con...Juan Carlos Ivancevich
Prof.G.Walter Canonica
Allergy and Respiratory Diseases Clinic
DIMI-‐University of Genoa
Italy
Presidente Congreso SLaai 2015: Dr. Alfonso Cepeda Sarabia
1. Penicillin is the most prevalent reported medication allergy, though up to 90% of reported allergies are inaccurate due to factors like mislabeling or reactions caused by underlying infections rather than the drug.
2. Penicillin allergy diagnosis requires consideration of the chemical structure of penicillin and related drugs, the mechanisms of cross-reactivity, and test methods like skin testing and drug provocation.
3. Skin testing with penicillin reagents including the major determinant (benzylpenicilloyl-polylysine) and minor determinant mixture is currently the most reliable diagnostic method for evaluating IgE-mediated penicillin allergy.
Understanding Hyperpigmentation and Treating with Combined Strategies - NEW ...Jordana Lewis
The document discusses hyperpigmentation and melasma, outlining the causes and types of hyperpigmentation as well as protocols for treating it using a Yellow Peel chemical peel approach with combinations of retinol, salicylic acid, phytic acid, kojic acid, azelaic acid, and other ingredients over multiple treatments tailored to a patient's skin type and level of hyperpigmentation. The Yellow Peel protocols provide guidance on application times and endpoints based on a patient's phototype and hyperpigmentation severity to safely and effectively treat conditions like melasma, sun damage, and other causes of dark patches and spots on the skin
The document discusses haematological malignancies, describing:
1. How genetic mutations in haemopoietic stem cells disrupt normal blood cell differentiation, causing diseases depending on the affected differentiation pathway.
2. The main types of leukaemias including acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML), and chronic lymphocytic leukaemia (CLL).
3. Other haematological malignancies like myeloproliferative disorders, lymphomas, and multiple myeloma.
This document classifies and describes various oral white lesions. It discusses hereditary lesions such as leukoedema and white sponge nevus. Reactive lesions including frictional keratosis and nicotine stomatitis are covered. Preneoplastic lesions like actinic cheilitis and idiopathic leukoplakia are summarized. Other white lesions such as geographic tongue and lichen planus are also described. Non-epithelial lesions including candidiasis and Fordyce's granules are briefly outlined. Definitions of histopathological features and guidelines for differential diagnosis are provided.
Primary skin lesions include macules, papules, plaques, nodules, tumors, and wheals. Secondary lesions develop from primary lesions and include scales, crusts, excoriations, fissures, erosions, ulcers, and scars. Special lesions occur under certain conditions and include erythema, telangiectasia, purpura, petechiae, ecchymoses, vibices, and hematomas. The document provides detailed definitions and descriptions of these various skin lesions.
The document defines and describes various dermatopathological terms including their diagnostic significance. It discusses terms like acantholysis, acanthosis, anaplasia, apoptosis, bullae, basal lamina, colloid body, crust, and curlicue pattern. Acantholysis involves loss of adhesion between keratinocytes. Acanthosis is an increase in epidermal cell layers seen in conditions like psoriasis and eczema. Anaplasia refers to abnormal nuclear features in malignant cells. Apoptosis describes programmed cell death seen in conditions like lichen planus.
Dermatomyositis is a chronic inflammatory disorder of the skin and muscles that is characterized by an autoimmune pathogenesis. It commonly presents with characteristic rashes like Gottron's papules and heliotrope rash as well as proximal muscle weakness. Dermatomyositis can also involve internal organs like the lungs, esophagus and heart. Diagnosis involves assessing clinical features, muscle enzymes, electromyography, muscle/skin biopsies and identifying myositis-specific antibodies. Prognosis depends on the severity and organ involvement, with risks of residual weakness, contractures and death from respiratory or cardiac complications.
Dermatomyositis is a chronic inflammatory disorder of the skin and muscles that is considered an autoimmune disease. Key characteristics include Gottron's papules over the fingers and knuckles, a heliotrope rash around the eyes, and proximal muscle weakness. While muscle involvement is usually present, some patients experience clinically amyopathic dermatomyositis without obvious muscle findings. Interstitial lung disease is a common complication and a leading cause of mortality. Diagnosis involves assessing characteristic rashes and lesions, muscle enzyme levels, muscle biopsy, and ruling out other potential causes through testing.
This document provides information on dermatological syndromes and eczema. It begins with objectives of recognizing common eczema signs and symptoms, making differential diagnoses, and understanding disease evolution. It then covers skin components and cell junctions. Eczema is defined as a recurrent inflammatory skin condition characterized by dry, itchy skin that can affect all ages. Differential diagnoses for eczema include infections, psoriasis, and contact dermatitis. Etiology is multifactorial involving genetic susceptibility and environmental triggers. Pathophysiology involves impaired skin barrier function and immune responses mediated by Th2 cells. Scoring systems like EASI are used to measure severity.
Lichenoid Dermatoses, Characteristics of Lichenoid Dermatoses, What are the Major Lichenoid Dermatoses, Lichen planus (LP), Introduction of LP, Epidemiology of LP, Etiology of LP, Pathogenesis of LP, Clinical Features & Clinical variants of LP, Histopathology of LP, Immunohistochemistry of LP, Differential Diagnosis of LP, Treatment of LP
MALT lymphoma arises from mucosa-associated lymphoid tissue (MALT) found along mucosal surfaces. It most commonly involves the stomach and is often associated with H. pylori infection. Histologically, it ranges from resembling normal MALT to displaying lymphoepithelial lesions and infiltration of lymphoma cells. Immunohistochemistry shows B-cell markers and molecular testing can identify translocations involved in pathogenesis. IPSID is a subtype associated with C. jejuni infection seen in certain regions. Staging involves extent of involvement from mucosa to large masses with cytologic atypia.
Vascular tumors can be benign, intermediate, or malignant. Benign tumors include hemangiomas which are localized collections of blood vessels. Capillary hemangiomas are common in infants and usually regress by age 7. Cavernous hemangiomas contain large blood-filled spaces. Lymphangiomas are lymphatic system analogs. Benign glomus tumors arise from specialized cells and cause pain. Kaposi sarcoma is an intermediate tumor associated with HHV-8 and can range from indolent to aggressive depending on subtype. Malignant tumors include angiosarcomas, which demonstrate invasion and metastasis and have a poor prognosis. Hemangiopericytomas also have potential for malignant behavior.
The document summarizes key aspects of the lymphatic system and disorders that can affect it. It describes the functions and divisions of the lymphatic system, including circulating lymph and lymphoid tissues. It then discusses several lymphatic disorders like lymphedema, lymphangiomatosis, and lymphangiosarcoma. The document also reviews the spleen's roles in filtering blood and immunity. It lists several disorders that can cause splenomegaly and types of splenic disorders. Finally, it examines the thymus's role in immunity and discusses thymic hyperplasia, thymoma, and characteristics of benign and malignant thymoma.
This document discusses primary cutaneous lymphomas, specifically mycosis fungoides. It notes that mycosis fungoides accounts for about 50% of primary cutaneous lymphomas and presents as erythematous patches or plaques on the skin that can progress to tumors or generalized erythema. Diagnosis involves skin biopsy showing atypical lymphocytes in the epidermis and classification using the WHO-EORTC system. Prognosis depends on stage, with patch/plaque stage having the best survival and visceral involvement the worst. Treatment aims to control symptoms and involves skin-directed therapies like phototherapy or topical chemotherapy as well as systemic therapies for advanced disease.
This document discusses primary cutaneous lymphomas, specifically mycosis fungoides. It notes that mycosis fungoides accounts for about 50% of primary cutaneous lymphomas and presents as erythematous patches or plaques on the skin that can progress to tumors or generalized erythema. Diagnosis involves skin biopsy showing atypical lymphocytes in the epidermis and classification using the WHO-EORTC system. Prognosis depends on stage, with patch/plaque stage having the best survival and visceral involvement the worst. Treatment aims to control symptoms and involves skin-directed therapies like phototherapy or topical chemotherapy as well as systemic therapies for advanced disease.
This document discusses the classification and characteristics of mature lymphoid neoplasms. It covers several types of B-cell and T-cell/NK-cell neoplasms as well as Hodgkin's lymphoma. Chronic lymphocytic leukemia is described in more detail, including that it involves the accumulation of B lymphocytes in the blood, bone marrow, lymph nodes and spleen. Diagnosis involves blood tests and bone marrow aspiration showing lymphocytic dominance. Hodgkin's lymphoma is characterized by the presence of Reed-Sternberg cells in lymph node biopsies and generally has a high survival rate when detected early.
Lichen planus is a common inflammatory skin disease characterized by flat-topped, shiny papules that can occur on the wrists, trunk, thighs, shins and genitals. Oral lichen planus often presents as white lacy lines or erosive ulcers inside the cheeks and affects females more than males. Treatment includes topical corticosteroids. Lichen nitidus features small, shiny papules on the penis and abdomen while lichen striatus causes linear papules along lines of Blaschko, typically in children. Lichen sclerosus et atrophicus presents as white patches that can cause scarring and atrophy, particularly affecting female genitalia.
Here are the answers to your questions:
1. Common types of salivary gland benign tumors with origin of each:
- Pleomorphic adenoma - originates from the intercalated duct cells and myoepithelial cells.
- Oncocytic tumors - originate from the striated duct cells.
- Acinous cell tumors - originate from the acinar cells.
- Mucoepidermoid tumors and squamous cell carcinomas develop in the excretory duct cells.
2. The histological features of mucoepidermoid carcinoma include:
- Containing mucin-producing cells and epithelial cells of the epidermoid variety.
- Divided into
Automated cell counter & its quality controlSaikat Mandal
This document discusses various premalignant lesions of the skin, including actinic keratosis, oral leukoplakia, Bowen's disease, erythroplasia of Queyrat, and bowenoid papulosis. It describes the clinical presentation, histological features, causative factors, and risk of progression to squamous cell carcinoma for each condition. The document focuses on describing the characteristic layers and cell types found in normal skin and how these features are altered in the various premalignant lesions.
csf.pptx found in spinal cord. Csf is collected by lambar punctureLincyJohny1
The CSF is formed by the choroid plexus in the brain and maintains a constant chemical makeup. Examination of CSF cells and components can help diagnose CNS diseases. Normal CSF contains few lymphocytes and monocytes. Increased or transformed cells may indicate conditions like meningitis, multiple sclerosis, or cancers like medulloblastoma. Specific leukemias and lymphomas can also be identified in the CSF through cytological analysis of cell morphology and markers.
This document discusses systemic lupus erythematosus (SLE) and conditions that can mimic its presentation. It describes how SLE often has a waxing and waning chronic course that can vary in severity. Several infectious, inflammatory, and neoplastic conditions can present similarly to SLE through involvement of multiple organ systems and production of autoantibodies. Correct diagnosis requires a thorough history, physical exam, targeted testing, and biopsies to distinguish SLE from its mimickers. Serological similarities alone do not confirm SLE if clinical features are inconsistent.
The document contains medical images and descriptions of various conditions:
1) Images show lesions and rashes characteristic of conditions like pyoderma gangrenosum, dermatitis herpetiformis, and livedo reticularis.
2) Radiographic images depict abnormalities related to osteonecrosis, DISH syndrome, and Gardner's syndrome.
3) Microscopic slides show cellular features of diseases such as malaria, CLL, and Goodpasture's syndrome.
1. Viral infections like verruca vulgaris (wart) caused by human papillomavirus and moluscum contagiosum caused by poxvirus can infect the eyelid. Warts clinically appear as elevated papillary lesions and moluscum contagiosum appear as dome-shaped waxy nodules.
2. Degenerative diseases like xanthelasma and amyloidosis can affect the eyelid. Xanthelasma clinically appears as bilateral yellow plaques on the eyelids and amyloid deposits appear as multiple waxy nodules.
3. Various neoplasms can occur in the eyelid including seborrheic keratosis, basal cell carcinoma, squamous
NON-MALIGNANT REACTIVE DISORDERS OF LYMPHOCYTEShm alumia
This document discusses non-malignant reactive disorders of lymphocytes. It describes the history of identifying variant lymphocytes and three main types of variant lymphocytes: Type I plasmacytoid lymphocytes, Type II lymphocytes seen in infectious mononucleosis, and Type III transformed lymphocytes. The morphology of each cell type is defined along with the process of lymphocyte transformation in response to antigens. Differential diagnoses are discussed where reactive lymphocytes are seen, including infectious mononucleosis, cytomegalovirus, and toxoplasmosis. Conditions of absolute and relative lymphocytosis with normal or variant lymphocyte morphology are also outlined.
The document discusses salivary gland diseases, focusing on sialadenitis (inflammation of the salivary glands) and salivary gland tumors. Sialadenitis can be caused by viruses, bacteria, or autoimmune disorders. The most common viral cause is mumps. Bacterial sialadenitis often results from ductal obstruction. Chronic sialadenitis is usually caused by Sjögren's syndrome. Common benign salivary gland tumors include pleomorphic adenoma, Warthin's tumor, and monomorphic adenomas. Malignant tumors include mucoepidermoid carcinoma and adenoid cystic carcinoma.
This document provides guidance on the pathological assessment of colorectal resection specimens. It describes the different types of colorectal surgery specimens and margins that need assessment. It discusses the total mesorectal excision technique for rectal cancers and how to evaluate the quality of the surgery. Key pathological features that require reporting are described, including tumor staging, lymphovascular invasion, perineural invasion, tumor budding and tumor deposits. The document provides details on lymph node assessment and reporting colorectal cancers using a synoptic format.
Prion diseases are rapidly progressive neurodegenerative disorders caused by abnormal prion proteins (PrP) that can be sporadic, inherited, or transmitted. They include Creutzfeldt-Jakob disease (CJD) in humans and related diseases in other animals. Prion diseases are characterized by brain vacuoles and dementia. Normal PrP converts to an abnormal beta-sheet form (PrPsc) that accumulates in the brain and causes neurodegeneration through an unknown mechanism. Variant CJD results from exposure to bovine spongiform encephalopathy. There are no cures, so prevention focuses on infection control and screening high-risk populations.
The document summarizes the mechanisms of kidney allograft rejection. T lymphocytes recognize donor antigens through direct or indirect presentation by antigen presenting cells, and initiate either antibody-mediated rejection through antibody binding and complement activation or T-cell mediated rejection through T-cell infiltration and cytokine release. The innate immune system also contributes through toll-like receptor activation and complement factors. Histologic findings are used to classify rejection.
Parasitic diseases of the central nervous systemShahin Hameed
This document summarizes several parasitic infections that can affect the central nervous system. It discusses the epidemiology, life cycle, clinical manifestations, pathogenesis, pathology, and diagnosis of cerebral malaria caused by Plasmodium falciparum and Plasmodium vivax parasites, toxoplasmosis caused by Toxoplasma gondii, and human African trypanosomiasis caused by Trypanosoma brucei. Cerebral malaria presents with seizures, confusion, and coma and is caused by parasite sequestration in brain blood vessels. Toxoplasmosis commonly causes encephalitis in immunocompromised individuals and congenital infections. Trypanosomiasis involves chronic meningitis and
This document discusses whole blood, blood components, and blood derivatives. Whole blood contains all blood components, while blood components are parts separated from whole blood through centrifugation or apheresis. Blood derivatives are products made from fractionating plasma from multiple donors. The document describes various blood components like packed red blood cells, platelets, fresh frozen plasma and cryoprecipitate. It also discusses blood derivatives including albumin, coagulation factor concentrates, and immunoglobulins. It provides details on how these products are prepared, stored, and used to treat different conditions.
This document discusses the approach to patients with monoclonal immunoglobulin disorders. It covers the classification of Ig abnormalities, the evaluation needed for diagnosis including medical history and laboratory tests, and methods to detect monoclonal proteins such as protein electrophoresis, immunofixation, quantitative immunoglobulins, and urine and bone marrow studies. It also discusses non-IgM monoclonal gammopathy of undetermined significance (MGUS), its clinical management and risk of progression to multiple myeloma (MM). Patients with MGUS should be followed indefinitely due to the ongoing risk of progression.
Bernard-Soulier syndrome is a rare inherited bleeding disorder characterized by large platelets and prolonged bleeding times. It results from mutations that cause a dysfunctional platelet glycoprotein receptor complex, leading to defective platelet adhesion. Patients present with mucocutaneous bleeding from an early age. Diagnosis involves identifying thrombocytopenia, large platelets on smear, and abnormal platelet aggregation tests. Treatment focuses on transfusions and minimizing trauma; stem cell transplantation may be considered for severe cases.
Microvillous inclusion disease (MVID), also known as microvillous atrophy, is a rare congenital disorder characterized by severe watery diarrhea that begins within the first days of life. The diarrhea is caused by morphological abnormalities in the small intestine that prevent proper nutrient absorption. Diagnosis is made through small intestine biopsy showing atrophy of microvilli and inclusion bodies on electron microscopy. There is no cure, and patients require long-term total parental nutrition and risk complications like liver failure. While transplantation can cure MVID, the underlying genetic cause remains unknown.
This document discusses maternal mortality and various causes of death during or after pregnancy. It covers direct causes like preeclampsia, amniotic fluid embolism, and postpartum hemorrhage. Indirect causes discussed include sudden cardiac death, venous thromboembolism, and infections. The document provides details on evaluating different conditions pathological findings. It stresses the importance of a thorough autopsy including samples, cultures, and examination of key organs to determine the cause of maternal death.
The document discusses models for evaluating translational research. It proposes a process marker model that views translational research as a continuous process from basic research to impacts on health outcomes. This model uses observable process markers along the continuum that can be measured, such as dates, to evaluate the duration between stages. This approach avoids debates around definitions and phases and allows for a common framework to link evaluation studies. Key challenges include developing clear yet complex models and relying on descriptive statistics for results.
This document discusses various types of crystalline nephropathies, which are renal injuries caused by crystal deposition in the kidneys. It divides crystalline nephropathies into four categories: those seen with dysproteinemias, drug-induced, calcium-related, and those related to metabolic disorders. Specific examples discussed in detail include light chain cast nephropathy, Fanconi syndrome caused by light chains, sulfadiazine, acyclovir, and indinavir crystals. Calcium phosphate nephropathy, oxalate nephropathy, uric acid nephropathy, and cystinosis are also summarized. The document stresses the importance of clinical correlation for accurate diagnosis and
This document discusses human leukocyte antigen (HLA) gene locus and HLA matching in organ transplantation. It contains the following key points:
1. HLA genes encode antigen-presenting molecules that are crucial for the immune system's recognition of self vs. non-self. Close HLA matching between donor and recipient is important for transplant success.
2. Modern HLA typing techniques include DNA-based methods like sequence-specific priming and probing, as well as serological detection methods using lymphocyte microcytotoxicity assays.
3. Achieving an accurate HLA match and minimizing recipient immune response requires histocompatibility testing of HLA genes as well as immunosuppressive therapy after transplantation.
We are distracted every 11 minutes and it takes 25 minutes to refocus. Focus is a scarce resource for leaders due to constant distractions. Developing focus requires self-management including identifying your strengths, managing your time well, and creating an environment conducive to flow. Mastering focus through self-management makes leaders and their organizations more successful by allowing leaders to be a greater asset and better address challenges.
This document discusses vitamin and mineral deficiencies. It describes the fat-soluble and water-soluble vitamins, how deficiencies can be primary or secondary, and provides details on specific vitamin deficiencies like vitamins A, D, and C. Vitamin A deficiency can cause night blindness and xerophthalmia. Vitamin D deficiency results in rickets in children and osteomalacia in adults. Scurvy is caused by vitamin C deficiency and is characterized by bone disease and hemorrhages.
Crohn's disease is a chronic inflammatory bowel disease that can involve any part of the gastrointestinal tract. Metastatic Crohn's disease (MCD) is a rare cutaneous manifestation where noncaseating granulomatous skin lesions occur at sites separate from the GI tract in patients with Crohn's. MCD most often presents as papules, plaques or nodules on the arms, legs, genitalia and face. Histopathology of MCD shows granulomatous inflammation in the dermis. Treatment options include steroids, antibiotics, immunosuppressants, infliximab and surgery.
Megaloblastic Anaemia - Vit B12 deficiencyShahin Hameed
This document discusses megaloblastic anemia caused by vitamin B12 deficiency. It covers the normal metabolism and absorption of vitamin B12, the causes of deficiency including pernicious anemia, clinical features such as macrocytic anemia and neurological changes, diagnostic tests, and management with parenteral B12 injections. Deficiency results in defective DNA synthesis and affects all proliferating cells.
Carcinoma of the gallbladder is the most common malignancy of the extrahepatic biliary tract. It occurs most frequently in the seventh decade of life and has a poor 5-year survival rate of around 5-12% despite surgical intervention. The most important risk factor is gallstones, present in 95% of cases. Carcinomas of the gallbladder show infiltrating or exophytic patterns of growth and are usually adenocarcinomas, though some are squamous cell carcinomas. They typically invade the liver and involve lymph nodes by the time of discovery.
The document summarizes the structure of mammalian cells. It describes the key organelles including the nucleus which houses the genetic material, the endoplasmic reticulum which synthesizes proteins, the Golgi apparatus which modifies and packages proteins and lipids, mitochondria which generate energy, and lysosomes which digest waste. It also discusses the plasma membrane which encloses the cell and cytoskeleton which provides structure. Electron micrographs provide visual examples of these organelles.
This document discusses the epidemiology, pathogenesis, and histopathology of fatty liver disease. It covers both non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD). For NAFLD, key points include its increasing prevalence due to the rise in obesity and diabetes. The pathogenesis involves insulin resistance leading to lipid accumulation in the liver. Histologically, NAFLD is graded based on steatosis, lobular inflammation, and hepatocyte ballooning. For ALD, heavy drinking can lead to steatosis in most people, while a subset develop alcoholic steatohepatitis. The pathogenesis of ALD also involves oxidative stress and cytokine pathways. Liver biopsy remains the gold standard
This document defines and describes gestational trophoblastic disease, which includes abnormal placentas and gestational tumors. It covers topics like complete and partial hydatidiform moles, invasive and metastatic moles, gestational choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. Prognostic factors, treatment approaches, and histopathological features are discussed for different conditions. The genetics, clinical presentation, imaging and spread of these gestational diseases are also summarized.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
2. DEFINITION
Cutaneous pseudolymphoma is defined by the
WHO as a reactive polyclonal benign
lymphoproliferative disease, predominantly
composed of either B-cells or T-cells, localised
or disseminated.
3. CLINICAL ASPECTS
Clinical manifestations are frequently not
diagnostic and overlap with lymphoma.
Two main problems exist:
1. Lesional regression is common in cutaneous
lymphoma and accordingly, regression does not
necessarily indicate that the lesion is
pseudolymphoma.
2. Occasional cases of initial cutaneous
pseudolymphoma can evolve into lymphoma (so-
called ‘pseudo-pseudolymphoma’)
4. In general, pseudolymphoma is rare on the
scalp and never displays clinical poikiloderma.
In addition, lesions showing variability in
size, shape and colour and occuring in non-
exposed skin (such as buttocks) should be
regarded as cutaneous T-cell lymphoma (CTCL)
until proved otherwise.
6. EPITHELIAL NEOPLASMS:
Tumours such as neuroendocrine carcinoma
(Merkel cell tumour), neuroblastoma and
primitive neuro-ectodermal tumour can mimic
cutaneous lymphoma.
Epidermal involvement in Merkel cell tumour
can result in intra-epithelial collections of
cells that mimic Pautrier micro-abscesses in
CTCL
7. LYMPHOCYTE-RICH
EPITHELIAL NEOPLASMS
Classically these include eccrine
spiradenoma and lympho-epithelioma-like
carcinoma of the skin.
A more recent entity is cutaneous lymph-
adenoma, although increasingly this is
regarded as a trichoblastoma with
adamantinoid features
8. CUTANEOUS LYMPHADENOMA
There is outer palisading of cells, focally with clear-cell
change, within a loose fibrous stroma. There is also focal pigment
and a possible papillary mesenchymal body (lower left edge).
Numerous intraepithelial lymphocytes are present, characteristic of
this lesion.
9. IMMUNE RESPONSE TO EPITHELIAL
DYSPLASIA OR MALIGNANCY AND
OTHER NEOPLASMS
Cutaneous neoplasms such as basal cell
carcinoma, malignant melanoma and
dermatofibroma can elicit extremely
strong lymphocytic stromal responses, in
which the underlying neoplasm can be
difficult to identify.
Lymphomatoid variants of actinic
keratosis and benign lichenoid keratosis
(lichen planus-like keratosis) exist.
10. DISEASES SEEN
UNCOMMONLY IN THE SKIN
Include
Extramedullary haemopoiesis,
Malakoplakia,
Whipple’s disease
Ectopic thymus
Rosai-Dorfman disease
Inflammatory pseudotumour,
Castleman’s disease and
Kikuchi’s disease.
11. ROSAI-DORFMAN DISEASE:
Can herald, co-exist with or follow nodal or
systemic disease
Its histologic appearance is usefully
remembered by the alternative term of
histiocytic lymphophagocytic panniculitis.
S100 positive
Moderate number of plasma cells present and
stroma appears sclerotic or storiform.
13. INFLAMMATORY PSEUDOTUMOURS:
A spectrum of disease that incorporates
plasma cell granuloma and inflammatory
myofibroblastic tumour.
Former can display germinal centres, plasma
cells and fibrosis.
The latter displays myofibroblastic
proliferation and 2p23 re-arrangement
14. CASTLEMAN’S DISEASE:
especially the plasma cell variant, can
present in the skin and in particular the
vulva.
The identification of human herpes
virus type 8 can be helpful.
15. KIKUCHI’S DISEASE:
Display the characteristic features of
necrosis, karyorrhexis, apoptosis, immu
noblasts and plasma cells.
Exclude possibility of lupus
erythematosus.
16. CLASSICAL DERMATOSES
Many classic dermatoses mimic lymphoma and
this is particularly frequent with autoimmune and
connective tissue disorders.
1. Lupus erythematosus
2. Lichen sclerosus
3. Pigmented purpuric dermatosis and lichen
aureus
4. Lymphomatoid dermatitis/eczema
5. Lymphotoid folliculitis
6. Acne rosacea
17. 7. Angiolymphoid hyperplasia and Kimura’s
disease
8. Chronic photodermatoses
9. Perniosis (chilblains)
10. Annular erythemas
11. Traumatic ulcerative granuloma
(eosinophilic ulcer/granuloma of the
tongue)
12. Jessner and Kanof’s lymphocytic
infiltration of the skin
18. LUPUS ERYTHEMATOSUS:
(lupus erythematosus panniculitis)
Characteristic features include epidermal
involvement, germinal centre
formation, plasma cells and hyaline necrosis.
Cases may be extremely difficult to
distinguish from subcutaneous panniculitis-like
T-cell lymphoma.
19. This has resulted in some acceptance of an
intermediary entity described as
indeterminate lymphocytic lobular panniculitis
or atypical lymphocytic lobular panniculitis
Lupus erythematosus display localisation on
hair follicles mimicking the folliculotropic
variant of mycosis fungoides.
20. LICHEN SCLEROSUS:
The interface dermatosis present in lichen
sclerosus can closely mimic cutaneous CTCL in
early stages.
Can display florid, small-to-medium blood
vessel lymphocytic vasculitis which closely
resembles angiocentric variants of cutaneous
lymphoma
21. PIGMENTED PURPURIC DERMATOSIS
AND LICHEN AUREUS
Suspicionraised in cases which are persistent
or contain atypical cells.
Inthese cases, consideration should be given
a possible drug-related aetiology.
22. LYMPHOMATOID DERMATITIS/ECZEMA
Described in association with external
sensitization, it is now recognised to occur
in occasional cases of atopic dermatitis and
in particular, those with high IgE levels
23. LYMPHOMATOID FOLLICULITIS
Predominantly in patients under 50 years of age
Immunohistochemistry reveals mixed populations
of B- and T-cells.
Most characteristic diagnostic feature is the
presence of moderate numbers of perifollicular
antigen-presenting cells which are CD1a and S100
positive.
Another feature is the tendency towards
spontaneous regression.
24. ACNE ROSACEA
Characterised by follicular interface
changes which, together with a paucity of
granulomas, can mimic early stages of
follicular CTCL.
25. ANGIOLYMPHOID HYPERPLASIA AND
KIMURA’S DISEASE
Characterised by large numbers of
lymphocytes and / or eosinophilis.
Prominent hob-nail endothelial cells with
vacuoles in small-to medium sized
vessels, and germinal centres are the main
diagnostic clues to angiolymphoid hyerplasia
Kimura’sdisease can mimic human T-cell
lymphotropic lymphoma.
26. CHRONIC PHOTODERMATOSES
Chronic actinic dermatitis (including
actinic reticuloid) and polymorphous light
eruption are classical mimics of cutaneous
lymphoma.
Histological clues in chronic actinic
dermatitis include dermal fibrosis and
multinucleate stromal giant cells
Polymorphous light eruption is often
associated with edema of papillary dermis
27. Actinicprurigo recently added to this group
and cause diagnostic problems by a high
density of B-cells
Photodermatoses can display increases in CD8
T-cells but this phenotype can also be present
in some variants of CTCL.
28. PERNIOSIS (CHILBLAINS)
An abnormal inflammatory response to
cold, seen most frequently in acral
locations, but it can occur on the thighs
of horse-riders.
Mimicked by variants of lupus
erythematosus termed chilblain lupus.
Both perniosis and chilblain lupus can
resemble lymphoma because of dense
perivascular collections of lymphocytes.
29. ANNULAR ERYTHEMAS
Especiallyerythema annulare centrifugum
can mimic lymphoma with dense
perivascular collection of lymphocytes.
30. TRAUMATIC ULCERATIVE GRANULOMA
(EOSINOPHILIC ULCER/GRANULOMA OF THE
TONGUE)
Located on the tongue, this entity can
contain eosinophils and blast cells
mimicking lymphoma.
31. JESSNER AND KANOF’S LYMPHOCYTIC
INFILTRATION OF THE SKIN
Lesions are usually on the face and
discoid in nature. Papules expand
peripherally but clear in centre and give
rise to a circinate appearance.
Spontaneous remission can occur but
remission in weeks, months, or longer.
32. Histologically, mild perivascular and peri-
adnexal lymphocytic infiltrate. There should
be no involvement of the epidermis and
oedema of papillary dermis appears frequent.
Immunohistologysuggested increased dermal
CD8 lymphocytes but no HLA-DR expression.
This contrasts with lupus erythematosus
which has fewer CD8 lymphocytes and greater
HLA-DR expression.
33. Some studies highlighted the presence of so-
called plasmatoid monocytes. The entity may
overlap with polymorphous light eruption or
lupus erythematosus.
The entity has been described in HIV positive
patients and occasionally, as a drug reaction.
35. ACRAL PSEUDOLYMPHOMATUS
ANGIOKERATOMA OF CHILDREN
(APACHE)
First described in children on the
extremities of arms and legs and often
multiple and unilateral.
Histologically,
it is characterised by
prominent postcapillary venules and a
moderately dense lymphocytic infiltrate.
36. The cellular infiltrate may show interface
changes with the epidermis and
immunohistochemistry reveals mixed
populations of B- and T-cells
There appears to be overlap with the entity of
papular angiolymphoid proliferation with
epithelioid features (PALEFACE).
37. SOLITARY PSEUDO T-CELL LYMPHOMA
Characterised by mixed populations of B-
and T- cells, an increase in CD8 T-cells
and the presence of histiocytes.
Thereappears to be some overlap wit
lymphomatoid benign lichenoid keratosis.
38. PSEUDOLYMPHOMA OF
HAEMOTOLOGICAL DISEASE
Syn: insect-bite like reaction or
eosinophilic eruption of haematological
disease
Initially
recognized that mosquito bites in
patients with chronic lymphocytic
leukemia could be associated with florid
cutaneous responses. This was followed
by reports of insect bite like reaction in
patients with CLL but no apparent history
of insect bite.
39. More recently, this pseudolymphotamous
reaction has been reported in patients with
mantle zone lymphoma and in association with
HIV infection. The entity is generally
considered to have an association with altered
immunity.
41. DRUGS
List
of drugs causing pseudolymphomatous
reactions is extensive and can be usefully
remembered by the prefix (anti-).
Anti
depressants, anticonvulsants, antihypertensives, anti
biotics, anti-inflammatory and antihistamines.
To this can be added calcium-channel blockers, lipid
lowering drugs, colony stimulating
factors, interleukins and inhibitors against
tyrosinase and tumour necrosis factors.
42. VIRAL INFECTIONS
In association with molluscum
contagiosum, herpes simplex and
varicella-zoster
virus, parapox, cowpox, Epstein-Barr
virus, human T-cell lymphotropic virus and
HIV.
43. Molluscum contagiosum and herpes viruses
appear to show a specific tendency for
follicular reactions.
HIV can manifest with a
pseudolymphomatous interface dermatosis
which is CD8 prominent
44. BACTERIAL INFECTIONS
Associated with infections by
spirochaetes including Borrelia
burgdorferi and Treponema pallidum
The cutaneous reaction to borrelia is
specifically termed borrelia
lymphocytoma and occurs in young
patients with frequent involvement of
earlobes, nipple or genitals.
45. Histological reaction has a pronounched B-
cell component, which can mimic marginal
zone or follicular centre lymphoma.
Germinal centres can appear
enlarged, irregular and have no mantle zone.
Blast–cell numbers can be increased
significantly
Histiocytes and granulomas can be present
and infiltrate can be of so-called ‘bottom-
heavy’ distribution.
46. PARASITES AND OTHER EXTERNAL
ORGANISMS
Includes scabies and bites from many
organisms, including scorpions, spiders
and leeches.
Initiate a reaction which is eosinophil rich
with both B and T-cell.
48. ANTIGEN INJECTIONS
Occurs frequently with vaccinations
containing aluminium hydroxide
Histiocytes display a characteristic
purple-grey cytoplasm and particulate
aluminium can be identified in some cells
at high power magnification.
Histochemical stains for aluminium are
positive and aluminium can be identified
on X-ray micro-analysis
49. Histological
appearance can be variable and
display patterns mimicking marginal zone
lymphoma, granuloma annulare, lupus
erythematosus or fat necrosis.
Pseudolymophomatous reactions have been
reported following desensitising procedures
for pollen, dust and house mites.
50. METALS AND PIGMENT
Reported most commonly against metal-
based pigment in tattoos and the metals
in earrings and acupuncture.
51. ETHNIC SCARIFICATION/FEMALE
GENTIAL MUTILATION
Cutaneous pseudolymphomatus reactions
can follow this procedure.
52. SILICONE
Associated with entry of silicone into
soft tissue and skin
Describedfollowing silicone injection for
both breast and genital enlargement.
54. PLASMA CELLS
Prominent in certain infective and
autoimmune /connective tissue
disorders, to mimic cutaneous lymphoma.
Applied particularly to spirochaete and
Leishmania spp.infections and connective
tissue disorders such as lupus
erythematosus, morphoea and necrobiosis
lipoidica.
55. Prominent in cutaneous manifestations of
Castleman’s disease and represent a significant
cellular component in stromal response to
epidermal dysplasia and malignancy.
Cutaneous plasmacytosis and cutaneous
angioplasmocellular hyperplasia are 2 examples of
reactive plasma cell proliferation.
Distinction
from neoplastic proliferation depends
largely on the absence of a monoclone on
immunohistochemistry and also genotypic analysis.
56. HISTIOCYTES
Interstitial granulomatous disease is
characterized by the presence of palisaded
neutrophilic and granulomatous infiltrates with
focal collagen degeneration.
Can present as either a drug eruption or in
association with autoimmune /connective tissue
diseases, such as rheumatoid arthritis or lupus
erythematosus.
57. ANTIGEN-PRESENTING CELLS
Reactive Langerhans’ cells can show
prominence in numerous classical dermatoses.
For example, they can become prominent
within the epidermis in eczema/dermatitis and
mimic Pautrier abscesses as in CTCL.
Inaddition, intra-epidermal Langerhans’ cells
can become so prominent in CTCL that they
can mimic Langerhans cell histiocytosis
.
59. Patterns can be divided into:
Morphological,
Cellular and cytological type
Based on immunohistochemistry
60. MORPHOLOGICAL PATTERNS
The main types described are those involving the
epidermis (epidermotrophic), dermis (non-
epidermotropic), follicular (with or without follicular
mucinosis), subcutaneous and vascular.
In general, an epidermotrophic infiltrate will have a
significant T-cell component, whereas other patterns
can be of T-cell, B-cell or mixed type.
The pattern focused on blood vessels is specifically
termed a lymphomatoid vascular reaction and is
particularly associated with drug reactions, lupus
erythematosus and varicella-zoster virus reaction.
61. CELLULAR AND CYTOLOGICAL
PATTERNS
LYMPHOMATOID:
when cellular density and or nuclear atypia is
pronounched or when features of mycosis
fungoides are present.
Entities include lymphomatoid dermatitis
and lymphomatoid actinic and benign
lichenoid keratosis.
62. PSEUDO-PAUTRIER ABSCESSES:
represent situations where the number of
antigen-presenting cells is substantially in excess
of lymphocytes present.
Also known as Langerhans’ cell microgranulomas.
Seen in common dermatoses.
ADIPOCYTE RIMMING:
The rimming of adipocytes by lymphocytes in
subcutaneous fat is observed in subcutaneous
panniculitis-like T-cell lymphoma, lymphocytic
lobular panniculitis and especially lupus
erythematosus panniculitis.
64. IMMUNOPHENOTYPIC PROFILES
Panor subset T-cell antigen loss can be a
feature of CTCL but can be seen in reactive
T-cell disorders.
CD56 is used to identify CD56-positive
natural killer/T-cell lymphomas.
The CD15 antigen was initially associated
with the descriptions of Hodgkin’s lymphoma.
However treatment with agents like colony
stimulating factors can be associated with a
cutaneous pseudolymphomatus reaction with
CD15 positivity.
65. CD30 – POSITIVE PSEUDOLYMPHOMA
CD30 was associated with early immunophenotypic
developments in Hodgkin’s lymphoma.
This was quickly extended into the area of
cutaneous CD30-positive T-cell lymphoproliferative
disorders including lymphomatoid papulosis and
anaplastic large cell lymphoma.
CD30 positivity can be associated with activation of
other cell types like those of B-cell, natural killer cell
and myeloid lineage and additional natural tissue such
as decidua and some non-lymphoid mesenchymal and
epithelial tumour
66. Reactive CD30-positive T-cells can occur in
drug eruptions, viral infections, tuberculosis
and scabies.
CD30-positive cells can be large, atypical &
clustered and represent over 75% of cell
population in some viral infections and scabies.
CD30-positiveT-cells should be regarded as
potentially occuring in any cutaneous
inflammatory condition and their final
interpretation based on overall histologic
appearance & clinical setting.
67. CD30-positive decidua can mimic CD30-
positive anaplastic large cell lymphoma.
CD30-positive cells amongst
neutrophils, as in ruptured follicular cysts
and hidradentitis suppurativa, can mimic
the neutrophil-rich variant of CD30-
positive anaplastic large cell lymphomas.
69. THE EVOLUTION OF HISTORICAL
CUTANEOUS PSEUDOLYMPHOMA INTO
LYMPHOMA OR LYMPHOID
HYPERPLASIA
70. HISTORICAL PERSPECTIVE OF
CUTANEOUS PSEUDOLYMPHOMA
Kaposi and Spiegler published independently
on cutaneous lymphoid infiltrates
Their descriptions were those of either
single or multiple sarcomatous-like skin
lesions, referred to as sarcoids.
Some cases regressed and were associated
with a good prognosis, whereas others spread
and cause death.
Credit for these observations was given by
Darier.
71. Although Kaposi and Spiegler described both fatal and
non-fatal cases, authors over the next 70 years
focussed on the latter.
Although meaning the same disease, this resulted in
copious different terminology, including:
Lymphocytoma
Lymphadenosis benigna cutis
Cutaneous lymphoplasia
Cutaneous lymphoid hyperplasia
Large-cell lymphocytoma
Reactive pseudolymphoma
The term ‘pseudolymphoma of Spielger-fendt’
advocated by Lever, erroneously applied the rubber
stamp of benign to this group of disorders..
72. THE ADVENT OF CUTANEOUS
MARGINAL ZONE LYMPHOMA
Primary cutaneous marginal zone and follicular
centre lymphoma now recognized in international
lymphoma classification.
Advances facilitating the recognition of primary
cutaneous marginal zone lymphoma included
immunohistochemistry which identified
lymphocyte subtypes, immunohistochemical and
genotypic methods to assess clonality and finally
the recognition of MALT lymphoma in GIT.
73. Thiswas followed by recognition that MALT
lymphoma also existed in skin and some cases
could be linked to antigen presentation.
Finally, developments in lymphoma
classification saw the term MALT lymphoma
replaced by marginal zone lymphoma.
74. CUTANEOUS LYMPHOID
HYPERPLASIA
Preferred term for reactive/benign
lymphoproliferative disorders where no
etiological agent is apparent.
Based on the presence or absence of epidermal
involvement and the phenotypic cell content,
they are referred to as either cutaneous T-cell
or B-cell predominant lymphoid hyperplasia.
75. Cutaneous B-cell predominant lymphoid
hyperplasia is difficult to distinguish from
cutaneous lymphoma because reactive
germinal centres and tingible body
macrophages can also be seen in primary
cutaneous marginal zone lymphoma.
In both reactive and neoplastic
conditions, lymphoid follicles and germinal
centres show similar morphological changes
including increased size, asymmetry, loss of
polarity, confluence, increased blast-cell
numbers and increased mitotic activity.
76. As morphological appearances are
unhelpful, detailed immunohistochemistry
should be always undertaken.
Significant
help and attention should be paid
to B-cell distribution, nuclear proliferation
ratee and bcl-2 bcl-6 and CD10 status.
77. CLONAL DERMATITIS AND CLONAL
CUTANEOUS LYMPHOID
HYPERPLASIA
Studies into CTCL, using TCR gene re-
arrangement analysis, identified a small
number of cases of eczema/dermatitis, in
the control population, with T-cell
monoclones. This observation formed the
basis of a new disease entity called clonal
dermatitis.
Similar findings were then made in some
cases of cutaneous lymphoid hyperplasia
and this led to the equivalent term of
clonal cutaneous lymphoid hyperplasia.
78. Clonal dermatitis/clonal cutaneous lymphoid
hyperplasia has a low but significant risk of
transformation into lymphoma and requires
multidisciplinary team discussion, possible
staging and follow up with re-biopsy if necessary.
79. CONCLUSION
In the future, molecular abnormalities specific
to the diagnosis of primary cutaneous lymphoma
may be identified and new methodologies, such
as gene expression profiling, will be useful in this
extremely difficult area.
At the moment, the co-existence of genotypic
and cytogenetic abnormalities should heighten
the degree of suspicion for lymphoma, as should
the presence of monoclones that are
persistent, reproducible and of significant size.