Langerhans cell histiocytosis: a case report and glimpses into its nomenclature

Class I Langerhans cell histiocytosis (LCH) is described in a two- and a half-year-old male. The initial expression of the disease was conspicuous by the presence of extensive pustular crusted rash and, later in its course, by purpura, diabetes insipidus, otitis media, enlargement of the liver and spleen, and infiltration into the lungs. The patient expired due to extensive hemorrhage over 24 hours.

Verrucous plaque: unique morphological expression of post-kala-azar dermal Leishmaniasis (PKDL)

Relatively unusual verrucous plaque as well as other expressions of P.K.D.L. are reported in a 46-year-old male. The diagnosis was confirmed by the documentation of Leishman-Donovan bodies in the tissue smears as well as in the cytoplasm of the histiocytes in the tissue section.

Leprosy

Leprosy is a chronic infectious disorder, presumptively caused by Mycobacterium leprae. This article reviews the epidemiology, etiopathogenesis, classification, clinical features, reactions, diagnosis, and treatment of the disease.

Cutaneous tuberculosis

Tuberculosis has been a well-known affliction of mankind since antiquity. This article reviews the etiopathogenesis, clinical features, diagnosis, differential diagnosis, and treatment of the disease.

In situ characterization of lymphocytic immunophenotypes and interleukin-2 receptors in cutaneous tuberculosis and leprosy--a comparative evaluation

The granulomas of lupus vulgaris (LV) were characterized by preponderance of CD4+ lymphocytes and a raised CD4+/CD8+ ratio. In contrast, in scrofuloderma (SF) the CD8+ T-lymphocyte subpopulation predominated and the CD4+/CD8+ ratio was significantly decreased. A higher percentage of lymphocytes expressed interleukin-2 receptor (IL-2R) in LV as compared with SF, indicating an activated cellular immune response in the former. Immunophenotypic changes in tuberculosis verrucosa cutis (TBVC) were intermediate between LV and SF. CD4+ lymphocytes were the main infiltrating T-cell type in borderline tuberculoid leprosy (BT), while CD8+ lymphocytes predominated in the granuloma of lepromatous lepromatous (LL). The CD4+/CD8+ ratio and percentage of lymphocytes expressing IL-2R was significantly higher in BT as compared with LL. These immunophenotypic findings suggest that in both cutaneous tuberculosis and leprosy there is a continuous spectrum with regard to cell-mediated immunity depending on the clinical presentation.

Primary actinomycosis of the breast: a clinical review and a case report

An uncommon situation of primary actinomycosis of the breast is reported in a 40-year-old woman who presented with a lump, clinically simulating malignancy, in the right breast. Diagnosis of actinomycosis was established by incision biopsy. Resolution of infection, while conserving the breast, was achieved by timely diagnosis, limited surgery, and effective antibiotic therapy. Diagnostic failures leading to avoidable mastectomies have not been uncommon in cases previously reported in the literature. It is, therefore, imperative that this condition be considered in the differential diagnosis of intractable breast abscess and malignancy.

Scrofuloderma of the scalp, psoas abscess, and caries spine: an unusual association

An unusual association of scrofuloderma of the scalp, psoas abscess, and caries spine was seen in a 4-year-old girl. The diagnosis was confirmed by relative and absolute criteria. The peripheral T-lymphocytes and their subsets were within normal limits, although her immunohistopathological changes indicated an intermediary response across the spectrum depicting an unstable immunity. This may have been responsible for the silent spread of Mycobacterium tuberculosis and the current association.

Immunohistopathological spectrum in cutaneous tuberculosis

Granulomas of lupus vulgaris were characterized by a raised CD4+/CD8+ ratio, while in scrofuloderma this was significantly decreased. Tuberculosis verrucosa cutis showed intermediate changes. These immunological variations suggest that cutaneous tuberculosis forms a spectrum with strong cell-mediated immunity seen in lupus vulgaris, and weaker cell-mediated responses in scrofuloderma; tuberculosis verrucosa cutis is intermediate between the two.