Polarized Microscopy in Lesions With Altered Dermal Collagen

A Polarized Light Microscopy Study in a Case of Morphea

We report a case of plaque type of scleroderma with specific clinical features and conventional histopathology, with sclerosis and hipocellularity of fibroblasts and preservation of elastic tissue. We describe polarized light microscopy findings, on conventional stained slides and on picro sirius red stained slides. We appreciate that picro sirius red stain allows a better characterization of collagen fibres composition in papillary and reticular dermis, that is severely disturbed in morphea, with an inverse distribution of collagen fibres type I and III comparative with normal dermis.

A Rare Case of Misdiagnosis: Recurrence of Dermatofibrosarcoma Protuberans That Was Treated Surgicallyas a Keloid

Aim

In this report, we presented the patient with Dermatofibrosarcoma Protuberans (DFSP), removed by considering as the keloid scar in the general surgery clinic with misdiagnosis.

Case report

The patient was a 19-year-old female student with no scar or previous trauma history in the lesion area. Pathology report of excisional biopsy revealed as a DFSP, reachedsubcutis and dermis. In staging by CT, there had been no distant metastases. There was a lesion with the size of 2x1.5x1.5cm. A large resection was made to include the entire mass and the lower fascia. The defect area was repaired with a Limberg flap. There was no tumor recurrence in the first 6 months following the operation with high-level aesthetics for patient satisfaction.

Conclusion

DFSP should be remembered in cases of operative or spontaneous keloid scarring lesions. The surgical treatment is possible after extensive resection with flap or graft repair.

Probing endogenous collagen by laser-induced autofluorescence in burn wound biopsies: A pilot study

The focus of the current study was to interrogate the predictive potential of laser-induced autofluorescence (LIAF) by objectively assessing collagen synthesis in burn wound granulation tissues ex vivo. Prior grafting, granulation tissues (20 samples) following burn injury were collected from 17 subjects of age range 18 to 60 years with patient/donor consent and the corresponding autofluorescence spectra were recorded at 325 nm He-Cd laser (≈2 mW) excitations. The resulting endogenous collagen intensity from the above tissue samples was computed by normalizing the nicotinamide adenine dinucleotide levels. In addition, the hydroxyproline content was also estimated biochemically from the same granulation tissues. A comparative assessment of both LIAF and biochemical estimations for endogenous collagen by hydroxyproline resulted in strong positive correlation among them. The above relevant observations suggest that LIAF is equally informative as that of biochemical estimations, in evaluating endogenous collagen content in wound granulation tissues. Thus, it can be concluded that LIAF has the predictive potential, as a noninvasive objective tool to measure the endogenous collagen levels in wound biopsy tissues and provide complementary data conducive for making clinical decisions.

Fluorescence microscopy for the evaluation of elastic tissue patterns within fibrous proliferations of the skin on hematoxylin-eosin-stained slides

BACKGROUND

Diagnosis of fibrous tumors can be challenging and expensive due to the use of special stains.

OBJECTIVE

Determine the usefulness of fluorescence microscopy in the evaluation of elastic tissue patterns on hematoxylin-eosin-stained slides.

METHODS

In total, 228 slides representing different fibrous tumors were evaluated for their elastic tissue patterns by fluorescence microscopy, and sensitivity and specificity were determined for relevant comparisons.

RESULTS

Fluorescence microscopy was found to be useful, especially for distinguishing dermatofibroma from dermatofibrosarcoma protuberans and dermatomyofibroma from other fibrous tumors.

LIMITATIONS

In some cases, excessive background staining made patterns difficult to interpret.

CONCLUSION

Evaluation of elastic tissue patterns by fluorescence microscopy in fibrous tumors is a cheap and efficient means to further delineate these often challenging tumors.