Histopathological progression of hidradenitis suppurativa/acne inversa : A morphological study with a closer look on the early changes of the folliculosebaceous apocrine apparatus

BACKGROUND

It is generally acknowledged that the first morphological change of hidradenitis suppurativa/acne inversa (HS/AI) consists of infundibular plugging of the folliculosebaceous apocrine apparatus, which is followed by acute and chronic inflammation, cysts with sinus formation, and fibrosis. Alternatively, it has been hypothesized that HS/AI is primarily a neutrophilic autoinflammatory disease and that the follicular plugging typical of this disease is secondary to inflammation.

OBJECTIVE

To review the sequence of the changes that mark the disease development, we have performed a histopathologic study on the surgical material from a series of axillary and inguinal/perineal cases.

METHODS

The histologic material from surgery on Hurley's second and third stage HS/AI was retrieved and collected with the patients' clinical images. The virtually uninvolved skin peripheral to the lesions was studied together with the main inflammatory foci on vertical sections stained with hematoxylin-eosin and immunohistochemistry for the follicle sheaths.

RESULTS

The fully developed lesions showed acute and chronic, suppurative and granulomatous inflammation overlapping fibrosis, cysts, and sinuses. Instead, the skin adjacent to florid inflammation showed plugging and dysmorphic alterations of the hair follicles associated with immunopathological changes of the inner root sheath keratin expression.

CONCLUSION

Our observations coincide with the classical pathological studies on the progressive changes of HS/AI; however, in our specimens, the virtually normal skin peripheral to the fully developed lesions show seemingly initial follicular changes that suggest development error. This finding would support the hypothesis of combined mutation-induced epithelial differentiative defects and immunological derangement in HS/AI pathogenesis.

Survival and malformations rates, oxidative status in early life stages of Cyprinus carpio due to exposure to environmentally realistic concentrations of paracetamol

Paracetamol (PCM) is among the most consumed analgesic and antipyretic drugs worldwide. Due to its high consumption, this drug has been reported ubiquitously on different water bodies, posing a real threat to aquatic organisms. Until now, several studies have pointed out that PCM may induce oxidative stress, histological damage and developmental disorders on different aquatic species. Nonetheless, there is still a huge knowledge gap about the toxic effects that PCM may induce in species of commercial interest such as the common carp Cyprinus carpio. The aim of this study was to evaluate survival and malformation rates induced by PCM (0.5 μg/L - 3.5 μg/L) in early life stages of common carp. Furthermore, oxidative stress biomarkers were evaluated at 72 and 96 h post fecundation. PCM reduced the survival rate of the embryos of up to 90%, as concentration increased. LC₅₀ and EC_50m were 1.29 μg/L and 2.84 μg/L, respectively. Biomarkers of cellular oxidation and antioxidant enzymes were modified in a concentration-dependent way with respect to the control group (p < 0.05). The main developmental alterations observed were lordosis, scoliosis, craniofacial malformations, hypopigmentation, growth retardation, pericardial edema and rachyschisis. These data indicate that environmentally realistic concentrations of PCM could be hazardous and affects the development in early stages of C. carpio. Moreover, our findings also indicate that C. carpio embryos may be a useful in vivo model to evaluate embryonic and teratogenic effects of drugs such as PCM.

Unilateral Ankylosis of Temporomandibular Joint (TMJ) with Contralateral Condylar Aplasia and Related Orthopedic Deformity - Syndromic or Nonsyndromic?

Condylar aplasia which means "failure of development" is a rare condition and can be unilateral or bilateral. Mandibular condylar Aplasia without any association with syndrome is extremely rare. Temporomandibular joint (TMJ) ankylosis results from trauma, infection and inadequate surgical treatment of the condylar area. Congenital cases are very rare. We report case of congenital unilateral aplasia of left mandibular condyle with ankylosis of right condyle, with an associated orthopedic deformity in a nine-year-old male patient, which may be a part of some unreported syndrome that has not been mentioned so far in literature. As per our best knowledge, no other case including such clinical features has been reported.