The diagnostic accuracy of fine needle aspiration cytology in leprosy: a clinico-histopathological correlation

Background: Leprosy is a chronic granulomatous condition mainly affects cooler parts of the body; skin, upper respiratory tract, anterior segment of the eye, superficial portion of peripheral nerves and testes. Redley and Joplin have classified it into five types; Tuberculoid (TT), Borderline Tuberculoid (BT), Mid Borderline (BB), Lepromatous Borderlilne (BL) and Lepromatous (LL). FNAC is simple, rapid and cost effective method over the biopsy to diagnose, classify and monitor leprosy in a patient. The present study was undertaken to evaluate and compare FNAC smears findings with histopathological findings and to classify lesions on RJ scale.Methods:This prospective and descriptive study was done in department of pathology in Sri Venkateshwara institute of medical science, pondicherry, India between June 2007 to June 2010. The patients were examined by the investigator with dermatologist later on slit smear was done. FNAC perform and comparison with biopsy and clinical history was done using SPSS software version 16.0.Results:Total 82 cases were included with age from 8 years to 79 years with mean age 38.16. Male to female ratio was 1.0: 0.7. FNAC shows parity 71.42% for tuberculoid and 58.33% for lepromatous leprosy and histopathology shows parity 100% for tuberculoid and 75% for lepromatous leprosy that indicate FNAC is useful usually for polar or stable group than the unstable or borderline cases.Conclusion:FNAC is a quick and safe for early diagnosis and classify cases into paucibacilary and multibacillary. Exact RJ Scale categorization on FNAC should not be used in isolation but FNAC should be supplemented to the histopathological diagnosis.

A Rare Occurrence of Shagreen Patch on the Face of a Pediatric Patient with Tuberous Sclerosis

How to Cite this Article: Ravi A, Veerabhadra D, Richa G, Ngangbam S. A Rare Occurrence of Shagreen Patch on the Face of aPediatric Patient with Tuberous Sclerosis. Iranian Journal of Child Neurology 2012;6(1):39-42.Tuberous sclerosis is a neurocutaneous syndrome characterized by a clinical spectrum varying from severe mental retardation and incapacitating seizures to normal intelligence and lack of seizures, often within the same family(1). The younger the patients present with symptoms and signs of TSC (tuberous sclerosis complex), the greater are the likelihood of mental retardation (2). Skin features are very characteristic of the disease and help in the early diagnosis of the disease. Shagreen patch is one of the major diagnostic features of the disease. It is a less common skin lesion consisting of an excess amount of fibrous tissue similar to that found in scar tissues (3). It is a section of thickened, elevated pebbly skin like an orange peel. The name is derived from the French phrase “peau chagrinee”. It is usually found on the lower back, buttock, thigh and the nape of the neck commonly. In this case report we report a characteristic skin lesion, the shagreen patch in a six-year-old child with TSC at an unusual site (the cheek) never reported before with the best of our knowledge.References: 1. Datta AK, Mandal S, Bhattacharya S. Autism and mentalretardation with convulsion in tuberous sclerosis: a casereport. Cases J 2009;2:7061.2. Haslam RHA. Neurocutaneous syndrome. In KliegmanRM, Behrman RE, Jenson HB, Stanton BF (editors).Nelson Text book of Pediatrics,18th Edition. NewDelhi: Elsevier. 2008.P. 2485-6.3. Mallory SB (editor). Illustrated manual of pediatricdermatology, diagnosis and management, 1st Edition.UK:Taylor & Francis. 2005.P. 369-89.4. Roach ES, DiMario FJ, Kandt RS, Northrup H. TuberousSclerosis Consensus Conference: recommendationsfor diagnostic evaluation. National Tuberous SclerosisAssociation. J Child Neurol 1999 Jun;14(6):401-7.5. Roach ES, Gomez MR, Northrup H. Tuberous sclerosiscomplex consensus conference: revised clinicaldiagnostic criteria. J Child Neurol 1998 Dec;13(12):624-8.6. Raymond SK. Tuberous sclerosis complex andneurofibromatosis type 1: the two most commonneurocutaneous diseases. Neurol Clin N Am2002:20:941-64.7. Prabhu S, Mahesh KP. Tuberous sclerosis with oralangiofibroma: Case report. Br J Oral Maxillofac Surg2010 Apr;48(3):205-7.8. Hake S. Cutaneous manifestation of tuberous sclerosis.Ochsner J 2010 Fall;10(3):200-4.