Cytological Diagnosis of Primary Cutaneous Nocardiosis in a Known Case of Lepromatous Leprosy, Syphilis and HIV

Nocardiosis is an acute, subacute or chronic bacterial infection caused by a group of aerobic, gram positive and weakly acid fast species of genus Nocardia. Primary Cutaneous Nocardiosis (PCN) is relatively uncommon disease and is usually seen in immunocompetent persons. We report a case of primary cutaneous nocardiosis in a known case of lepromatous leprosy, syphilis and HIV patient who presented with painful swelling over right thigh

Effectiveness of the International Consensus Group criteria for manual peripheral smear review

Context: The International Consensus Group for Hematology Review (ICGHR) are essentially review criteria designed to reduce the number of manual smear reviews following analysis in automated hematology analyzers (AHAs). Although AHAs are an indispensable part of the present-day clinical laboratory, manual smear reviews still play an integral role in identifying morphological abnormalities and to confirm the results of the analyzers. Aims: The aim of this study is to evaluate the efficacy of the ICGHR criteria and our laboratory criteria using the Sysmex XN-1000 for manual peripheral smear review (MSR). Study Design: A prospective cross-sectional comparative study between the two sets of criteria for MSR was performed. Material and Methods: A total of 860 whole blood samples sent over a period of 19 months for complete blood count testing to our laboratory were collected using systematic random sampling. Truth tables were prepared for each set of criteria. Tests of proportion were used to compare performance specifications between both sets of criteria. Results: Using ICGHR criteria, sensitivity was 81.58%, specificity was 84.61%, 83.38% positive predictive value, and 82.92% negative predictive value. The microscopic smear review rate was 47.56% and efficiency was 83.14%. Using our laboratory criteria, sensitivity was 98.80%, specificity was 41.40%, positive predictive value of 61.46%, and negative predictive value of 97.34%. The microscopic smear review rate was 78.14% and efficiency 69.30%. Conclusions: There was a significant reduction in the microscopic smear review rates using the ICGHR criteria compared to our laboratory criteria. The ICGHR criteria can thus be adapted to daily laboratory practice provided they are first optimized and locally validated before use

Acrokeratosis Verruciformis of Hopf: A Rare Case Report

Acrokeratosis Verruciformis of Hopf (AKV) is rare autosomal dominant cutaneous dermatosis described by Hopf in 1931. It is presented at birth but may appear in early child hood; sometimes the onset may be delayed until fifth decade of life. It usually presents with multiple planar wart – like lesions, typically observed on the dorsal aspect of the hands and feet but may extend on to knees, elbows, forearms and also on other parts of the body. The main differential diagnosis is Darier disease and seborrheic keratosis which has similar presentation. The unique finding of AKV is Church spire elevation of epithelium which differentiates from Darier disease. Due to the scarcity of the cases here we present a case of AKV in a 29 year old male which was diagnosed on clinical examination and confirmed with histopathological examination. We have made an attempt to describe histologic features of AKV with differential diagnosis of these lesions through review of literature