Extranodal (cutaneous) Rosai Dorfman: a rare presentation

Rosai Dorfman disease is a rare histiocytic disorder of unknown etiology commonly involving the cervical lymph nodes first described in 1969, Extranodal involvement is very rare. Clinical course is variable

Trichoscopic findings in cicatricial alopecias and hair shaft disorders and its application in histopathology

Background: Many studies have been published on dermoscopy of hair and scalp disorders in the past few years, but these have been mainly carried out in western countries. Indian skin is mainly type IV and V and has its own unique set of problems and pathological findings. Hence, we conducted a study at our institute to study the dermoscopic patterns of various cicatricial alopecias.Methods: This was a descriptive study conducted in the Dermatology outpatient department, Skinaccess clinics, Nashik, between August 2014 to June 2016. The most common and characteristic feature seen in patients with cicatricial alopecia was hair follicle effacement seen in all 24 patients (100%). Hair follicle plugging was seen in 6 (25%) patients with DLE, and one patient with idiopathic scarring. Hyperkeratotic perifollicular scaling was seen in 2 patients with lichen plano pilaris. Perifollicular hyperpigmentation was seen in one patient of discoid lupus erythematosus (DLE) and 2 patients with idiopathic scarring. Hair casts were seen in 2 patients with lichen plano pilaris, and in one patient with idiopathic scarring. Patchy depigmentation was seen in 4 patients with discoid lupus erythematosus, 3 patients with idiopathic scarring, and one patient with lichen plano pilaris.Results: The most common and characteristic feature seen in patients with cicatricial alopecia was hair follicle effacement seen in all 24 patients (100%). Hair follicle plugging was seen in 6 (25%) patients with DLE, and one patient with idiopathic scarring. Hyperkeratotic perifollicular scaling was seen in 2 patients with lichen plano pilaris. Perifollicular hyperpigmentation was seen in one patient of discoid lupus erythematosus (DLE) and 2 patients with idiopathic scarring. Hair casts were seen in 2 patients with lichen plano pilaris, and in one patient with idiopathic scarring. Patchy depigmentation was seen in 4 patients with discoid lupus erythematosus, 3 patients with idiopathic scarring, and one patient with lichen plano pilaris.Conclusions: Hair follicle effacement is a characteristic dermoscopic feature of cicatricial alopecia. Hair follicle plugging, patchy depigmentation and red dots are seen in DLE. In lichen plano pilaris the dermoscopic findings of blue dots, white dots and perifollicular scaling were found to be useful for making an accurate diagnosis. Perifollicular scaling and tufting of hair is characteristically seen in patients with folliculitis decalvans. Dermoscopy is very useful in differentiating cicatricial from non-cicatricial alopecias. A biopsy obtained from the peripheral edge of the patch is more likely to show diagnostic features than the central portion. Dermoscopic guided biopsies were shown to yield definitive pathological diagnosis in 95% of the cases. Hair shaft disorders can be easily diagnosed by dermoscopy, without the need for hair

Cytopathological evaluation of various thyroid lesions based on Bethesda system for reporting thyroid lesions

Background: An encouragement for the thyroid proposal was the Bethesda system for reporting cervical cytology interpretations, a uniform reporting system for thyroid FNA will facilitate effective communication among health care providers. The objective of the present study was to classify thyroid lesions in various categories under Bethesda system correlating the cytological findings in various thyroid lesions with clinical and radiological details.Methods: A retrospective study on FNAC thyroid was performed in a tertiary hospital and a Medical teaching institution in Mumbai, Maharashtra, India which included cases which were reported from 1st January 2010 to 31st July 2011. For cytomorphological analysis, all smears (Papanicolaou and MGG) were reviewed and cases were categorized into six Bethesda categories. The FNAC findings were correlated with clinical, radiological and laboratory findings. Discrepancies between original diagnosis and review diagnosis as well as difficulties encountered during application of Bethesda were studied in detail.Results: Total 413 FNACs were received during the study period. The original diagnoses included 10 different categories or labels some of which were descriptive. On application of Bethesda, maximum cases were found in category II (82.32%) followed by category I i.e. inadequate (7.7%). Category III (Atypia of Undetermined significance) included wide spectrum of cases which were previously diagnosed as goitre, suspicious or neoplastic.Conclusions: Bethesda system of reporting thyroid FNAC has brought uniformity in cytology reporting. It has facilitated better understanding between cytopathologist and clinicians as every category connotes specific risk of malignancy and recommends treatment

Extranodal (cutaneous) Rosai Dorfman: a rare presentation

Rosai Dorfman disease is a rare histiocytic disorder of unknown etiology commonly involving the cervical lymph nodes first described in 1969, Extranodal involvement is very rare. Clinical course is variable