A Study of Various Histopathological Features and their Relevance in Pathogenesis of Psoriasis

Background:

The pathogenesis of psoriasis is still to be fully unraveled. The immunological theory with T cells at the centre of attraction and peripherally acting cytokines are the present favourites among aetiopathological factors. Histopathology of the skin lesions offers a good study model to understand the pathogenesis of this complex disease.

Aims:

To study the various histopathological parameters of psoriatic lesions, and to establish their correlation with the pathogenesis of the disorder.

Materials and Methods:

Eighty eight consecutive histopathologically proven cases of psoriasis were included in the study. Eight common histopathological parameters of psoriasis present in these biopsies were assessed and graded. We then statistically analyzed the relationship of the factors with one another and attempted to establish a better understanding of the pathogenesis of disease.

Results:

Significant correlations were found between degree of epidermal hyperplasia and inflammatory infiltrate, grade of inflammation and pustules of Kogoj, inflammatory infiltrate and grade of capillary proliferation as also between epidermal hyperplasia and the presence of parakeratosis.

Conclusion:

The study suggests that the immunopathogenesis of psoriasis is predominantly based on the inflammatory response. This is in consonance with other studies which have suggested that psoriasis is primarily a T lymphocyte based disease. Several treatment modalities are now based on this concept and it is hoped that the future treatment modalities will focus on the central role of inflammatory cells in the pathogenesis of this enigmatic disease.     

Disseminated Histoplasmosis in a 13-year-old girl: a case report

Background

Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immune-compromised individuals such as those with acquired immuno-deficiency syndrome.

Objective

To describe a case of disseminated histoplasmosis in an adolescent girl.

Method

We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies.

Result

An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen''s staining for mycobacteria tuberculosis was negative.

Conclusion

Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-year-old girl. Disseminated histoplasmosis should be considered as a differential diagnosis of childhood chronic infections and malignancies as in Nigeria.     

Exercising caution: social physique anxiety and protective self-presentational behaviour

This study examined relations among body mass index (BMI), social physique anxiety (SPA) and protective self-presentational exercise behaviours in a sample of 86 female participants in aerobics classes at a university fitness centre. Participants completed a questionnaire assessing demographic and exercise-related information, the 9-item version of the Social Physique Anxiety Scale, and measures of two forms of protective self-presentational exercise behaviour (i.e., preferring to stand away from the aerobics instructor and wearing concealing exercise attire). Consistent with previous research, SPA was positively associated with both preferred exercise studio floor position (r = .31, p < .05) and clothing concealingness (r = .25, p < .05). SPA did not mediate the relations between BMI and either of the two protective self-presentational behaviours. BMI was a better predictor of clothing concealingness than SPA, but the opposite was found for exercise studio floor position preferences (r = .31 with SPA versus r = .15 with BMI). The findings provide an enhanced understanding of factors associated with self-presentation in exercise.     

Role of informal care providers in home based long term care in diabetes mellitus at Kaiwara Primary Health Center area,Karnataka, India

ObjectiveTo find the prevalence of diabetics, identify informal care providers for them in Kaiwara Primary Health Center (PHC) area, assess the level of knowledge and skills of an informal care provider in home based long term care and improve the level of knowledge and skill of the informal care provider through a structured training capsule.MethodsA cross sectional and an interventional study was conducted on diabetics and their informal care providers in Kaiwara PHC area. Data were collected using pre-tested, structured questionnaire by an interview method. A structured training capsule was developed and implemented. Evaluation of the knowledge and skills was assessed at the beginning and at the end of the training. Student's paired/unpaired ‘t’ tests and correlation analysis were done.ResultsImprovement scores were calculated by subtracting the pre-evaluation scores from the post-evaluation scores. The mean improvement scores was (2.66±0.32) and was statistically significant (P <0.001). No significant difference in mean values was found in the knowledge and skills scores in relation to the socio-demographic variables in the study.ConclusionsKnowledge and skills component of the informal care provider in home based care of diabetes could be perceived as a “felt need”.