Evidence map›Paper›PMID 39359287›Full record

ArticleIndian dermatology online journal

A Retrospective Study of the Histopathological Spectrum of Erythema Nodosum Leprosum.

Varniraj Patel, Rhea Ahuja, Sudheer K Arava, Sujay Khandpur, Neetu Bhari, Vishal Gupta, M Ramam

Abstract read
In one paragraph

Article in Indian dermatology online journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

7 authors.

Varniraj PatelDepartment of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Rhea AhujaDepartment of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Sudheer K AravaDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Sujay KhandpurDepartment of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Neetu BhariDepartment of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Vishal GuptaDepartment of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
M RamamDepartment of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: There are no recent studies with a focus on the histopathology of erythema nodosum leprosum (ENL). Objectives: To describe the histopathological spectrum of ENL. Materials and Methods: Digital records from the pathology department were searched, and 125 slides were included. The histopathologic findings were recorded using a pre-designed proforma. Results: Several patterns were noted with the most common being a superficial and deep, perivascular and peri-appendageal, well-circumscribed dermal infiltrate that was seen in 70 (56.0%) biopsies. Other dermal patterns included a similar but loose infiltrate in 19 (15.2%) biopsies, diffuse dermal involvement in 9 (7.2%), top-heavy in 9 (7.2%), and bottom-heavy infiltrates in 12 (9.6%). Subcutaneous tissue was included in 107 biopsies. Extension of dermal infiltrates to the subcutis was noted in 71 (66.4%) biopsies and predominant involvement of the subcutis was noted in 6 (4.8%) biopsies, with lobular involvement in 60 (56.1%), septal involvement in 3 (2.8%), and septo-lobular involvement in 14 (13.1%). In 30 (28.0%) biopsies, the subcutaneous fat was uninvolved. The infiltrates contained neutrophils and foamy histiocytes in variable proportions, along with lymphocytes and plasma cells. Eosinophils were noted occasionally. Medium and/or small vessel vasculitis was noted in 11 (8.8%) biopsies. Fite-Faraco staining was available for 112 biopsies and revealed mainly fragmented and granular acid-fast bacilli (AFB) in 29 (25%) biopsies. Limitations: Our study had a retrospective design; we could not compare the lesional age and clinical characteristics of patients with the histological features. Conclusion: ENL is characterized by dermal infiltrates composed of foamy histiocytes and neutrophils in varying proportions arrayed in different dermal patterns. Extension of dermal infiltrates into the subcutis was frequent but absent in some. Predominant or exclusive involvement of the subcutis was rare. Vasculitis was noted in a small minority, while AFB were demonstrated in about a quarter of cases.

Indexed as

Erythema nodosum leprosumfoamy histiocyteshistopathologylobular panniculitisneutrophils

Identifiers

PMID39359287
PMCPMC11444462

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