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S e p t e m b e r 2 0 - 2 1 , 2 0 1 8 | R o m e , I t a l y
Dermatology Congress 2018 & World Nephrology 2018
Note:
Page 13
2nd WORLD NEPHROLOGY AND THERAPEUTICS CONGRESS
DERMATOLOGY AND TRICHOLOGY
&
International Congress on
Joint Event on
Archives of General Internal Medicine | ISSN: 2591-7951 | Volume 2
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
YEARS
Palitha Ratnayake, Arch Gen Intern Med 2018, Volume 2 | DOI: 10.4066/2591-7951-C5-013
COLOURS IN SKIN BIOPSIES – A CLUE TO
DIAGNOSIS
Substances with different coloursmay present in a skin biopsy sample, which
provide clues for the definitive diagnosis of the underlying skin disease.
On the other hand, pathologists use colored substances to highlight different
material in a biopsy sample, which is not apparent on routine hematoxylin,
and eosin stained skin biopsies. In this lecture different pathological entities
of skin will be discussed where the presence of colored substance plays a
major role in the diagnosis. Mucin in a skin biopsy will give bluish tinge to the
tissue. Mucin can be highlighted by different mucin stains like alcian blue,
colloidal iron and mucicarmine. When a bluish tinge is present in a biopsy
sample depending on the dermal location , diagnosis can be narrowed down.
In systemic lupus erythematosus and dermatomyositis mucin is present in
the stroma. Follicular mucinosis is a clue to mycosis fungoides, especially
folliculotrophic variant. Presence of mucin in a dermal based granuloma is a
clue to diagnose granuloma annulare. Calcium is a substance which can be
present in different skin lesions which appear dark blue in H and E stained skin
biopsies. Calciphylaxis, calcinosis cutis and pancreatic panniculitis are some
of the conditions where calcium is deposited in skin tissue. Fibrin gives ride
characteristic red colour. Fibrin is deposited in different conditions of skin
including vasculitis with fibrinoid necrosis, rheumatoid nodules with central
necrobiotic focus containing fibrin etc. Deposition of amorphous or granular
eosinophilic material appears as pink colour cutaneous deposits. In different
cutaneous pathological conditions which help to narrow down the differential
diagnosis. Amyloid, elastotic degeneration of skin and caseous necrosis can
appear as pink material, which can be differentiated using different special
stains. Special stains are also used to highlight different micro organisms
in cutaneous infections. Fungi may appear purple with PAS stain and black
with Grocotte stain. Giemsa stain highlights donovani bodies in cutaneous
leishmaniasis in purple. Acid fast stains use to highlight mycobacterial which
appear pink. It is important to pay attention to variation in colours and their
patterns, which will provide valuable clues in the diagnosis of cutaneous
diseases.
Biography
Palitha Ratnayake is the current President of Sri
Lanka College of Pathologists. Following MD in His-
topathology, he has completed advanced course in
Dermatopathology at St John Institute in St Thomas
Hospital, London in 2001 and Fulbright Fellowship
in Dermatopathology in University of California, USA
in 2009. He has done many research studies in the
field of Dermatopathology and given speeches at
both local and international conferences and sym-
posia. He holds many years of experience in teach-
ing junior dermatologists and pathologists and has
been contributing as an examiner for MD Histopa-
thology for several years. His special research inter-
est is mycosis fungoides, cutaneous leishmaniasis
and cutaneous infections.
Palitha Ratnayake
Teaching Hospital-Kandy, Sri Lanka