NADA, E., Assaf, H., El Sharkawy, R., Zaghloul, A., Abd El Meged, M., Abd El Wahed, M., Ahmed, A. (2018). Histopathological evaluation of skin in cirrhotic patients with pruritus. EKB Journal Management System, 22(1), 447-452. doi: 10.21608/smj.2018.42529
ESSAMELDIN ABDELAZIZ NADA; Hanan AbdlRadi Assaf; Reham Ezz El-Dawla El Sharkawy; Amr Mohamed Zaghloul; Marwa Mohamed Abd El Meged; Mahmoud Rezk Abd El Wahed; Asmaa Mahmoud Ahmed. "Histopathological evaluation of skin in cirrhotic patients with pruritus". EKB Journal Management System, 22, 1, 2018, 447-452. doi: 10.21608/smj.2018.42529
NADA, E., Assaf, H., El Sharkawy, R., Zaghloul, A., Abd El Meged, M., Abd El Wahed, M., Ahmed, A. (2018). 'Histopathological evaluation of skin in cirrhotic patients with pruritus', EKB Journal Management System, 22(1), pp. 447-452. doi: 10.21608/smj.2018.42529
NADA, E., Assaf, H., El Sharkawy, R., Zaghloul, A., Abd El Meged, M., Abd El Wahed, M., Ahmed, A. Histopathological evaluation of skin in cirrhotic patients with pruritus. EKB Journal Management System, 2018; 22(1): 447-452. doi: 10.21608/smj.2018.42529
Histopathological evaluation of skin in cirrhotic patients with pruritus
1DERMATOLOGY, Venereology and Andrology, Faculty of Medicine , sohag university.
2Department of Dermatology, Venereology and Andrology, Sohag Faculty of Medicine, Sohag University.
3Departments of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University.
4Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.
5Department of pathology, Assuit Faculty of Medicine, Assuit University.
Abstract
Background: Cirrhosis often is a silent disease Clinical symptoms at presentation may include jaundice of the eyes or skin, pruritus, gastrointestinal bleeding, coagulopathy, increasing abdominal girth, and mental status changes. Pruritus may be the presenting symptom, arising years before any other classic clinical and laboratory markers of hepatic dysfunction. This study examines the clinical, laboratory and histopathological changes in the skins of cirrhotic patients with pruritus in comparison with cirrhotic patients without pruritus and healthy control skins . Patients and Methods:To evaluate clinical, laboratory and histopathological changes in cirrhotic patients with pruritus, cirrhotic patients without pruritus and corresponding healthy (control). skin biopsies (20 specimens each) using hematoxylin and eosin stain and to study mast cell density using gimesa stain. Results: In the skin biopsy specimens of the cirrhotic patients with pruritus we found several histological changes including: epidermal hyperplasia (acanthosis) ,vascular ectasia(dilated dermal blood vessels), hypertrophied dermal nerve endings, mixed inflammatory cellular infilterate and lymphocytic vasculopathy (swelling of the endothelial cell lining of the blood vessels without fibrinoid necrosis, leucocytoclasia or extravasation of red blood cells). Evaluation of mast cell count in Gimesa stained skin sections revealed an increased numbers of these cells in the group of cirrhotic patients with pruritus ( N=5-10). The cells noted in perivascular, perineural and interstitial distribution (between collagen bundles). Conclusions:We report, for the first time, some histopathologial changes in the skins of cirrhotic patients with pruritus in comparison with cirrhotic patients without pruritus and healthy control skins .
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