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A histopathological approach: when papulopustular lesions should be in the diagnostic criteria of Behçet's disease?
J Eur Acad Dermatol Venereol. 2009 Sep; 23(9):1056-60.JE

Abstract

BACKGROUNDPapulopustular lesions (PPL) are commonly seen cutaneous lesions in Behçet's disease (BD). Some authorities do not recommend using cutaneous lesions for diagnostic criteria because these lesions are confused with acne vulgaris. Objective To understand if PPL have diagnostic value in BD.

METHODS

Biopsy was performed on papulopustular lesions of Behçet's patients for histopathological examination to compare with the control group composed of patients with acne vulgaris. Forty two patients with BD and 21 control patients with acne vulgaris were enrolled in the study. Histopathological findings were classified as leukocytoclastic vasculitis, lymphocytic vasculitis, superficial and/or deep perivascular infiltration, and folliculitis and/or perifolliculitis.

RESULTS

Of the specimens from 42 Behçet's disease patients, 7 (16.7%) revealed leukocytoclastic vasculitis and 3 (7.1%) had lymphocytic vasculitis, 15 (35.7%) had superficial perivascular and/or interstitial infiltration, 12 (28.6%) had superficial and deep perivascular and/or interstitial infiltration, 5 (11.9%) had folliculitis or perifolliculitis. Of the control group patients, 9 (42.9%) had folliculitis or perifolliculitis, 8 (38.1%) revealed superficial perivascular inflammation and 4 (19.0%) revealed mixed superficial and deep perivascular inflammation. Vasculitis was not encountered in any control group specimens. Vasculitis ratio was statistically higher in Behcet's disease patients (P = 0.016).

CONCLUSIONS

We evaluated more patients than previous related studies reported in the literature. Histopathological findings of vasculitis were encountered only in BD group. Non-vasculitis histopathological findings were also encountered in the control group patients. In conclusion, PPL can be used as a diagnostic criterion of BD subsequent to finding vasculitis in histopathological examination of the biopsy specimen of the PPL.

Authors+Show Affiliations

Department of Dermatology, Ministry of Health, Ankara Education and Research Hospital, Ankara, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19453803

Citation

Kalkan, G, et al. "A Histopathological Approach: when Papulopustular Lesions Should Be in the Diagnostic Criteria of Behçet's Disease?" Journal of the European Academy of Dermatology and Venereology : JEADV, vol. 23, no. 9, 2009, pp. 1056-60.
Kalkan G, Karadag AS, Astarci HM, et al. A histopathological approach: when papulopustular lesions should be in the diagnostic criteria of Behçet's disease? J Eur Acad Dermatol Venereol. 2009;23(9):1056-60.
Kalkan, G., Karadag, A. S., Astarci, H. M., Akbay, G., Ustun, H., & Eksioglu, M. (2009). A histopathological approach: when papulopustular lesions should be in the diagnostic criteria of Behçet's disease? Journal of the European Academy of Dermatology and Venereology : JEADV, 23(9), 1056-60. https://doi.org/10.1111/j.1468-3083.2009.03256.x
Kalkan G, et al. A Histopathological Approach: when Papulopustular Lesions Should Be in the Diagnostic Criteria of Behçet's Disease. J Eur Acad Dermatol Venereol. 2009;23(9):1056-60. PubMed PMID: 19453803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A histopathological approach: when papulopustular lesions should be in the diagnostic criteria of Behçet's disease? AU - Kalkan,G, AU - Karadag,A S, AU - Astarci,H M, AU - Akbay,G, AU - Ustun,H, AU - Eksioglu,M, Y1 - 2009/04/29/ PY - 2009/5/21/entrez PY - 2009/5/21/pubmed PY - 2009/11/18/medline SP - 1056 EP - 60 JF - Journal of the European Academy of Dermatology and Venereology : JEADV JO - J Eur Acad Dermatol Venereol VL - 23 IS - 9 N2 - UNLABELLED: BACKGROUNDPapulopustular lesions (PPL) are commonly seen cutaneous lesions in Behçet's disease (BD). Some authorities do not recommend using cutaneous lesions for diagnostic criteria because these lesions are confused with acne vulgaris. Objective To understand if PPL have diagnostic value in BD. METHODS: Biopsy was performed on papulopustular lesions of Behçet's patients for histopathological examination to compare with the control group composed of patients with acne vulgaris. Forty two patients with BD and 21 control patients with acne vulgaris were enrolled in the study. Histopathological findings were classified as leukocytoclastic vasculitis, lymphocytic vasculitis, superficial and/or deep perivascular infiltration, and folliculitis and/or perifolliculitis. RESULTS: Of the specimens from 42 Behçet's disease patients, 7 (16.7%) revealed leukocytoclastic vasculitis and 3 (7.1%) had lymphocytic vasculitis, 15 (35.7%) had superficial perivascular and/or interstitial infiltration, 12 (28.6%) had superficial and deep perivascular and/or interstitial infiltration, 5 (11.9%) had folliculitis or perifolliculitis. Of the control group patients, 9 (42.9%) had folliculitis or perifolliculitis, 8 (38.1%) revealed superficial perivascular inflammation and 4 (19.0%) revealed mixed superficial and deep perivascular inflammation. Vasculitis was not encountered in any control group specimens. Vasculitis ratio was statistically higher in Behcet's disease patients (P = 0.016). CONCLUSIONS: We evaluated more patients than previous related studies reported in the literature. Histopathological findings of vasculitis were encountered only in BD group. Non-vasculitis histopathological findings were also encountered in the control group patients. In conclusion, PPL can be used as a diagnostic criterion of BD subsequent to finding vasculitis in histopathological examination of the biopsy specimen of the PPL. SN - 1468-3083 UR - https://www.unboundmedicine.com/medline/citation/19453803/A_histopathological_approach:_when_papulopustular_lesions_should_be_in_the_diagnostic_criteria_of_Behçet's_disease L2 - https://doi.org/10.1111/j.1468-3083.2009.03256.x DB - PRIME DP - Unbound Medicine ER -