MIGRATION of foreign bodies to the lumbar spine has been reported in dogs but is uncommon (Johnston and Summers 1971, Brennan andIhrke 1983). When identified, the foreign body has invariably been a grass awn. Inhalation followed by migration via the pleural space, and ingestion and transabdominal migration, have been proposed as modes by which foreign material may reach the lumbar spine (Johnston and Summers 1971, Frendin and others 1999). This short communication describes a case of sudden-onset paraparesis due to a septic focus associated with the migration of a large sprig of conifer to the lumbar vertebral canal of a dog.A four-year-old female neutered dobermann was referred for evaluation of acute-onset non-ambulatory pelvic limb paresis. Patellar, panniculus and pelvic limb withdrawal reflexes were considered normal, as was pedal sensation. The thoracic limbs were neurologically normal. Bladder control at presentation was not determined. The dog was normothermic. The dog had a history of short episodes of intermittent lethargy and suspected back pain over two years, which had previously responded to antibiotic and anti-inflammatory drug treatment. The most recent episode had occurred 10 days before presentation, and had rapidly responded to medical treatment, with the owner reporting a return to normal within seven days.Radiographs of the thoracolumbar spine were obtained under general anaesthesia. There was profuse ventral spondylosis involving L2 and L3, an irregularly widened L2-L3 intervertebral disc space and variable radiopacity, including multiple punctate lucencies and sclerosis, of the involved vertebral bodies (Fig 1a). These findings were suggestive of persistent osteomyelitis of the vertebral bodies L2 and L3 and associated chronic discospondylitis. Lumbar myelography was performed by injection of 6 ml iohexol (Omnipaque; GE Healthcare) via lumbar puncture at L5-L6. There were multifocal mild deviations in the left and right contrast columns (on a ventrodorsal view) and a major deviation of the right contrast column towards the midline at the level of L2-L3 (Fig 1b).A right-sided hemilaminectomy centred over the L2-L3 intervertebral disc was performed. Perioperatively, 140 mg carprofen (Rimadyl; Pfizer) and 700 mg cefazolin (Kefzol; Lilly) were administered intravenously. Intravenous fluid therapy with lactated Ringer's solution (Aqupharm No11; Animalcare) was administered at a rate of 10 ml/kg/hour throughout the procedure. As the inner periosteum was incised, purulent fluid exuded from the epidural space. A layer of granulation tissue 2 to 3 mm thick covered the dural sac. The bone of the vertebral body of L2 was soft and contained a cavity 20 mm in diameter, which was explored with a small probe. A large sprig of plant material, approximately 25 mm in length (Fig 2), was retrieved from the defect. Tissue from the cavity was collected and submitted for histopathology and bacterial culture and sensitivity testing. The wound was closed routinely and the dog recovered from anaesthesia uneventful...

Granuloma annulare (GA) is a common benign inflammatory skin condition classically presenting as skin-colored to erythematous dermal papules and annular plaques. Histologically, GA displays a dermal granulomatous infiltrate with palisaded histiocytes surrounding focally altered collagen. The exactly etiology of GA remains unknown, but it has been associated with trauma, various infections, diabetes mellitus, malignancy, thyroid disease, dyslipidemia, and several medications. In 2017, a case of GA developing in a patient treated with the interleukin 17A antagonist secukinumab was reported. Here we report a second case of GA in association with secukinumab use.

Langerhans cell histiocytosis (LCH) is a proliferative disorder of Langerhans cells that can be challenging to distinguish histologically from Langerhans cell (LC) hyperplasia, seen in a variety of inflammatory dermatoses. Lesional cells in both entities demonstrate positive staining for CD1a and S100. Previous studies have demonstrated positive staining of fascin, CD31, and p53 in cases of LCH, but currently, no studies have compared the staining profiles of these markers between LCH and LC hyperplasia. The authors compared immunohistochemical staining profiles of LCH (n = 15) and various inflammatory dermatoses with LC hyperplasia (n = 15) using fascin, CD31, and p53. Fascin, CD31, and p53 were graded as a percentage of CD1a staining cells in the epidermis and dermis of each specimen. Fascin showed no significant differences in staining between the 2 entities. CD31 was positive in the dermal infiltrate in 40% of cases of LCH and negative in all cases of LC hyperplasia. p53 was positive in the epidermal infiltrate in 50% of cases of LCH, and positive in the dermal infiltrate in 93% of cases of LCH, whereas negative in all cases of LC hyperplasia. Fascin was not a helpful marker in distinguishing LCH from LC hyperplasia. CD31, if positive in the dermal infiltrate, is suggestive of a diagnosis of LCH, but exhibits a relatively low sensitivity for this purpose. p53 proved to be a helpful and accurate diagnostic immunohistochemical stain when distinguishing between LCH and LC hyperplasia.

Background Muir‐Torre syndrome (MTS) is a rare inherited syndrome, with an increased risk of sebaceous and visceral malignancy. Prior reports suggest screening for mismatch repair (MMR) deficiency may be warranted in patients <50 years and when sebaceous neoplasms are located on a non‐head and neck location. Previously, appropriate use criteria (AUC) were developed for clinical scenarios in patients >60 years concerning the use of MMR protein immunohistochemistry (MMRP‐IHC). This analysis explores the appropriateness of testing in patients ≤60 years. Methods Panel raters from the AUC Task Force rated the use of MMRP‐IHC testing for MTS for previously rated scenarios with the only difference being age. Results Results verify the previously developed AUC for the use of MMRP‐IHC in neoplasms associated with MTS in patients >60 years. Results also show that in patients ≤60 years with a single sebaceous tumor on a non‐head and neck site, MMRP‐IHC testing should be considered. Testing can also be considered with a 2‐antibody panel on periocular sebaceous carcinoma in younger patients. Conclusions Our findings align with known evidence supporting the need to incorporate clinical parameters in identifying patients at risk for MTS, with age being a factor when considering MMRP‐IHC testing.

Background:Telogen effluvium (TE) is a type of acquired, diffuse alopecia that occurs due to an abnormal shift of scalp hair follicles from anagen to telogen, leading to premature shedding of hair. Previous studies have suggested the existence of a neuroimmunologic “brain-hair follicle” axis, in which mast cells have been implicated as an important link between the nervous system and immunologic system.Objective:The current study sought to investigate the role of mast cell presence and mast cell degranulation in the pathogenesis of TE.Materials and Methods:Mast cells were counted using Giemsa and tryptase immunohistochemical stains in scalp biopsy specimens with the pathologic diagnosis of TE (TE, n = 10), alopecia areata (AA, n = 7), and androgenic alopecia (ANDRO, n = 9).Results:We found significant (P < 0.001) group-level differences between the mean mast cell counts per high-power fields for each type of alopecia studied. Tukey post hoc analysis showed the mean mast cell count for TE to be significantly larger than AA for both Giemsa (P = 0.002) and tryptase (P = 0.006); significantly larger than ANDRO for both Giemsa (P < 0.001) and tryptase (P < 0.001); and significantly larger when compared to normal scalp skin for both Giemsa (P < 0.001) and tryptase (P < 0.001). No significant difference of mean mast cell counts was observed for AA compared to ANDRO for Giemsa (P = 0.373) or tryptase (P = 0.598) stains.Conclusion:Our findings suggest that mast cells could play a role in mediating stress-induced hair loss seen in TE.