Background: Accurate diagnosis of vesiculobullous lesions of skin requires evaluation of clinical, histopathologic and immunofluorescence findings.

Hepatitis C virus (HCV) is a major cause of chronic liver disease in patients on hemodialysis. As no useful noninvasive predictors of disease activity and fibrosis have been found, liver biopsy is essential in these patients to accurately assess the severity of disease and thus the prognosis and plan management. The present study was undertaken to assess the degree of severity of necroinflammatory changes and fibrosis in liver biopsies of patients on hemodialysis with chronic HCV infection. Liver biopsies obtained from 45 patients on hemodialysis with serological evidence of chronic hepatitis C were studied. The grading of necroinflammatory activity and staging of fibrosis were histologically assessed. The majority of patients (30, i.e. 66.7%) had mild disease with mild inflammatory activity and stage 0, 1 or 2 fibrosis. There was no significant correlation between the degree of fibrosis and the age of the patients (rs = 0.015), the duration of hemodialysis (rs = 0.047) or the presence of steatosis (rs = 0.064). There was a positive correlation between the presence of bile ductular proliferation and the severity of fibrosis (rs = 0.612). It was concluded that chronic HCV infection in hemodialysis patients is relatively mild early in its course. However, serial follow-up liver biopsies are mandatory to plan appropriate intervention strategies.

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Heart and its great vessels are involved in tertiary syphilis in the form of syphilitic aortitis often 20 years or more after primary infection is contracted. In a 60 year old male cadaver, we found an enlarged heart with aneurysm of ascending aorta and semilunar septa was found protruding in to the lumen of arch of aorta distal to the origin of left subclavian artery. Right pulmonary vessels were dilated. Right and left atrial cavity were dilated, left ventricular hypertrophy with dilatation was noted. Hispathological findings of the specimens were suggestive of syphilitic aortitis. Cardiovascular syphilis though uncommon is still a significant cause of mortality and morbidity, which can be reduced by adequate screening, accurate diagnosis and appropriate treatment.