Abstract:Background and objectives: Microinvasive oral squamous cell carcinoma is an early stage malignancy characterized by invasion of superficial lamina propria without invasion of deeper structures. These lesions have a varied clinical presentation, minimal lymphatic involvement and a better prognosis. However, there is no clear consensus on its diagnosis and subsequent management. The aim of this study is to assess the depth of invasion of confirmed cases of microinvasive oral squamous cell carcinoma using special stains and immunohistochemistry with clinical correlation of these lesions.Method: Tissue specimen of clinically diagnosed cases of oral leukoplakia (n=90), oral submucous fibrosis (n=60) and oral carcinoma (n=50) were microscopically evaluated for the presence of microinvasion by two independent examiners. The next step involved confirming the basement membrane breach by using Periodic acid Schiff (PAS) stain for evaluating the integrity of basement membrane. The confirmed cases were assessed using special stain and immunohistochemistry to measure the depth of invasion and were further correlated with the clinical features.Results: A total of 29 cases were confirmed as microinvasive OSCC. These included clinically diagnosed 11 cases of leukoplakia, 7 cases of OSMF and 11 cases of carcinoma. Median age at diagnosis was 46 yrs; males (69%) were more affected than females (31%). The predominant risk factor was tobacco chewing alone (31.03%) which was in the form of gutkha and arecanut; common site was buccal mucosa (76%); predominant clinical presentation was a patch; and histopathology revealed varying grades of epithelial dysplasia. The mean depth of invasion was 31.29 µm (0.03 mm) with the range being 16.91 -66.6 µm (0.02 -0.07 mm). Conclusion:The study suggest that depth of invasion could be a reliable marker to assess microinvasion and that severity of epithelial dysplasia is not a pre-requisite for microinvasive carcinoma.

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Context: Areca nut, a causative factor for oral submucous fibrosis (OSMF), is identified as a Group 1 human carcinogen. Oral squamous cell carcinoma (OSCC) associated with OSMF is now one of the most common malignancies in South and Southeast Asian countries. Aim: The present study was aimed to have clarity whether OSCC associated with OSMF is a pathologically different disease having different prognosis. Settings and Design: The difference between OSCC associated with OSMF and OSCC not associated with OSMF was studied in relation to expression of molecular markers, Ki-67, a proliferative and prognostic marker for OSCC and matrixmetalloproteinase-9 (MMP-9), and alpha smooth muscle actin (α-SMA), markers for invasiveness. Subjects and Methods: Expression was analyzed immunohistochemically using paraffin-embedded tissues from ten normal oral mucosa (Group I), thirty OSCC associated with OSMF (Group II), and thirty OSCC not associated with OSMF (Group III). Results: Group II showed OSCC occurring at younger age with more cases of well-differentiated OSCC. It also showed lower expression of Ki-67, MMP-9, and α-SMA as compared to Group III, and the difference was statistically significant. In addition, statistically significant low expression of markers was found in well and moderate grades of Group II as compared to those of Group III. Conclusion: OSCC associated with OSMF may have better prognosis and survival rate as it is found to occur at younger age with better grade of tumor differentiation and less expression of molecular markers Ki-67, MMP-9 and α-SMA. Thus, OSCC associated with OSMF can be considered a different disease pathologically and biologically. In-depth analysis of this molecular profiling can help to establish diagnostic, prognostic and therapeutic modalities for this unique malignancy.

Eosinophilic pustular folliculitis (EPF) was originally described by Ofuji in Japanese patients without any systemic disease. Later it was widely associated with HIV. Lately a large number of hematological malignancies have been associated with EPF. We hereby report an association of non-Hogkins lymphoma with EPF, probably the first in Indian context.

Leprosy (Hansen's disease) is a chronic infectious disease caused by Mycobacterium leprae. It still continues to be a major health problem in many countries including India. Early diagnoses and prompt treatment is the corner stone in reducing the load of infection and morbidity caused by Hansen's disease. OBJECTIVEThe objective of this study was to assess the clinical and epidemiological profile and asses the conditions that required inpatient care in patients of Hansen's disease over a period of 6 years between 2010 and 2016 in the Department of Skin, Goa Medical College. METHODSThis was a descriptive, observational and retrospective study, in which data of admitted patients in a tertiary care hospital was collected over a period of six years (2010)(2011)(2012)(2013)(2014)(2015)(2016) and was analysed for clinical and epidemiological profiles. RESULTSIn our study, males outnumbered the females and age group of 20-50 years was maximally affected. Multibacillary cases were more frequent among the newly-detected cases with BL (Borderline Lepromatous) and LL (Lepromatous) being the commonest spectrum. Reactions (Type I and II), trophic ulcers and disabilities were the major cause of admissions and even included patients who had completed their chemotherapy. CONCLUSIONIn our study, we found that prevalence of multibacillary cases is still high. This is important as globally elimination of leprosy is highly aimed at. The importance of counselling and educating patients is important not only to adhere to treatment regimes, but also for early recognition of symptoms. KEYWORDSHansen's, Multidrug Therapy, Disabilities. HOW TO CITE THIS ARTICLE: Ghodge R, Bhandare P, Shukla P, et al. A retrospective analysis of clinical profile of admitted leprosy patients in a tertiary care hospital of Goa over a six year period. J. Evolution Med. Dent. Sci. 2016;5(72):5249-5252, DOI: 10.14260/jemds/2016/1189 INTRODUCTION Hansen's disease is a disabling infectious disease and is a major health problem in India owing to the chronic course and disabilities. The principal of reducing the load of infection is the corner stone of leprosy control. The present study was undertaken to know the clinical profile of admitted leprosy patients, causes of hospitalisations and to observe any changing trends in the state of Goa. MATERIALS AND METHODSThis is a descriptive, observational and retrospective study in which data was collected over a period of six years from January 2010 to December 2015. The data of all admitted Financial or Other, Competing Interest: None. Submission 29-07-2016, Peer Review 22-08-2016, Acceptance 29-08-2016, Published 07-09-2016. Corresponding Author: Dr. Mayur Bhobe, Sriram, House No: 613/e/d/c, SPARC, Behind Chowgule College, Cupangale, Fatorda-403602, Goa. E-mail: mayur8509@gmail.com DOI: 10.14260/jemds/2016/1189 leprosy patients in the department of skin was collected from Medical Records Department of Goa Medical College. Subsequent admissions of the same patient were not considered to prevent duplicati...