medigraphic.com
Órgano oficial de la Sociedad Mexicana de Cirugía Dermatológica y Oncológica, AC

2013, Number 1

<< Back Next >>

Dermatología Cosmética, Médica y Quirúrgica 2013; 11 (1)

Usefulness of pas-stain in histopathologycal diagnosis

Hajar ST, Kresch TNS, Moreno CG, Arenas R, Vega MME

Language: Spanish
References: 16
Page: 13-18
PDF size: 274.25 Kb.


ABSTRACT

Background: The hematoxylin-eosin stain (he) is a commonly used histopathology tool to analyze skin sections. However, this medium does not bind to elements such as elastic fibers or mast cells, nor does it differentiate between melanic pigments and hemosiderin. Therefore, some diagnostic procedures require special stains, including: periodic acid-Schiff (pas), to visualize microorganisms; Gomori-Grocott (methenamine silver), for screening fungi; and the and Ziehl-Neelsen and Kinyoun stains, for actinomycetes and micobacterias.1 Of these, pas is potentially the most useful, as it binds with basal membrane glycogen and various skin structures.
Objective: To describe the usefulness of pas stain as a diagnostic tool in dermatopathology.
Methodology: Review of pas-stained samples from a total of 1000 skin biopsies obtained in 2008 by the Department of Dermatology of the General Hospital “Dr. Manuel Gea González”.
Results: The authors reviewed a total of 43 pas-stained biopsies from 36 patients diagnosed with non-infectious (58%) and infectious (42%) dermatoses. Of the latter, infectious etiology was confirmed in 33.33% of pas-stained samples, with further 9.3% false-negative results in spite of isolation of infectious agents in culture media (11.6%). In all, 18.6% of pas-stained samples were positive for infectious and inflammatory lesions, such as discoid lupus erythematosus.
Conclusions: pas stain is a useful diagnostic tool for clinically suspected infectious conditions of the skin. However, due to its retrospective nature, this review cannot assess the benefits of pas in differential diagnosis.


REFERENCES

  1. Gupta E, Bhalla P, Khurana N, Singh T. “Histopathology for the diagnosis of infectious diseases”. Indian J Med Microbiol 2009; 27(2): 100-106.

  2. Barnhill R, Crowson AN, Magro C. Dermatopathology, 3ª ed. Washington, McGraw-Hill, 2010: 458-494.

  3. Kligman AM, Mescon H. “The Periodic Acid-Schiff Stain for the Demonstration of Fungi in Animal Tissue”. J Bacteriol 1950; 60(4): 415-421.

  4. Hale AJ. “The Effect of Formalin on the Periodic Acid-Schiff Staining of Certain Types of Mucus”. J Histochem Cytochem 1955; 3(6): 421-429.

  5. Leblond CP, Glegg RE, Eidinger D. “Presence of Carbohydrates with Free 1, 2-Glycol Groups in Sites Stained by the Periodic Acid-Schiff Technique”. J Histochem Cytochem 1957; v5(5): 445-458.

  6. Lever WF, Schaumburg-Lever G. Histopathology of the Skin, 7ª ed. Philadelphia, Lipincott, 1990: 45.

  7. Ochoa PC, Smith OD, Swerdlow M. “The Dermal-Eepidermal Junction; A Preliminary Study with Periodic Acid-Schiff Stain”. AMA Arch Dermatol 1957; 75(1): 70-77.

  8. Sugai SA, Gerbase AB, Cernea SS, Sotto MN, Oliveira ZN, Vilela MA, Rivitti EA, Miyauchi LM, Sampaio SA. “Cutaneous Lupus Erythematosus: Direct immunofluorescence and Epidermal Basal Membrane Study”. Int J Dermatol 1992; 31(4): 260-264.

  9. Singh G, Lavanya MS, “The Reliability of Periodic Acid-Schiff Staining in the Diagnosis of Onychomycosis”. Indian J Dermatol Venereol Leprol 2009; 75(1): 73.

  10. Barak O, Asarch A, Horn T. “PAS is Optimal for Diagnosing Onychomycosis”. J Cutan Pathol 2010; 37(10): 1038-1040.

  11. Nash JW, Ross P Jr, Neil Crowson A, Taylor J, Morales JE, Yunger TM, Magro C. “The Histopathologic Spectrum of Cryofibrinogenemia in Four Anatomic Sites: Skin, Lung, Muscle, and Kidney”. Am J Clin Pathol 2003; 119(1): 114-122.

  12. Ruíz J, Arenas R, Vega ME. “Esporotricosis: Estudio histopatológico de 22 casos”. Dermatología Rev Mex 1996; 40 (2): 106-112.

  13. Wilsmann-Theis D, Sareika F, Bieber T, Schmid-Wendtner MH, Wenzel J. “New Reasons for Histopathological Nail-Clipping Examination in the Diagnosis of Onychomycosis”. J Eur Acad Dermatol Venereol 2011; 25(2): 235-237.

  14. Karimzadegan-Nia M, Mir-Amin-Mohammadi A, Bouzari N, Firooz A. “Comparison of Direct Smear, Culture and Histology for the Diagnosis of Onychomycosis”. Australasian J Dermatol 2007; 48: 18-21.

  15. Weinberg JM, Koestenblatt EK, Tutrone WD, Tishler HR, Najarian L. “Comparison of Diagnostic Methods in Evaluation of Onychomycosis”. J Am Acad Dermatol 2003; 49: 193-197.

  16. Mayer E, Izhak OB, Bergman R. “Histopathological Periodic Acid-Schiff Stains of Nail Clippings as a Second-Line Diagnostic Tool in Onychomycosis”. Am J Dermatopathol 2012; 34: 270-273.




2020     |     www.medigraphic.com