Pathology
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Atlas of dermatopathology
Josef Feit, Hana Jedličková, Günter Burg, Luděk Matyska, Spasoje Radovanovic et al.
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+ Introduction
+ Literature
+ Support
+ Skin biopsy
+ Non-tumorous skin diseases
+ Skin tumors
+ Cysts of the skin and subcutis
+ Soft tissue lesions
+ Some lesions of the oral cavity
+ Dermatovenerology
+ Collection of histological slides by prof. Günter Burg
+ Collection of histological slides by prof. Werner Kempf
+ Collection of histological slides of dr. Ram Chandra Adhikari
Gout, arthritis uratica
Introduction

Herogenous group of diseases characterized by increased level of uratic acid in the blood, caused by overproduction of purines, increased catabolism of nucleic acids, decreased excretion of uric acid (idiopathic gout, about 80%) or decreased degradation of purines.

Clinical signs
  • precipitated urates form chalky white deposits on intra-articular structures
  • subcutaneous deposits (tophi), sometimes discharged transcutaneously, sometimes in late stages of the disease
  • location: helix of the ear, elbow, fingers, toes
  • size: up to several centimeters
Histology

Epidermis normal or ulcerated. Usually large deposits of amorphous, amphophilic or slightly basophilic material with parallel, needle shaped clefts within the dermis and subcutis. Lymphohistiocytic infiltrate, often with granulomatous foreign-body reaction. Sometimes calcifications or ossifications are present as well.

For better visualisation fixation in 100% ethanol is preferred; the crystals are birefingent. If the tissue is fixed with formaldehyde, the crystals usually dissolve. The fixation fluid can be tested for presence of urates (murexid reaction).

Pictures