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View Full Version : Skin Biopsy???? What does this mean??



Ronnie
07-19-2011, 11:47 AM
Skin biopsy to find out what rash is. Rheumi said it was a photosensitivity rash from the sun. Dermi did skin biopsy and pathology report says in the comment: the histological differential diagnosis includes a contact dermatitis, an eczematous drug eruption, and less likely the urticarial phoase of bullous pemphigoid. due to presence of somewhat brisk superficial to mid dermal perivascular lyphocytic infiltrate, the papulovesicular variant of polymorphous light eruption is also with the histologic differential. the presence of langerhads cell mircroabscess along with epidermal spogioisis and a mixed dermal infiltrate with eosinophils suggests an allergic contact dermattis, which i somewhat favor however the papulovesicular variant of polymorphous light eruption cannot be excluded. clinicopathologic correlation is recommended.

Microscopic description: There is spongiosis. A collection of mononuclear cells with abundant cytoplasm and reniform nuclei, consistent with Langerhans cell microabsess is present within the epidermis. In the dermis there is a somewhat brisk superficial to mid dermal perivascular lymphohistiocytic inflammatory infiltrate with scattered eosinophils.

Can you tell me if there is any chance that this has to do with something systemic like CREST or lupus? Or anything else. I have fever, severe leg pain, raynauds, livido reticularis, ana of 1:80, rash, 4 docs mentioned maylar rash, and have taken 12 doses of antibiotic for many different infections...cellulitis, severe sinusitis, 3x bronchitis, UTI, etc.

Ronnie
07-19-2011, 11:55 AM
Those doses were in the last 12 months.

Peridot20_Gem
07-19-2011, 12:09 PM
Ronnie,

They should'nt be doing that, they're lowering your immune system even lower...you must state in future as i do i won't take no more than 2 lots in a year..it's not helping your system one bit.

Dermatitis besides ezcema can come with Lupus or just naturally out the blue but it seems like yours maybe connected with the Lupus...like my psoriasis is and my ezcema.

I'll do some checking for you on it Ronnie.

Peridot20_Gem
07-19-2011, 12:18 PM
Ronnie,

I've just found this link out for you, as i'm with an excellent Dermo and before i go on drugs he checks on the tablets i take and does print off a site he's with from the hospital and i think it's worth joining to help you besides refering knowledge of your conditions besides.

www.bad.org.uk/site/792/default.aspx

Peridot20_Gem
07-19-2011, 12:27 PM
Ronnie....i've put in about systemic like CREST or lupus.

It's to do with Scleroderma which i have mate and it causes the crest and it's also related to Lupus, as Scleroderma comes from Raynauds Disease.

I'll add some links for you to look at but i do suggest joining that other site i added.

www.diagnose-me.com/cond/C179467.html

www.garynullforum.com/GNthisArticle.php?article=234


I hope the links help when reading them Terry xxx

Ronnie
07-19-2011, 01:05 PM
Terry, you are so kind to always take your time to help. I don't have much time to find out things because I work full time and have two teenagers that don't drive. Thank you sincerely for always caring and helping me so much. I will get busy and look up those sites. Thanks again!

Peridot20_Gem
07-19-2011, 01:09 PM
Ronnie,

That's what we're all here for but the links i've given you take you direct to the pages to read, it's only the same as reading it off the site if i posted it.
The Scleroderma at the moment is affecting my calfs and making them swell just like when i had DVT and the pain is terrible.

Hugs to you Terry xxx

MommySquared
07-27-2011, 10:36 AM
Hi. I have a lot of experience with skin biopsies. My son (5) has had 4 since he was 2. We have never had any luck with the skin biopsies, as most of the time they are inconclusive. I just wanted to mention that, if the rheumy thinks it is photosensitivity, see if they can do the phototherapy/patch testing. For my son, they put him in a machine that was like a tanning bed for a certain amount of time (I can't remember how long as it's been a couple of years ago, with lots of stuff going on since then) everyday at the same time each day for 3 days. At the end of the 3rd day, his derm. evaluated the results. They also did some kind of photosensitivity test where I had to collect his urine for 24 hours, and it was tested. I don't remember the name of the test but it was for porphyria. Both of those tests are non-invasive, and I'm surprised the derm. didn't do those before a skin biopsy. Your biopsy results sound kind of iffy, like nothing really stood out that made the pathologist say "This is what it is for sure", and that's how my son's have always been. He had seen derms for over 2 years until they finally ruled that his skin condition was secondary to something else. Did you dr. mention doing any allergy skin tests since the path. thinks its contact derm.? My son also did a nickel free diet, skin allergy test, and also went on some allergy meds as a preventative. Anyway, I hope you can get some answers and some relief.

Ronnie
07-28-2011, 10:49 AM
Hi. I have a lot of experience with skin biopsies. My son (5) has had 4 since he was 2. We have never had any luck with the skin biopsies, as most of the time they are inconclusive. I just wanted to mention that, if the rheumy thinks it is photosensitivity, see if they can do the phototherapy/patch testing. For my son, they put him in a machine that was like a tanning bed for a certain amount of time (I can't remember how long as it's been a couple of years ago, with lots of stuff going on since then) everyday at the same time each day for 3 days. At the end of the 3rd day, his derm. evaluated the results. They also did some kind of photosensitivity test where I had to collect his urine for 24 hours, and it was tested. I don't remember the name of the test but it was for porphyria. Both of those tests are non-invasive, and I'm surprised the derm. didn't do those before a skin biopsy. Your biopsy results sound kind of iffy, like nothing really stood out that made the pathologist say "This is what it is for sure", and that's how my son's have always been. He had seen derms for over 2 years until they finally ruled that his skin condition was secondary to something else. Did you dr. mention doing any allergy skin tests since the path. thinks its contact derm.? My son also did a nickel free diet, skin allergy test, and also went on some allergy meds as a preventative. Anyway, I hope you can get some answers and some relief.

Thank you so much for your responce. I thought I was just crazy to think there would be some other tests. I just don't understand these doctors. I read online about all these other tests but they never mention any of them. Just like being dxed with Raynauds. I read where they can do a nail capillary test but never had one. Just diagnosed by site. I also was dxed with fibromyalgia, but don't feel strongly that is what I have. I was also told that I probably have a connective tissue disorder but don't know which. Basically it is a wait and see. Well I don't want to wait and see things get worse before they start me on treatment....If you know what I mean. Thanks again for your response. I actually spoke to the person who wrote up the lab results and she told me I should have another skin biopsy done because part of the results say it could be lupus and the other part says it is not. What the heck does that mean????? Gotta luv it:)

tgal
07-28-2011, 11:32 AM
Thank you so much for your responce. I thought I was just crazy to think there would be some other tests. I just don't understand these doctors. I read online about all these other tests but they never mention any of them. Just like being dxed with Raynauds. I read where they can do a nail capillary test but never had one. Just diagnosed by site. I also was dxed with fibromyalgia, but don't feel strongly that is what I have. I was also told that I probably have a connective tissue disorder but don't know which. Basically it is a wait and see. Well I don't want to wait and see things get worse before they start me on treatment....If you know what I mean. Thanks again for your response. I actually spoke to the person who wrote up the lab results and she told me I should have another skin biopsy done because part of the results say it could be lupus and the other part says it is not. What the heck does that mean????? Gotta luv it:)

Hi Ronnie,

Being dxd with Raynauds by sight is not unusual. When Raynauds is active it is very clear what it is. I too was diagnosed by sight because my toes looked like the US Flag. As for fibromyalgia, many of us with AI diseases have it also. Sometimes the fibro causes more problems then the Lupus. Saysusie and I spoke about that a week or so ago. You get the AI diseases under control for a bit and the fibro goes nuts. Fibro hurts and causes many problems. I know some people think it is a made up disease but it isn't and it has to be dealt with.

I know mixed connective tissue disease is difficult to swallow because there is no name of a single disease but all that really means is we don't know what AI disease you have yet. Most of the AI diseases are treated basically the same so hopefully you are on some kind of meds for whatever it is. There is no test for Lupus and too often doctors don't understand that their blood tests are not always going to be positive when someone has Lupus. The blood work fluctuates with AI diseases, Lupus in particular, and doctors need to understand that there is more to a diagnosis then blood work.

I hope you get the answers you are looking for and I hope you feel better soon