Background: Cirrhosis often is a silent disease Clinical symptoms at presentation may include jaundice of the eyes or skin, pruritus, gastrointestinal bleeding, coagulopathy, increasing abdominal girth, and mental status changes. Pruritus may be the presenting symptom, arising years before any other classic clinical and laboratory markers of hepatic dysfunction. This study examines the clinical, laboratory and histopathological changes
in the skins of cirrhotic patients with pruritus in comparison with cirrhotic patients
without pruritus and healthy control skins .
Patients and Methods; To evaluate histopathological changes in cirrhotic patients with pruritus, cirrhotic patients without pruritus and corresponding healthy (control). skin biopsies (20 specimens each) using hematoxylin and eosin stain and to study mast cell density using gimesa stain.
Results: In the skin biopsy specimens of the cirrhotic patients with pruritus we found several histological changes including: epidermal hyperplasia (acanthosis) ,vascular ectasia(dilated dermal blood vessels), hypertrophied dermal nerve endings, mixed inflammatory cellular infilterate and lymphocytic vasculopathy (swelling of the endothelial cell lining of the blood vessels without fibrinoid necrosis, leucocytoclasia or extravasation of red blood cells). Evaluation of mast cell count in Girnesa stained skin sections revealed an increased numbers of these cells in the group of cirrhotic patients with pruritus ( N=5- l 0). The cells noted in perivascular, perineural and interstitial distribution (between collagen bundles).
Conclusions; We report, for the first time, some histopathologial changes in the skins of cirrhotic patients with pruritus in comparison with cirrhotic patients without pruritus and healthy control skins .
Introduction:
Cirrhosis refers to a progressive, diffuse, fibrosing and nodular condition that disrupts the entire normal architecture of the liver I i ).In developed countries, the leading causes of cirrhosis are HCV infection, alcohol misuse, and nonalcoholic fatty liver disease (2). Hepatitis B viral infection is the most common cause of cirrhosis in developing countries