Autopsy and Case Reports
https://app.periodikos.com.br/journal/autopsy/article/doi/10.4322/acr.2021.247
Autopsy and Case Reports
Short Communication

Value of the toluidine blue test as an aid to determine the biopsy site in actinic prurigo cheilitis

Lily Margoth Cedeño-Suárez; María Elisa Vega-Memije; Juan Carlos Cuevas-González; Adalberto Mosqueda-Taylor

http://dx.doi.org/10.4322/acr.2021.247 Autops Case Rep, vol.11, e2021247, 2021
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Abstract

ABSTRACT: Actinic prurigo (AP) is a type of photodermatosis that primarily affects the Latin American mestizo population. Histologically, AP cheilitis exhibits acanthosis with spongiosis and vacuolation of the basal cell layer overlying a dense lymphocytic inflammatory infiltrate that forms well-defined lymphoid follicles. Toluidine blue is a thiazide, acidophilic, and metachromatic dye used in vivo to selectively stain the acidic components of tissues such as sulfates, carboxylates, and phosphate radicals that are incorporated into DNA and RNA. It is necessary to develop a method that allows detecting, on clinical grounds the area of the lesion in which it is more feasible to find such structures. Thus to increase the sensitivity of the biopsy, in AP cheilitis to accurately identify where the lymphoid follicles reside, based on the higher concentration of DNA in such structures and thus confirm the diagnosis. In this study, staining was positive in 85% of patients with AP cheilitis, in 14 of whom 82% lymphoid follicles were observed by histopathology. One of the pathologist’s problems in establishing the diagnosis of AP is that the main histopathological characteristics are not always identified in the submitted samples because it is not easy to clinically identify the most representative site of the lesion selected for performing a biopsy. Based on our results, we propose using toluidine blue as an auxiliary method to choose a tissue sample to facilitate the diagnosis and allow clinicians to make clinical correlations between the histopathological and therapeutic findings.

Keywords

Actinic Prurigo, toluidine blue O-polyacrylamide polymer, Tertiary Lymphoid Structures

References

1 Martínez-Luna E, Bologna-Molina R, Mosqueda-Taylor A, et al. Inmunohistochemical detection of mastocytes in tissue from patients with actinic prurigo. J Clin Exp Dent. 2015;7(5):656-9. http://dx.doi.org/10.4317/jced.52823. PMid:26644844.

2 Vega-Memije ME, Mosqueda-Taylor A, Irigoyen-Camacho ME, Hojyo-Tomoka MT, Domínguez-Soto L. Actinic prurigo cheilitis: clinicopathologic analysis and therapeutic results in 116 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(1):83-91. http://dx.doi.org/10.1067/moe.2002.123539. PMid:12193899.

3 Albornoz-López del Castillo C, Barrios Sánchez O, Rojas Casanova P, Bastian Manso L, Santana Garay JC. Eficacia del azul de toluidina y lugol en el diagnóstico precoz del cáncer bucal. AMC. 2010;14:1-11.

4 Martin IC, Kerawala CJ, Reed M. The application of toluidine blue as a diagnostic adjunct in the detection of epithelial dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(4):444-6. http://dx.doi.org/10.1016/S1079-2104(98)90071-3. PMid:9574954.

5 Chainani-Wu N, Madden E, Cox D, Sroussi H, Epstein J, Silverman S Jr. Toluidine blue aids in detection of dysplasia and carcinoma in suspicious oral lesions. Oral Dis. 2015;21(7):879-85. http://dx.doi.org/10.1111/odi.12358. PMid:26173924.

6 Vega-Memije ME, Mancheno-Valencia A, Bologna-Molina RE, Toussaint-Caire S, Cuevas-González JC. Expression of E-cadherin, syndecan 1, Ki-67, and maintenance minichromosome 3 in tissue lesions of actinic prurigo obtained by incisional biopsy. Indian J Pathol Microbiol. 2018;61(2):225-7. http://dx.doi.org/10.4103/IJPM.IJPM_574_17. PMid:29676362.
 

Submitted date:
11/02/2020

Accepted date:
12/01/2020

Publication date:
03/12/2021

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