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Topic:Clinical Pathology

Clinical pathology in horses involves the study and analysis of biological samples to diagnose and monitor diseases and health conditions. This discipline encompasses various laboratory tests and procedures that assess the physiological and biochemical status of equines. Common analyses include hematology, biochemistry, urinalysis, and cytology, each providing insights into different aspects of equine health. Hematology evaluates blood components, such as red and white blood cells and platelets, to identify conditions like anemia or infection. Biochemistry tests measure enzymes, electrolytes, and metabolites to assess organ function and metabolic status. Urinalysis examines urine samples for indicators of renal function and systemic diseases. Cytology involves the microscopic examination of cells from tissues or fluids to detect abnormalities. This page aggregates peer-reviewed research studies and scholarly articles that explore the methodologies, applications, and diagnostic value of clinical pathology in equine medicine.
A Case Report of Uterine Body Constriction Precluding Normal Parturition Leading to Dystocia in a Mare.
Veterinary sciences    February 10, 2023   Volume 10, Issue 2 139 doi: 10.3390/vetsci10020139
Willette J, Gerras A, Sledge D, Koch D.A 13-year-old multiparous Quarter Horse mare was presented to the Michigan State University's, Large Animal Emergency service for dystocia. Clinical evaluation revealed a minimally dilated cervix on vaginal examination, with a palpable deceased fetus. Postmortem evaluation following owner-elected humane euthanasia revealed a circumferential, tan, fibrous band at the base of the uterine body that constricted the uterus and was adhered to the left and right ovaries. A routine histologic section of the incarcerating cord attached to the ovary consisted predominately of dense fibrous connective ti...
Multiple Sex Cord-stromal Tumors in a Standardbred Stallion Testis.
Journal of equine veterinary science    February 10, 2023   Volume 123 104246 doi: 10.1016/j.jevs.2023.104246
Roxon C, Slack J, Bender S, Burns H, Turner R.A 12-year-old Standardbred stallion presented with a 5-month history of a growing mass in the left testis as well as an overall decrease in left testicular size. Palpation and ultrasonography of the left testis revealed a firm, hypoechoic, clearly delineated soft tissue mass in the craniolateral portion of the testis that measured 2.5 × 2.3 × 1.9 cm. Two smaller, hypoechoic regions also were visible ultrasonographically in the left testis, suggesting the presence of multifocal/multicentric neoplasia. The affected testis was very small (testicular volume of 40.3 cm). The right testis was ...
Clinical insights: Advances in imaging of the equine distal limb.
Equine veterinary journal    February 8, 2023   Volume 55, Issue 2 167-170 doi: 10.1111/evj.13916
Spriet M.No abstract available
Detection and Genotypic Analysis of Anaplasma bovis and A. phagocytophilum in Horse Blood and Lung Tissue.
International journal of molecular sciences    February 7, 2023   Volume 24, Issue 4 3239 doi: 10.3390/ijms24043239
Seo MG, Ouh IO, Kwak D.A clinical case of was reported for the first time in our previous study (2019) in a horse, a nondefinitive host. Although is a ruminant and not a zoonotic pathogen, it is responsible for persistent infections in horses. In this follow-up study, the prevalence of spp., including , was assessed in horse blood and lung tissue samples to fully understand spp. pathogen distribution and the potential risk factors of infection. Among 1696 samples, including 1433 blood samples from farms nationwide and 263 lung tissue samples from horse abattoirs on Jeju Island, a total of 29 samples (1.7%) teste...
Sample stability and heparin interference in ionized calcium and ionized magnesium measurements in horses using the Stat Profile Prime Plus co-oximetry electrolyte analyzer.
Veterinary clinical pathology    February 6, 2023   Volume 52, Issue 2 252-260 doi: 10.1111/vcp.13200
Sanmartí J, Robles-Guirado JA, Jose-Cunilleras E, Bassols A.The determination of iCa and iMg is important in veterinary medicine, but their immediate determination in whole blood is not always possible. Their stability in other sample types and the existence of interferences must be evaluated before its use. Objective: We aimed to analyze the effects of storage time on the stability of iCa, iMg, and other analytes in whole blood, plasma, and serum samples in horses and assess the interference of heparin in these measurements. Methods: Whole blood, heparin-plasma, and serum samples from 10 horses were stored at 4°C and analyzed 1, 2, 3, 4, 5, 6, 7, 8, ...
Bilateral patellar aplasia in a foal.
Veterinary medicine and science    February 3, 2023   Volume 9, Issue 3 1143-1148 doi: 10.1002/vms3.1083
Ludwig EK, Hallowell K, Womble M, O'Neil E.A 2-day-old Cleveland Bay colt was referred to the Equine Emergency Service of the Farm Animal and Equine Veterinary Medical Center at North Carolina State University's College of Veterinary Medicine for evaluation of decreased nursing behaviour and right hindlimb lameness of 2 days' duration. When assisted to stand, the foal was unable to extend either hindlimb or bear weight on the hindlimbs, the right patella was luxated laterally and unable to be reduced, and the foal assumed a crouched position. Stifle radiographs revealed minimal, heterogeneous, ill-defined ossification of both patellae....
Analytical Performance Evaluation of the New GEM® Premier™ 5000 in Comparison to the Epoc® Blood Gas Analyzer in Horses.
Veterinary sciences    February 3, 2023   Volume 10, Issue 2 114 doi: 10.3390/vetsci10020114
Sandersen C, Dmitrovic P, Dupont J, Cesarini C, Guyot H, Serteyn D, Kirsch K.Different blood gas analyzers are used in equine practice. Every machine needs to be validated, as they have not been designed for use in horses. The aim of this study was to compare the newly marketed GEM5000 machine to the formerly validated epoc machine for blood gas analysis in horses. In this prospective, non-blinded, comparative laboratory analyzer study, 43 equine blood samples were analyzed on both analyzers and values were compared between the two machines via Lin's concordance analysis, Passing-Bablok regression analysis and Bland-Altman plots. Duplicate measurements were conducted o...
Complications following diagnostic and therapeutic sacroiliac joint region injections in horses: A study describing clinicians’ experiences.
Equine veterinary journal    February 2, 2023   doi: 10.1111/evj.13929
Nagy A, Dyson S.There are no detailed data on complications of sacroiliac (SI) joint region injections or on the variability of the methods and circumstances of injections among clinicians. Objective: To describe complications following diagnostic, therapeutic and combined SI joint region injections and the details of how these are routinely performed by a large number of clinicians. Methods: Cross-sectional questionnaire survey. Methods: Clinicians (members of American and European specialist colleges and veterinarians known to the authors), invited by email, who had performed ≥1 SI joint region injection,...
IgE+ plasmablasts predict the onset of clinical allergy.
Frontiers in immunology    February 2, 2023   Volume 14 1104609 doi: 10.3389/fimmu.2023.1104609
Simonin EM, Babasyan S, Tarsillo J, Wagner B.IgE+ plasmablasts develop following allergen exposure and B cell activation. They secrete IgE and therefore are directly linked to maintain the mechanisms of IgE-mediated allergies. Here, we show that the presence of IgE+ plasmablasts in peripheral blood not only coincides with clinical allergy, but also predicts the upcoming development of clinical disease. Using an equine model of naturally occurring allergy, we compared the timing of allergen exposure, arrival of IgE+ plasmablasts in peripheral blood, and onset of clinical disease. We found that IgE+ plasmablasts predict the development of ...
Acute phase proteins levels in horses, after a single carbohydrate overload, associated with cecal alkalinization.
Frontiers in veterinary science    February 2, 2023   Volume 10 1043656 doi: 10.3389/fvets.2023.1043656
Peixoto Rabelo I, Barroco de Paula V, Carvalho Bustamante C, Santana AM, Gomes da Silva D, Baldassi AC, Canola PA, Araújo Valadão CA.Horses submitted to carbohydrate overload can develop laminitis due to changes in cecal pH and microbiota, followed by an increase in transmural absorption of luminal content, including bacterial toxins. In response to acute injury there is hepatic overproduction of several proteins known as acute phase proteins (APP). Few studies have evaluated protein fractionation to characterize the inflammatory response in acute laminitis. The aim of this study was to test the viability of an experimental model to induce acute laminitis, using a single carbohydrate overload, and the influence of a bufferi...
Assessment of information as regards the toxicity of deoxynivalenol for horses and poultry.
EFSA journal. European Food Safety Authority    February 2, 2023   Volume 21, Issue 2 e07806 doi: 10.2903/j.efsa.2023.7806
Schrenk D, Bignami M, Bodin L, Del Mazo JKCJ, Grasl-Kraupp B, Hogstrand C, Leblanc JC, Nielsen E, Ntzani E, Petersen A, Sand S, Schwerdtle T....In 2017, the EFSA Panel on Contaminants in the Food Chain (CONTAM) adopted a Scientific Opinion on the risks for animal health related to the presence of deoxynivalenol (DON) and its acetylated and modified forms in food and feed. No observed adverse effect levels (NOAELs) and lowest observed adverse effect levels (LOAELs) were derived for different animal species. For horses, an NOAEL of 36 mg DON/kg feed was established, the highest concentration tested and not showing adverse effects. For poultry, an NOAEL of 5 mg DON/kg feed for broiler chickens and laying hens, and an NOAEL of 7 mg DO...
Hendra Virus: An Update on Diagnosis, Vaccination, and Biosecurity Protocols for Horses.
The Veterinary clinics of North America. Equine practice    February 1, 2023   Volume 39, Issue 1 89-98 doi: 10.1016/j.cveq.2022.11.009
Wang X, Wise JC, Stewart AJ.Hendra virus (HeV) emerged as a zoonotic pathogen in the 1990s, causing low morbidity but high mortality in humans and horses. Pteropid bats are the natural reservoir of HeV and other important zoonotic viruses such as Nipah and Ebola viruses. Equivac HeV, manufactured by Zoetis (Parkville, Victoria, Australia), is the only commercially available vaccine for horses. There is no commercial vaccine for humans. The epidemiology, clinical features, pathology, diagnosis, management, and prevention of HeV will be reviewed.
Biliary parascarosis in a foal.
Veterinary medicine and science    February 1, 2023   Volume 9, Issue 3 1149-1153 doi: 10.1002/vms3.1087
Sazmand A, Yavari M, Babaei M, Nourian A, Otranto D.Migration of Ascaris lumbricoides through the papilla of Vater in humans, and entry into the biliary tree, is well-recognised. Ascaris suum and Toxocara vitulorum have been recovered from the liver of swine and buffalo. We necropsied a Persian Kurdish filly at age 6 months, weighing ∼100 kg. Death evidently was caused by oleander (Nerium oleander) intoxication. An 8-cm adult male Parascaris was found at the lobar-left hepatic bile duct junction. We suggest that the nematode entered anteriorly into the hepatic tree, via the duodenum, major duodenal papilla, bile duct, left hepatic duct and f...
Equine Granulocytic Anaplasmosis.
The Veterinary clinics of North America. Equine practice    February 1, 2023   Volume 39, Issue 1 133-145 doi: 10.1016/j.cveq.2022.11.011
Oliver A, Conrado FO, Nolen-Walston R.Equine granulocytic anaplasmosis is a clinically significant and common disease of equids that has a broader prevalence than was once thought. The most common clinical signs include high fever and edema, with mild to mderate thrombocytopenia and lymphopenia typically noted on complete blood count. Subclinical cases are reported and many are self-limiting. Rare clinical presentations include neurologic disease, vasculitis, dysphagia, rhabdomyolysis, or bicavitary effusion. Most cases resolve rapidly with appropriate antimicrobial intervention.
Plasma Creatine Kinase and Aspartate Aminotransferase Activities Before, During, and After 5 Days of Intramuscular Penicillin Administration in Sedentary Horses.
Journal of equine veterinary science    February 1, 2023   Volume 122 104231 doi: 10.1016/j.jevs.2023.104231
Foreman-Hesterberg CR, Foreman JH.Muscle damage can result in leakage of intracellular enzymes such as creatine kinase (CK) and aspartate transaminase (AST) into plasma. There are no controlled documentations of the effects of intramuscular antibiotic drug administration on plasma CK and AST activities in horses. The objective of this experiment was to test the hypothesis that 5 days of intramuscular procaine penicillin G injection in normal horses would result in increased plasma activities of CK and AST. Nine healthy adult horses were sampled for 7 days preceding, 5 days during, and 32 days following procaine penicillin G (2...
Monorchidism in a Phenotypic Mare With a 64,XY, SRY-Positive Karyotype.
Journal of equine veterinary science    February 1, 2023   Volume 126 104232 doi: 10.1016/j.jevs.2023.104232
Middlebrooks B, McCue P, Nelson B, May E, Divine C, Barton C, Conley A.Disorders of sexual development (DSD) are associated with atypical chromosomal, gonadal, or phenotypic sex. It is likely that the number of cases of DSD are underestimated in the equine population. Monorchidism in the horse is very rare. This case report describes the clinical assessment of a phenotypic mare with stallion-like behavior which led to the diagnosis of a DSD. A 4-year-old Quarter Horse mare presented in good body condition, with normal external genitalia for a mare, and normal mammary glands with two bilaterally symmetric teats. No uterus, cervix, or gonads were detected on transr...
Pathological Features and Genomic Characterization of an Actinobacillus equuli subsp. equuli Bearing Unique Virulence-Associated Genes from an Adult Horse with Pleuropneumonia.
Pathogens (Basel, Switzerland)    January 31, 2023   Volume 12, Issue 2 224 doi: 10.3390/pathogens12020224
Kamali M, Carossino M, Del Piero F, Peak L, Mitchell MS, Willette J, Baker R, Li F, Kenéz Á, Balasuriya UBR, Go YY. subsp. is the etiological agent of sleepy foal disease, an acute form of fatal septicemia in newborn foals. is commonly found in the mucous membranes of healthy horses' respiratory and alimentary tracts and rarely causes disease in adult horses. In this study, we report a case of a 22-year-old American Paint gelding presenting clinical signs associated with an atypical pattern of pleuropneumonia subjected to necropsy. The gross and histopathological examinations revealed a unilateral fibrinosuppurative and hemorrhagic pleuropneumonia with an infrequent parenchymal distribution and heavy iso...
Comparison of systemic trimethoprim-sulfadimethoxine treatment and intrauterine ozone application as possible therapies for bacterial endometritis in equine practice.
Frontiers in veterinary science    January 27, 2023   Volume 10 1102149 doi: 10.3389/fvets.2023.1102149
Köhne M, Hofbauer L, Böttcher D, Tönissen A, Hegger A, Görgens A, Ulrich R, Sieme H.Bacterial endometritis is one of the major problems in equine reproduction and usually treated with antimicrobial drugs. The study aimed to compare the effects of intrauterine ozone application and systemic antibiotic treatment (trimethoprim-sulfadimethoxine) on intrauterine bacterial growth and possible side effects on the endometrium in a clinical setting. Mares ( = 30) with signs of endometritis (positive uterine bacterial culture and cytological findings) were assigned randomly to different treatments: intrauterine insufflation of an ozone-air-mix (240 ml, 80 μg ozone/ml) twice at a 48 h-...
Potential outbreak by herpesvirus in equines: detection, clinical, and genetic analysis of equid gammaherpesvirus 2 (EHV-2).
Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]    January 27, 2023   Volume 54, Issue 2 1137-1143 doi: 10.1007/s42770-022-00890-3
de Almeida Campos AC, Cicolo S, de Oliveira CM, Molina CV, Navas-Suárez PE, Poltronieri Dos Santos T, da Silveira VB, Barbosa CM, Baccarin RYA....Equid herpesvirus (EHV) commonly affects horses causing neurologic and respiratory symptoms beside spontaneous abortions, meaning huge economic losses for equine industry worldwide. In foals, the virus can facilitate secondary infections by Rhodococcus equi, important in morbidity and mortality in equines. A total of five genotypes of EHV were previously described in Brazil including EHV-1, EHV-2, EHV-3, EHV-4, and EHV-5. EHV-2 genotype had only been previously described in Brazil in asymptomatic animals. We report the investigation of the dead of 11 foals in Middle-west region of Brazil showi...
Effect of time and autologous serum addition on the analysis of cerebrospinal fluid in horses.
Journal of veterinary internal medicine    January 24, 2023   Volume 37, Issue 2 713-717 doi: 10.1111/jvim.16637
Quattrini C, Scalco R, Vernau W, Dini P, Aleman M.Cerebrospinal fluid (CSF) is highly labile and delayed processing might alter results of analysis. Objective: To determine the effects of time and addition of autologous serum on cytological evaluation of CSF. Methods: Ten client-owned adult horses requiring euthanasia. Methods: Prospective study. Serum and CSF were collected from each horse before and within 10 minutes after euthanasia. CSF samples were divided into 15 aliquots (2 mL each); 1 aliquot was submitted for routine CSF analysis within 60 minutes of collection. Four drops of autologous serum were added to 7 of the aliquots, and ...
Comparison Between the Direct Method and Friedewald’s Formula for the Determination of Low-Density Lipoprotein Cholesterol Serum Levels in Horses.
Journal of equine veterinary science    January 24, 2023   Volume 122 104230 doi: 10.1016/j.jevs.2023.104230
Ribeiro RM, Ribeiro DDSF, Cota LO, Carvalho AM, Gobesso AAO, Faleiros RR.This study aimed to compare the use of enzymatic colorimetry and Friedewald's formula for the determination of LDL in horses. A total of 260 samples were used. Direct analysis was performed to determine low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol, triglycerides (TG), and total cholesterol (TC). The LDL level was calculated using the Friedewald equation (LDL= TC-HDL-TG/5). The correlations between the direct LDL analysis and the LDL calculated using the Friedewald formula were determined by Pearson's tests, and the coefficient of determination was also obtained by ...
Detection of Equine Papillomaviruses and Gamma-Herpesviruses in Equine Squamous Cell Carcinoma.
Pathogens (Basel, Switzerland)    January 23, 2023   Volume 12, Issue 2 179 doi: 10.3390/pathogens12020179
Miglinci L, Reicher P, Nell B, Koch M, Jindra C, Brandt S.Squamous cell carcinoma (SCC) seriously compromises the health and welfare of affected horses. Although robust evidence points to equine papillomavirus type 2 (EcPV2) causing genital lesions, the etiopathogenesis of equine SCC is still poorly understood. We screened a series of SCCs from the head-and-neck (HN), (peri-)ocular and genital region, and site-matched controls for the presence of EcPV2-5 and herpesvirus DNA using type-specific EcPV PCR, and consensus nested herpesvirus PCR followed by sequencing. EcPV2 DNA was detected in 45.5% of HN lesions, 8.3% of (peri-)ocular SCCs, and 100% of g...
The equine patellar ligaments and the infrapatellar fat pad – a microanatomical study.
BMC veterinary research    January 23, 2023   Volume 19, Issue 1 20 doi: 10.1186/s12917-023-03579-3
Fjordbakk CT, Marques-Smith P.Interpretation of patellar ligament (PL) ultrasonography may be difficult, as hypoechoic or heterogenous echogenicity are common findings. Verifying suspected disease of equine PLs by histopathology is also problematic as descriptions of normal PL vascularity and histology are scarce. The current study describes the PL and infrapatellar fat pad (IFP) vascular pattern from computed tomography scans of barium perfused normal equine specimens (n = 8; age 10 days to 18 years), as well as routine histology to serve as a reference for future investigations into PL pathology and IFP disease. Re...
Optimization of the Equine-Sperm Freeze Test in Purebred Spanish Horses by Incorporating Colloidal Centrifugation.
Animals : an open access journal from MDPI    January 22, 2023   Volume 13, Issue 3 doi: 10.3390/ani13030382
Gutiérrez-Cepeda L, Crespo F, Blazquez JC, Serres C.The Purebred Spanish Horse, according to our clinical experience, is characterized by having a high number of stallions that do not meet the international commercial recommendations for equine-sperm cryopreservation. This means that artificial insemination with frozen semen from these stallions is less widespread than in other breeds. In this study, we investigated if the incorporation of single-layer colloidal centrifugation prior to cryopreservation in clinical conditions could increase the number of ejaculates of Purebred Spanish stallions suitable for this processing, observing the influen...
Intramural Purkinje fibers facilitate rapid ventricular activation in the equine heart.
Acta physiologica (Oxford, England)    January 18, 2023   Volume 237, Issue 3 e13925 doi: 10.1111/apha.13925
Elbrønd VS, Thomsen MB, Isaksen JL, Lunde ED, Vincenti S, Wang T, Tranum-Jensen J, Calloe K.The Purkinje fibers convey the electrical impulses at much higher speed than the working myocardial cells. Thus, the distribution of the Purkinje network is of paramount importance for the timing and coordination of ventricular activation. The Purkinje fibers are found in the subendocardium of all species of mammals, but some mammals also possess an intramural Purkinje fiber network that provides for relatively instantaneous, burst-like activation of the entire ventricular wall, and gives rise to an rS configuration in lead II of the ECG. To relate the topography of the horse heart and the dis...
Effect of Volumes of Solutions on Intraocular Pressure During Intravitreal Injection of Low Dose Gentamicin in Horses With Recurrent Uveitis: A Randomized Controlled Study.
Journal of equine veterinary science    January 17, 2023   Volume 122 104228 doi: 10.1016/j.jevs.2023.104228
Launois T, Hontoir F, Dugdale A, Dedieu M, Vandeweerd JM.Horses with recurrent uveitis can be treated by intravitreal injection of low dose gentamicin under sedation and after local anesthetic techniques including the retrobulbar nerve block. Since it is reported that retinal degeneration can be secondary to an acute increase of intraocular pressure (IOP), the current randomized controlled study was carried out in order to investigate the changes in IOP following retrobulbar anesthesia, with two different volumes of local anesthetic (lidocaine) solution (10 and 5 mL), and intravitreal injection of 6 mg gentamicin in two different volumes of solution...
Development of a laparoscopic technique for inguinal hernioplasty in standing horses.
The Veterinary record    January 15, 2023   Volume 192, Issue 8 e2584 doi: 10.1002/vetr.2584
Vitoria A, Romero A, Barrachina L, Fuente S, Gil L, de Blas I, Vázquez Bringas FJ.Most previously described techniques for laparoscopic inguinal hernioplasty (IH) in horses require advanced laparoscopic skills. Our objective was to describe a new laparoscopic IH technique using a surgical anchoring system. Methods: Standing laparoscopic IH was performed unilaterally in eight experimental stallions, using the contralateral inguinal canal (IC) as a control. A polyether ether ketone harpoon was anchored in the craniolateral aspect of the vaginal ring, and an extracorporeal knot was used to fix the device. Clinical evaluation, including testicular palpation and lameness examina...
Complications in Laparoscopic Access in Standing Horses Using Cannula and Trocar Units Developed for Human Medicine.
Veterinary sciences    January 15, 2023   Volume 10, Issue 1 61 doi: 10.3390/vetsci10010061
Vázquez FJ, Vitoria A, Gómez-Arrue J, Fuente S, Barrachina L, de Blas I, Romero A.First cannulation is a critical manoeuvre in equine laparoscopy. This retrospective study aimed at the comparison of the frequency and type of complications detected when using different human laparoscopy devices for laparoscopic access in standing horses, and the influence of body condition in such complications. Forty-four procedures were included, and retrieved data comprised cannula insertion technique, body condition, and type and frequency of complications. Laparoscopic access techniques were classified into five groups: P: pneumoperitoneum created using Veress needle prior to cannulatio...
Proximal Interphalangeal Arthrodesis in Horses: A Meta-Analysis of Retrospective Studies.
Journal of equine veterinary science    January 14, 2023   Volume 122 104226 doi: 10.1016/j.jevs.2023.104226
de Souza AF, Paretsis NF, De Zoppa ALDV.The aim of this study was to determine the clinical outcomes reported in retrospective studies of proximal interphalangeal arthrodesis (PIA) in horses through a meta-analysis of retrospective studies. CAB Abstracts, PubMed, ScienceDirect, Web of Science, and Scopus were searched. The primary outcomes included survival and surgical site infection (SSI) rates, return to activities, and time of hospital stay and casting. Subgroups were formed for fractures and other conditions. Meta-analyses were performed with fixed and random effects models to estimate proportions, mean values, and effect size ...
Cutaneous plaques associated with a putative novel papillomavirus type in a horse.
New Zealand veterinary journal    January 12, 2023   Volume 71, Issue 2 100-105 doi: 10.1080/00480169.2022.2157347
Munday JS, Grant K, Orbell G, Vaatstra BL.A 6-year-old Thoroughbred mare developed multiple flat plaques, < 1 cm in diameter, on the left front fetlock. These were treated topically using 5-fluorouracil and resolved after 4 weeks. However, additional similar plaques developed on the left front pastern 5 months later. These lesions resolved within 3 months without treatment. Unassigned: One plaque that developed initially and one plaque that developed later were examined histologically. Both consisted of well-demarcated foci of moderate epidermal hyperplasia. Scattered throughout both plaques were cells showing evidence of papillo...
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