{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:48:21Z","timestamp":1761630501682},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2008,11,19]],"date-time":"2008-11-19T00:00:00Z","timestamp":1227052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2009,2]]},"abstract":"<jats:p><jats:bold>Background:\u2002<\/jats:bold> Palisading granulomatous reactions are documented in many diseases. Although subcutaneous cystic echinococcosis (CE) is documented rarely, a subcutaneous palisading, granulomatous, pseudocystic (PGP) reaction to elusive <jats:italic>E<\/jats:italic><jats:italic>chinococcus<\/jats:italic><jats:italic> granulosus <\/jats:italic>membranous components, in the absence of cutaneous fistulisation, is undocumented.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> Seven\u2010year clinicopathological review of subcutaneous echinococcal PGP reactions.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Gross: seven thick\u2010walled \u2018cysts\u2019 containing clear or straw\u2010colored fluid were investigated. Histopathology: the pseudocysts contained a palisade of epithelioid histiocytes and giant cells. Focal periodic acid Schiff (PAS)\u2010positive eosinophilic fragments, some resembling keratin \u2018flakes\u2019, were identified within the lumen or within the cellular palisade, consistent with a PGP reaction to fragmented <jats:italic>E. granulosus <\/jats:italic>membrane. Clinical correlation: the initial histopathological diagnosis of two patients was ruptured epidermoid cysts with an assumed granulomatous reaction to eosinophilic keratinous debris. Subsequent diagnosis of CE in the liver and cervical soft tissue necessitated review of the \u2018epidermoid cysts\u2019; PAS\u2010positive <jats:italic>E. granulosus <\/jats:italic>membranous fragments masqueraded as keratinous debris. Renal, hepatic and pleuropulmonary CE were confirmed in the remaining patients following confirmation of an echinococcal PGP reaction.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> Heightened awareness and obsessive appraisal of subcutaneous PGP reactions for subtle, focal, PAS\u2010positive and echinococcal membranous fragments are pivotal to the diagnosis that also serves as a clue to visceral CE.<\/jats:p>","DOI":"10.1111\/j.1600-0560.2008.01017.x","type":"journal-article","created":{"date-parts":[[2008,11,19]],"date-time":"2008-11-19T11:43:17Z","timestamp":1227094997000},"page":"240-245","source":"Crossref","is-referenced-by-count":9,"title":["Subcutaneous palisading granulomatous pseudocysts of <i>Echinococcus granulosus <\/i>origin"],"prefix":"10.1111","volume":"36","author":[{"given":"Julian","family":"Deonarain","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pratistadevi 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