Vulvar herpes zoster infection: a rare and challenging diagnosis

2021 ◽  
Vol 14 (12) ◽  
pp. e246797
Author(s):  
Matilde Matos Martins ◽  
Patrícia Ferreira ◽  
Raquel Maciel ◽  
Cristina Costa
Keyword(s):  
Herpes Zoster ◽  
Lower Limb ◽  
Severe Pain ◽  
Clinical History ◽  
Symptomatic Improvement ◽  
Serological Testing ◽  
Review Of The Literature ◽  
Herpes Zoster Infection ◽  
The Right

A 26-year-old woman under immunosuppression with infliximab due to Crohn’s disease was referred to the gynaecology emergency room with dispersed and coalescing vesicular lesions on the vulvar region extending to the right lower limb involving S2–S3 dermatome, associated with severe pain. Clinical history, physical examination and serological testing was consistent with herpes zoster infection. The patient was treated with valaciclovir for 14 days and cefradine for 7 days (due to the possibility of secondary bacterial infection). Significant symptomatic improvement was noted after 1 week. The 1-year follow-up was unremarkable. According to our knowledge and review of the literature, this is one of the few cases reported of vulvar herpes zoster, especially related to infliximab.

scholarly journals Unusual coexistence of first and second branchial fistulas: clinical case and review of the literature

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094430
Author(s):  
Danqing Liu ◽  
Guangqi Li ◽  
Jun Qiu ◽  
Jianyan Wang ◽  
Genwang Pei
Keyword(s):  
Clinical Signs ◽  
Preoperative Imaging ◽  
Review Of The Literature ◽  
False Positive Diagnosis ◽  
Fistula Recurrence ◽  
History Of ◽  
Physical Examinations ◽  
Missed Diagnosis ◽  
The Right

Branchial fistulas are uncommon in the clinical setting. The coexistence of first and second branchial fistulas has not been previously reported. We herein describe a 12-year-old girl who presented with a 2-year history of repeated swelling and purulence behind the right earlobe and neck. According to the patient’s physical and auxiliary examination findings, she was diagnosed with coexisting first and second branchial fistulas, both of which were completely removed by surgery. No clinical signs of fistula recurrence were present at the patient’s 20-month postoperative follow-up. Ipsilateral coexisting first and second branchial fistulas are very rare; thus, a false-positive diagnosis can easily occur if the doctor does not carefully perform specialized physical examinations. Surgery is an effective method for treating this condition. Adequate preoperative imaging preparation is imperative to ensure the most effective course of treatment. The purpose of this article is to improve clinicians’ awareness of this disease, thereby effectively reducing the rates of missed diagnosis and recurrence.

scholarly journals Overgrowth syndrome in neonates: a rare case series with a review of the literature

2019 ◽  
Vol 12 (1) ◽  
pp. e225640
Author(s):  
Aakash Pandita ◽  
Astha Panghal ◽  
Girish Gupta ◽  
Kirti M Naranje
Keyword(s):  
Lower Limb ◽  
Rare Case ◽  
Case Series ◽  
Port Wine Stain ◽  
Port Wine ◽  
Review Of The Literature ◽  
Term Neonates ◽  
Overgrowth Syndrome ◽  
Klippel Trenaunay Syndrome

We present here two-term neonates presenting with right lower limb hypertrophy, a port-wine stain, acral abnormalities and clubfeet. These neonates had overlapping features of Klippel Trenaunay syndrome and congenital lipomatous overgrowth, vascular malformation, epidermal nevi and scoliosis/skeletal abnormalities. Such overgrowth syndrome has not been previously described in the literature. Both the neonates are doing well and are under regular follow-up.

scholarly journals Unusual case of locally advanced and metastatic paratesticular liposarcoma: a case report and review of the literature

2015 ◽  
Vol 87 (1) ◽  
pp. 87 ◽  
Author(s):  
Stefano Chiodini ◽  
Lorenzo G. Luciani ◽  
Tommaso Cai ◽  
Alberto Molinari ◽  
Luca Morelli ◽  
...  
Keyword(s):  
Lower Limb ◽  
Unusual Case ◽  
Locally Advanced ◽  
Rapid Progression ◽  
Nodal Metastases ◽  
Rare Occurrence ◽  
Review Of The Literature ◽  
Favourable Evolution ◽  
The Right ◽  
Paratesticular Liposarcoma

Liposarcoma accounts for 20% of all sarcomas and is a rare occurrence in the paratesticular region. We present the case of a 66-year-old man with a massive liposarcoma of the right scrotum invading the lower limb and the abdominal wall skin. The case concerns an unusually large and aggressive liposarcoma (25 cm), presenting with multiple lung and nodal metastases. The patient had an unfavourable evolution with rapid progression of metastases, although there were no signs of local disease. In this case, a wide local excision was performed in order to obtain local control of the disease. Even though paratesticular sarcomas might have a more favourable evolution, the association with lung involvement carries an ominous prognosis. Diagnosis of paratesticular sarcoma should be kept in mind in case of irregular necrotic masses in the inguinal and scrotal region.

scholarly journals Trichilemmal cyst of the neck: case report and review of the literature

2021 ◽  
pp. 13-17
Author(s):  
Othman El Houari ◽  
Amal Hajjij ◽  
Ilias Tahiri ◽  
Mohamed Said Anajar ◽  
Loubna Taali ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Neck Surgery ◽  
Cervical Region ◽  
Malignant Degeneration ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Follicular Cyst ◽  
Trichilemmal Cyst ◽  
The Right

Introduction: Trichilemmal cysts are lesions originating in the isthmus of the hair follicle. They are more common in women and occur in 90% on the scalp. Presentation of case: A 10-year-old female patient presented with a hard, slightly painful, nonexophytic mass in the right cervical region (Ia). After surgical resection in healthy margins, the diagnosis of trichilemmal cyst was made on histopathological examination. Discussion: The age of the patient as well as the cervical location of this type of lesion is an extremely rare presentation of trichilemmal cyst. Follow-up is rigorous in search of a triad: ichthyosis, keratosis, deafness, particularly in this patient. Conclusion: Close follow-up in this clinical case is indicated because the risk of malignant degeneration and development of similar lesions is present. Keywords: Follicular cyst; KID syndrome; Trichilemmal cyst; Neck surgery; Trichilemmal carcinoma

scholarly journals Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale Follow-Up

2021 ◽  
Vol 8 ◽  
Author(s):  
Quentin Senechal ◽  
Perrine Echegut ◽  
Marine Bravetti ◽  
Marie Florin ◽  
Lamia Jarboui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Iliac Vein ◽  
Pelvic Vein ◽  
Internal Iliac Vein ◽  
Internal Iliac ◽  
The Right ◽  
Pelvic Congestion

Purpose: To evaluate medium-term clinical outcomes of transcatheter embolization and stenting in women with several pelvic venous disorders responsible for chronic pelvic pain and varicose veins of the lower limbs.Materials and Methods: The study population included 327 consecutively recruited patients referred to the interventional radiology unit from January 2014 to December 2019 due to chronic pelvic congestion (91; 27.83%), lower limb varices (15; 4.59%), or a combination of both the symptoms (221; 67.58%). Preprocedural pelvic, transvaginal Doppler ultrasound (US), and MRI were conducted in all the patients and revealed anatomical varicosities and incompetent pelvic veins in 312 patients. In all the patients, selective catheterization demonstrated uterine venous engorgement, ovarian plexus congestion, or pelvic vein filling. Retrograde flow was detected on catheter venography in the left ovarian vein (250; 78%), the right ovarian vein (85; 26%), the left internal iliac vein (222; 68%), and the right internal iliac vein (185; 57%). Patients were followed-up at 1, 6, and 12 months, and years thereafter systematically by the referring angiologist and the interventional radiologist of center. They were contacted by telephone in November and December 2020 to assess pain perception and quality of life by using the visual analog scales from 0 to 10 with assessments made at the baseline and last follow-up. Of the 327 patients (mean age, 42 ± 12 years), 312 patients were suffering from pelvic congestion syndrome and 236 patients was suffering from lower limb varices. All underwent embolization by using ethylene vinyl alcohol copolymer (Onyx®). Eighty-five right ovarian veins, 249 left ovarian veins, 510 tributaries of the right internal iliac vein, and 624 tributaries of the left internal iliac vein were embolized. A cohort of patients also underwent nutcracker syndrome angioplasty (6.7%) and May–Thurner syndrome angioplasty (14%) with a stent placement.Results: The initial technical success rate was 80.9% for embolization of pathological veins and 100% for stenting of stenoses. Overall, 307 patients attended 12-month follow-up visits and 288 (82%) patients completed the telephone survey at mean 39 (±18)-month postintervention. Main pelvic pain significantly improved from 6.9 (±2.4) pre- to 2.0 (±2.4) postembolization (p < 0.001), as did specific symptoms in each category. Improvement or disappearance of pain was achieved in 266/288 (92.36%) patients with improved quality of life in 276/288 (95.8%) patients. There were 16 minor and 4 major adverse events reported on the follow-up.Conclusion: Pelvic vein embolization (Onyx®) is an effective and safe procedure with high clinical success and quality of life improvement rates.

Klippel–Trénaunay Syndrome and Developmental Coxa Vara in the Same Limb: A Case Report with a Review of the Literature

2021 ◽  
Author(s):  
Balaji Zacharia ◽  
Jittu Alex ◽  
Ashwin Rajmohan
Keyword(s):  
Lower Limb ◽  
Lower Limbs ◽  
Coxa Vara ◽  
Port Wine ◽  
Review Of The Literature ◽  
Left Femur ◽  
Port Wine Stains ◽  
Left Lower Limb ◽  
Klippel Trenaunay Syndrome

AbstractWe present a case of a 14-year-old girl who was first treated when she was 4 years old. She had progressive limping of the left lower limb from the age of 3 years. She was diagnosed to have developmental coxa vara of the left hip and treated by a subtrochanteric valgus osteotomy of the left femur. Later, she developed hypertrophy of the left upper and lower limbs. There were port-wine stains over the left lower limbs with multiple superficial varicosities. Her diagnosis was Klippel–Trénaunay syndrome (KTS). She is asymptomatic at the final follow-up. Both developmental coxa vara and KTS are rare conditions. We present this case to demonstrate the rarest combination of two rare conditions occurring in the same limb.

Isolated Anterior Interosseous Nerve Palsy Following Herpes Zoster Infection: A Case Report and Review of the Literature

1989 ◽  
Vol 14 (4) ◽  
pp. 447-448
Author(s):  
P. A. NEE ◽  
P. G. LUNN
Keyword(s):  
Case Report ◽  
Herpes Zoster ◽  
Nerve Palsy ◽  
Motor Nerve ◽  
Review Of The Literature ◽  
Herpes Zoster Infection ◽  
Anterior Interosseous Nerve ◽  
Peripheral Motor

A 64-year-old lady noticed weakness of her thumb within two weeks of having developed “shingles” causing vesicular lesions on her arm and hand. Clinical and neurophysiological testing confirmed a lesion of the anterior interosseous nerve. Although motor involvement after herpes zoster infection is recognised, this usually has a myotomal distribution; isolated involvement of a branch of a peripheral motor nerve has not previously been described.

Sign in / Sign up

Export Citation Format

Share Document