scholarly journals Erythema Dyschromicum Perstans: Identical to Ashy Dermatosis or Not

2015 ◽  
Vol 7 (2) ◽  
pp. 146-150 ◽  
Author(s):  
Takafumi Numata ◽  
Kazutoshi Harada ◽  
Ryoji Tsuboi ◽  
Yoshihiko Mitsuhashi
Keyword(s):  
African American ◽  
Recent Literature ◽  
Clinical Course ◽  
Skin Lesions ◽  
Clinical Findings ◽  
Typical Case ◽  
Unknown Etiology ◽  
Clinical Classification ◽  
Pigmentary Disorders ◽  
Clinical Cases

Erythema dyschromicum perstans (EDP) and ashy dermatosis (AD) are pigmentary disorders of unknown etiology. EDP is usually considered to be identical to AD; however, a new clinical classification for EDP was proposed in the recent literature. Herein, we report a typical case of EDP observed in an African-American man. Interestingly, the late skin lesions in this case fit the criteria of AD as well. While there appear to be a few clinical cases that can be diagnosed as both EDP and AD based on the clinical course, the preponderance of the evidence in the published reports of EDP and AD and the clinical findings reported here strongly suggest that they are two distinct entities in terms of the extent of the inflammation, albeit on the same spectrum of pigment disorders.

scholarly journals Increased uptake of fluorine-18 fluoro-2-deoxy-D-glucose (F18-FDG) in the spleen: A novel marker for severe Kikuchi-Fujimoto disease

2020 ◽  
Author(s):  
Hye Seong ◽  
Yong Hyu Jeong ◽  
Lee Woon ji ◽  
Jun Hyoung Kim ◽  
Jung Ho Kim ◽  
...  
Keyword(s):  
Disease Severity ◽  
Fdg Pet ◽  
Clinical Course ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Standardized Uptake Value ◽  
Clinical Findings ◽  
Unknown Etiology ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Kikuchi-Fujimoto disease (KFD), known as histiocytic necrotizing lymphadenitis, is an Asian-endemic disease of unknown etiology. Although KFD is usually self-limiting and benign, patients with prolonged systemic symptoms often have frequent hospital visits, long admission durations, and missed workdays. Immune-modulating drugs are used to shorten the clinical course in severe KFD. However, as there are no established severity markers, administration of these drugs is often arbitrary or delayed. We aimed to investigate the role of fluorine-18 fluoro-2-deoxy-D-glucose (F18-FDG) positron emission tomography/computed tomography (F18-FDG PET/CT) in KFD and to evaluate its performance as a disease severity marker. We retrospectively reviewed medical records of 31 adult patients with pathologically confirmed KFD who underwent F18-FDG PET/CT between November 2007 and April 2018 at a tertiary care referral hospital. Disease severity was assessed using the criteria based on clinical manifestations of advanced KFD. The number of systemic activated lymph nodes and severity of splenic activation were determined using semi-quantitative and volumetric PET/CT parameters. Results: The median value of the mean splenic standardized uptake value (SUV mean ) was higher in the 23 patients with severe KFD (1.79±0.99 vs. 2.38±1.18, p =0.058). Patients with severe KFD presented with more systemically activated volume and glycolytic activity than those with mild KFD (total lesion glycolysis: 473.5±504.4 vs 201.6±363.5, p =0.024). Multivariate logistic regression showed that myalgia (odds ratio [OR], 0.035; 95% confidence interval [CI], 0.001-0.792; p =0.035), total lymph node SUV max (cutoff, 9.27) (OR, 24.734; 95% CI, 1.323-462.407; p =0.032), and spleen SUV mean (cutoff, 1.79) (OR, 37.770; 95% CI, 1.769-806.583; p =0.020) were significantly associated with severe KFD. Conclusions: We suggest that 18 F-FDG PET/CT can be a useful tool for clinical workup in the predicting clinical course of KFD as a complement to laboratory and clinical findings to establish the severity.

scholarly journals An Epidemic of Scurvy, Identified Based on Lower Extremity Swelling, in a Southern Ethiopian Prison

2021 ◽  
Author(s):  
Wondwossen Amogne ◽  
Meskerem Nimani ◽  
Ishmael Shemsedin ◽  
Wadu Marshalo ◽  
Daddi Jima ◽  
...  
Keyword(s):  
Vitamin C ◽  
Fruits And Vegetables ◽  
Case Fatality ◽  
Cross Sectional Study ◽  
Clinical Findings ◽  
Unknown Etiology ◽  
Suspected Case ◽  
Cross Sectional ◽  
Southwestern Ethiopia ◽  
Clinical Cases

In October 2016, we received reports of five deaths among prisoners with leg swelling of unknown etiology in southwestern Ethiopia. A descriptive cross-sectional study was conducted to investigate the outbreak. A suspected case was defined as a prisoner with leg swelling of unknown etiology noted between May 15, 2016 and November 29, 2016. A total of 118 suspected cases were identified with unilateral or bilateral leg swelling without an identifiable cause from a total of 2,790 prisoners. Eight of the suspected cases were thoroughly examined, and seven of these suspected cases had clinical findings consistent with scurvy. Three of the clinical cases had undetectable vitamin C levels in the serum. The attack rate for the prison was 4.2% (118/2,790), and 11 deaths were identified, making the case fatality rate 9.3% (11/118). Clinical cases of scurvy had symptoms of fatigue, myalgia, arthralgia, and signs of follicular hyperkeratosis, petechiae, peripheral edema, and oral lesions. All clinical cases had severe anemia with hemoglobin <6.0 g/dL. The diet provided by the prison excluded fruits and vegetables. Scurvy was determined to be the cause of the outbreak, and vitamin C supplementation was promptly initiated. All symptomatic prisoners improved, and no further cases were identified in a 4-week follow-up period of active surveillance.

Scabies: A Neglected Global Disease

2020 ◽  
Vol 16 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Alexander K.C. Leung ◽  
Joseph M. Lam ◽  
Kin F. Leong
Keyword(s):  
English Language ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Sarcoptes Scabiei ◽  
Clinical Findings ◽  
Effective Control ◽  
Search Term ◽  
Skin Contact ◽  
Intense Pruritus ◽  
Meta Analyses

Background: Scabies is a skin disease caused by an obligate human parasite mite Sarcoptes scabiei var. hominis. Children under the age of two and elderly individuals are at the greatest risk. Knowledge of this condition is important for an early diagnosis to be made and treatment to be initiated. Objective: The review aimed to familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of scabies. Methods: A search was conducted using Pubmed with the built-in "Clinical Queries" tool. The search term "Scabies" was used. The categories of "epidemiology", "diagnosis", "therapy", "prevention" and "prognosis" had a limited scope for primary clinical studies. Meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews were included. Only papers published in the English language were included. A descriptive, narrative synthesis was provided of the retrieved articles. Results: Worldwide, scabies affects 200 to 300 million individuals annually. The average prevalence is estimated to be 5 to 10% in children of developing countries. Transmission usually occurs after close prolonged skin-to-skin contact. Classic scabies is characterized by an erythematous papular eruption, serpiginous burrows, and intense pruritus. Sites of predilection include the webs of the fingers, volar wrists, lateral aspects of fingers, extensor surfaces of elbows and knees, waist, navel, abdomen, buttocks, groins, and, genitals. A clinical diagnosis of classic scabies can be made on the basis of the history and clinical findings. Other clinical variants include crusted scabies, nodular scabies, and bullous scabies. Finding the mite, ova, or fecal pellets on microscopic examination of scrapings taken from skin lesions confirms the diagnosis of scabies infestation. For eradication of scabies mites, the drugs of choice are topical permethrin and oral ivermectin. Conclusion: Scabies is a highly contagious parasitic cutaneous disease that is stigmatising and debilitating. Increased awareness, accurate diagnosis, and prompt treatment are essential for the effective control of scabies and for the prevention of the spread of the disease.

scholarly journals Fatal Subacute Hepatic Failure in a Patient with AA-Type Amyloidosis: Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Ibrahim Altraif ◽  
Fayaz A. Handoo ◽  
Khaled O. Alsaad ◽  
Adel Gublan
Keyword(s):  
Alkaline Phosphatase ◽  
Case Report ◽  
Hepatic Failure ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Clinical Findings ◽  
Systemic Amyloidosis ◽  
Hepatic Involvement ◽  
Reactive Amyloidosis ◽  
Hepatic Amyloidosis

Although systemic amyloidosis of amyloid-associated protein (AA) type (secondary or reactive amyloidosis) frequently involves the liver, it rarely causes clinically apparent liver disease. Mild elevation of alkaline phosphatase and hepatomegaly are the most common biochemical and clinical findings, respectively. We report a case of systemic amyloidosis of AA type, which clinically presented as subacute hepatic failure and resulted in a fatal clinical course in a 69-year-old man. To the best of our knowledge, this is the fifth case of hepatic amyloidosis of AA type that clinically presented as fatal subacute hepatic failure, an unusual clinical presentation for hepatic involvement by systemic AA-type amyloid.

CAT SCRATCH SYNDROME

PEDIATRICS ◽  
1952 ◽  
Vol 10 (3) ◽  
pp. 311-318
Author(s):  
WILLIAM J. WATERS ◽  
SEYMOUR S. KALTER ◽  
JOHN T. PRIOR
Keyword(s):  
Skin Test ◽  
Laboratory Tests ◽  
Complement Fixation Test ◽  
Complement Fixation ◽  
Clinical Laboratory ◽  
Clinical Course ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Pathologic Findings ◽  
History Of

The clinical, laboratory and pathologic findings of a series of cases of cat scratch syndrome have been reviewed. In spite of a variable clinical course, certain features associated with a selected group of laboratory tests appear to be constant enough to be of diagnostic value. A history of contact with a cat and/or scratch which is usually associated with a peripheral skin lesion, lack of lymphangitis, presence of regional lymphadenopathy with tenderness to palpation are the most constant clinical findings. Fever, so frequently emphasized as a characteristic clinical sign, may be extremely variable in type and duration or entirely absent. A skin test with cat scratch antigen has been positive in all cases. Lacking this antigen, a negative Frei skin test in conjunction with a positive complement fixation test (Lygranum C. F.) is suggestive evidence for the diagnosis. With positive evidence from the above data, biopsy of an affected gland with its relatively nonspecific pathologic picture is not considered essential for the establishment of the diagnosis of cat scratch syndrome.

scholarly journals Primary Gastrointestinal Kaposi’s Sarcoma in a Patient with Human Immunodeficiency Virus

2018 ◽  
Vol 11 (3) ◽  
pp. 638-647 ◽  
Author(s):  
Martin Ignacio Zapata Laguado ◽  
Jorge Enrique Aponte Monsalve ◽  
Jorge Hernan Santos ◽  
Javier Preciado ◽  
Andres Mosquera Zamudio ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Kaposi's Sarcoma ◽  
Gastrointestinal Endoscopy ◽  
Rare Complication ◽  
Kaposi’S Sarcoma ◽  
Skin Lesions ◽  
Clinical Findings ◽  
Upper Gastrointestinal Endoscopy ◽  
Immunodeficiency Virus ◽  
Upper Gastrointestinal

Gastrointestinal bleeding in HIV patients secondary to coinfection by HHV8 and development of Kaposi’s sarcoma (KS) is a rare complication even if no skin lesions are detected on physical examination. This article indicates which patients might develop this type of clinical sign and also tries to recall that absence of skin lesions never rules out the presence of KS, especially if gastrointestinal involvement is documented. Gastrointestinal bleeding in terms of hematemesis has rarely been reported in the literature. We review some important clinical findings, diagnosis, and treatment approach. We present the case of an HIV patient who presented to the emergency department with hematemesis and gastrointestinal signs of KS on upper gastrointestinal endoscopy without any dermatological involvement.

scholarly journals Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser Therapy for Pigmented Skin Lesions: Efficacy and Safety

2013 ◽  
Vol 10 (2) ◽  
pp. 46-50 ◽  
Author(s):  
D Karn ◽  
S KC ◽  
A Amatya ◽  
EA Razouria ◽  
M Timalsina ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Safety Profile ◽  
Yttrium Aluminum Garnet ◽  
Skin Lesions ◽  
University Hospital ◽  
Efficacy And Safety ◽  
Yag Laser ◽  
Pigmentary Disorders ◽  
Yttrium Aluminum ◽  
Pigmented Skin Lesions

Background Nepalese population with Fitzpatrick skin types III-V has high prevalence of pigmentary disorders and it is a growing cosmetic concern. Q-Switched Neodymium- Doped Yttrium Aluminum Garnet (QS Nd-YAG) laser is an efficacious tool in the treatment of pigment disorders. Objective To highlight the efficacy and safety profile of various pigment disorders. Methods A prospective study done in Dhulikhel Hospital, Kathmandu University Hospital from January 2009 to January 2011. Patients undergoing laser for pigmented skin lesions were followed for response and safety profile. We included total 270 patients in the study with various disorders especially nevus, tattoos and melasma. Settings were repeated at 3-4 weeks interval and response was evaluated on clinical basis. Efficacy was then evaluated according to various parameters. Results For nevus, total 840 treatment sessions had been performed with an average of 6.88 sessions (range 3-11). Nd: YAG laser was very efficacious in removal of blue and black colored tattoos with an average of 7.9 and 9.5 sessions respectively. However, red mixed with blue and or green tattoos were relatively resistant to treatment and required average 10.33 treatment sessions. Melasma and freckles both responded to the therapy but recurrence rate was high. Conclusion Our results indicate that QS Nd: YAG laser is an effective modality for pigment disorders among Nepalese population. Nevus and melasma respond well but recurrence rate of melasma is high. Blue tattoos respond well while mixed colored tattoos are quite resistant to Nd: YAG laser alone. Transient pain and temporary hyperpigmentation are common side effects. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 46-50 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7343

scholarly journals Effect of Genetic and Laboratory Findings on Clinical Course of Antisynthetase Syndrome in a Hungarian Cohort

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Katalin Szabó ◽  
Levente Bodoki ◽  
Melinda Nagy-Vincze ◽  
Anett Vincze ◽  
Erika Zilahi ◽  
...  
Keyword(s):  
Prognostic Markers ◽  
Clinical Course ◽  
Disease Onset ◽  
Skin Lesions ◽  
Clinical Database ◽  
Laboratory Findings ◽  
Disease Phenotypes ◽  
Genetic Features ◽  
Hla Dqa1

The aim of this study was to determine the clinical, serological, and genetic features of anti-Jo-1 positive antisynthetase patients followed by a Hungarian single centre to identify prognostic markers, which can predict disease phenotypes and disease progression. It was a retrospective study using clinical database of 49 anti-Jo-1 positive patients. 100% of patients exhibited myositis, 73% interstitial lung disease, 88% arthritis, 65% Raynaud’s phenomenon, 43% fever, 33% mechanic’s hand, and 12% dysphagia. We could detect significant correlation between anti-Jo-1 titer and the CK and CRP levels at disease onset and during disease course. HLA DRB1⁎03 positivity was present in 68.96% of patients, where the CK level at diagnosis was significantly lower compared to the HLA DRB1⁎03 negative patients. HLA DQA1⁎0501-DQB1⁎0201 haplotype was found in 58.62% of patients, but no significant correlation was found regarding any clinical or laboratory features. Higher CRP, ESR level, RF positivity, and the presence of fever or vasculitic skin lesions at the time of diagnosis indicated a higher steroid demand and the administration of higher number of immunosuppressants during the follow-up within anti-Jo-1 positive patients. The organ involvement of the disease was not different in HLA-DRB1⁎0301 positive or negative patients who were positive to the anti-Jo-1 antibody; however, initial CK level was lower in HLA-DRB1⁎0301 positive patients. Distinct laboratory and clinical parameters at diagnosis could be considered as prognostic markers.

scholarly journals Dermatomyositis-specifikus autoantitesttel rendelkező és autoantitest-negatív betegeink klinikai jellemzőinek és laboratóriumi paramétereinek összehasonlítása

2015 ◽  
Vol 156 (36) ◽  
pp. 1451-1459 ◽  
Author(s):  
Levente Bodoki ◽  
Dóra Budai ◽  
Melinda Nagy-Vincze ◽  
Zoltán Griger ◽  
Zoe Betteridge ◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Matrix Protein ◽  
Skin Lesions ◽  
Clinical Findings ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Nuclear Matrix Protein ◽  
Specific Antibodies ◽  
Antibody Positivity ◽  
Specific Autoantibody

Introduction: Myositis is an autoimmune disease characterised by proximal muscle weakness. Aim: The aim of the authors was to determine the frequency of dermatomyositis-specific autoantibodies (anti-Mi-2, anti-transcriptional intermediary factor 1 gamma, anti-nuclear matrix protein 2, anti-small ubiquitin-like modifier activating enzyme, anti-melanoma differentiation-associated gene) in a Hungarian myositis population and to compare the clinical features with the characteristics of patients without myositis-specific antibodies. Method: Antibodies were detected using immunoblot and immunoprecipitation. Results: Of the 330 patients with nyositis, 48 patients showed dermatomyositis-specific antibody positivity. The frequency of antibodies in these patients was lower than those published in literature Retrospective analysis of clinical findings and medical history revealed that patients with dermatomyositis-specific autoantibody had more severe muscle weakness and severe skin lesions at the beginning of the disease. Conclusions: Antibodies seem to be useful markers for distinct clinical subsets, for predicting the prognosis of myositis and the effectiveness of the therapy. Orv. Hetil., 2015, 156(36), 1451–1459.

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