Porokeratosis of the Nail Unit: Case Series and Review

2021 ◽  
pp. 1-4
Author(s):  
Tatiana Mina Yendo ◽  
Tatiana Villas Boas Gabbi ◽  
Marcello Menta Simonsen Nico

<b><i>Background:</i></b> The lesions of porokeratosis (PK) lead to skin atrophy and scarring as long as they spread centrifugally. PK affecting the nail unit is seldom described. <b><i>Objective:</i></b> The aim was to revise the previously reported cases of ungual PK and to present 3 new cases. <b><i>Methods:</i></b> A PubMed search was performed with the keywords “nail” and “porokeratosis.” Previously reported cases as well as 3 new cases are depicted in tables. <b><i>Results:</i></b> Only 11 cases of ungual PK were found; 3 new cases have been added. All patients presented with typical lesions of PK (Mibelli, isolated, segmental, or ostial eccrine types) that happened to affect nails due to nail matrix or nail bed compromise, resulting in mild to severe nail scarring, including irreversible anonychia. The present 3 case series contrast with the previous single case reports. <b><i>Conclusions:</i></b> PK affecting the nails is exceedingly rare. Changes in nails affected by PK are irreversible, since, as on the skin, this is a chronic scarring process.

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.


Author(s):  
Xuefeng Wei ◽  
Xu Zhang ◽  
Zimu Song ◽  
Feng Wang

Abstract Background and Study Aims Primary intraspinal primitive neuroectodermal tumors (PNETs) account for ∼0.4% of all intraspinal tumors, but information about these tumors in the medical literature is limited to single case reports. We report four cases of primary intraspinal PNETs and present a systematic literature review of the reported cases. Materials and Methods We retrospectively reviewed and analyzed the clinical data of 4 patients with primary intraspinal PNETs who underwent neurosurgical treatment at our clinic between January 2013 and January 2020, and of 32 cases reported in the literature. Results The female-to-male ratio was 2.6:1. The mean patient age was 21.42 ± 15.76 years (range: 1–60 years), and patients <36 years of age accounted for 83.30% of the study cohort. Progressive limb weakness and numbness were the chief symptoms (accounting for ∼55.6%). The mean complaint duration was 0.89 ± 0.66 months for males and 2.72 ± 3.82 months for females (p = 0.028). Epidural (41.7%) was the most common site, and thoracic (47.3%) was the most frequent location. Most PNETs were peripheral, and magnetic resonance imaging (MRI) appearance was isointense or mildly hypointense on T1-weighted images and hyperintense on T2-weighted images. Homogeneous contrast enhancement was observed. The 1-year survival rate of patients who underwent chemoradiation after total or subtotal lesion resection was better compared with patients who did not undergo chemotherapy, radiotherapy, or total or subtotal resection. The modality of treatment was associated with survival time (p = 0.007). Conclusion Primary intraspinal PNETs mainly occur in young people with a female preponderance. In patients with a rapid loss of lower limb muscle strength and large intraspinal lesions on MRI, PNETs should be considered. Surgical resection and adjuvant radio chemotherapy are key prognostic factors.


Author(s):  
Kyle S Conway ◽  
Fozia Ghafoor ◽  
Amy C Gottschalk ◽  
Joseph Laakman ◽  
Renee L Eigsti ◽  
...  

Abstract 1p36 deletion syndrome is the most common terminal deletion syndrome, manifesting clinically as abnormal facies and developmental delay with frequent cardiac, skeletal, urogenital, and renal abnormalities. Limited autopsy case reports describe the neuropathology of 1p36 deletion syndrome. The most extensive single case report described a spectrum of abnormalities, mostly related to abnormal neuronal migration. We report the largest published series of 1p36 autopsy cases, with an emphasis on neuropathologic findings. Our series consists of 3 patients: 2 infants (5-hours old and 23-days old) and 1 older child (11 years). Our patients showed abnormal cortical gyration together with a spectrum of neuronal migration abnormalities, including heterotopias and hippocampal abnormalities, as well as cerebellar hypoplasia. Our findings thus support the role of neuronal migration defects in the pathogenesis of cognitive defects in 1p36 deletion syndrome and broaden the reported neuropathologic spectrum of this common syndrome.


2018 ◽  
Vol 32 (6) ◽  
pp. 641-653 ◽  
Author(s):  
Ilyas Sagar-Ouriaghli ◽  
Kate Lievesley ◽  
Paramala J Santosh

Objectives: To date, there is no single medication prescribed to alleviate all the core symptoms of Autism Spectrum Disorder (ASD; National Institute of Health and Care Excellence, 2016). Both serotonin reuptake inhibitors and drugs for psychosis possess therapeutic drawbacks when managing anxiety and aggression in ASD. This review sought to appraise the use of propranolol as a pharmacological alternative when managing emotional, behavioural and autonomic dysregulation (EBAD) and other symptoms. Materials and methods: Sixteen reports examined the administration of propranolol in the context of ASD. Results: Sixteen reports broadly covered cognitive domains, neural correlates, and behavioural domains. From the eight single-dose clinical trials, propranolol led to significant improvements in cognitive performance – verbal problem solving, social skills, mouth fixation, and conversation reciprocity; and changes in neural correlates – improvement in semantic networks and functional connectivity. The remaining eight case series and single case reports showed improvements in EBAD, anxiety, aggressive, self-injurious and hypersexual behaviours. Additionally, propranolol significantly improved similar behavioural domains (aggression and self-injury) for those with acquired brain injury. Conclusion: This review indicates that propranolol holds promise for EBAD and cognitive performance in ASD. Given the lack of good quality clinical trials, randomised controlled trials are warranted to explore the efficacy of propranolol in managing EBAD in ASD.


Author(s):  
Mohammed Salah Hussein ◽  
Faisal Mohammed Alyahya ◽  
Husam Fouad K. Barradah ◽  
Adeeb Abdullah Almuhanaa ◽  
B. Alzhrani, Olayan Mohammed ◽  
...  

Hypothyroidism and hyperthyroidism are both prevalent medical conditions that are frequently accompanied with neurologic and neuromuscular dysfunction. Triiodothyronine (T3) and thyroxine (T4) hormones are produced by the thyroid gland and play a crucial role in tissue formation and metabolism. Both of these hormones have a variety of impacts on the brain and neuromuscular system. Specially in children, because brain development can be effected by any disturbances in Thyroidal hormones level. And thus, conditions like Allan-Herndon-Dudley Syndrome & Benign Hereditary Chorea is considered genetic thyroidal diseases both will be discussed in this review. hypothyroidism can have serious consequences for neuropsychiatric function. The pathophysiological processes underlying the neurological symptoms of hypothyroidism and hyperthyroidism are likely to be multifactorial, in this review we will be looking at multiple neurological as well as psychiatric manifestations related to thyroidal hormones disorders. Methods: We used the phrases "hypothyroidism," "hyperthyroidism," "neurological problems," "neuropathy," "myopathy," "congenital hypothyroidism," and "encephalopathy" in a PubMed search, google scholar and google search engines. Case series, individual case reports, systematic reviews, retrospective analyses, and randomized controlled trials were among the papers examined. Classification of thyroidal dysfunction has been made depending on the thyroidal hormones level. The neurological consequences of congenital hypothyroidism were examined, as well as the clinical aspects of hypothyroidism and hyperthyroidism-related neuromuscular disorders, as well as other autoimmune illnesses. Hashimoto encephalopathy's evidence and pathophysiological issues were also examined. Conclusion: Thyroid is critical organ due to role of its thyroidal hormones, both hypothyroidism and hyperthyroidism induce some serious neurological and phycological disorders, some of which is genetic, hypothyroidism can impact the development of child and thus regular thyroidal hormones testing is recommended in children who demonstrates any signs of neurological psychiatric  or cognitive disease.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Guillermo López-Medina ◽  
Roxana Castillo Díaz de León ◽  
Alberto Carlos Heredia-Salazar ◽  
Daniel Ramón Hernández-Salcedo

The finding of gas within the gastric wall is not a disease by itself, rather than a sign of an underlying condition which could be systemic or gastric. We present the case of a woman identified with gastric emphysema secondary to the administration of high doses of steroids, with the purpose of differentiating emphysematous gastritis versus gastric emphysema due to the divergent prognostic implications. Gastric emphysema entails a more benign course, opposed to emphysematous gastritis which often presents as an acute abdomen and carries a worse prognosis. Owing to the lack of established diagnostic criteria, computed tomography is the assessment method of choice. Currently no guidelines are available for the management of this entity, since the evidence is limited to a few case series and a considerable number of single case reports.


2012 ◽  
Vol 46 (10) ◽  
pp. 1419-1424 ◽  
Author(s):  
Laura M Godfrey ◽  
John Erramouspe ◽  
Kevin W Cleveland

Objective: To evaluate the teratogenic potential of statins in women of child-bearing age. Data Sources: A PubMed search (1980-September 2012) was performed using the search terms statin and pregnancy, then repealed using statin and teratogenicity. Results were limited to articles published in English reporting on use of statins in humans. Study Selection and Data Extraction: All articles presenting data on pregnancy outcomes after statin use during any trimester of pregnancy were included. Three case reports, 2 case series, 2 systematic reviews, 2 registry-based studies, and 1 prospective observational cohort study were reviewed. Data Synthesis: Since initial premarketing studies of lovastatin in animals, terato-genesis has been assumed to be a classwide function of statins' mechanism of action. Data from human exposure during pregnancy have been gathered and analyzed in a variety of study formats to formulate useable conclusions on statins' actual teratogenic risk and pattern of associated birth defects. Although the current trend is that actual risk is lower than once thought, the available literature is limited by potential reporting bias, contains overlap in the data, and frequently lacks numbers of total exposures to statins during pregnancy with reported malformations. Additionally, no human studies included data on the 2 newest statins (rosuvastatin, pitavastatin); the more lipophilic statins (lovastatin, simvastatin) have the most experience and thus have more evidence related to teratogenic potential. Conclusions: Human teratogenic risk has not been proven nor has it been ruled out by the available data on statin use in pregnancy. Possible differences in risk between individual statins require further evaluation. Additional data, including prospective observational cohorts with inadvertent maternal exposure to statins during early weeks of gestation, should further help to clarify appropriate recommendations for statin use in this population.


2019 ◽  
Vol 10 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Luis Arrevola ◽  
María Almudena Acero ◽  
María Jesús Peral

Punctate inner choroidopathy (PIC) is a rare inflammatory chorioretinopathy that predominantly affects young myopic women. Visual prognosis is generally good, but occurrence of choroidal neovascularization (CNV) is common and may be vision threatening. Case reports and short case series support the effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) agents (ranibizumab and bevacizumab) for CNV associated with PIC given their anti-angiogenic and anti-inflammatory effects. Evidence concerning aflibercept, a more recent intravitreal anti-VEGF, is limited to a single case report. In this case report, we illustrate the case of a 43-year-old myopic woman presenting with visual acuity loss and distortion in the right eye over the last 5 days in whom CNV associated with PIC was diagnosed. Treatment with 1 injection per month of intravitreal aflibercept for 2 months and full-dose oral prednisone for 1 week, being tapered afterwards, improved visual acuity and resolved CNV, with benefits lasting up to 24 months.


2021 ◽  
Author(s):  
Erika Andreatta ◽  
Luigi Bonavina

Summary Background Myiasis is an infestation of neglected open wounds by fly larvae. Global warming, related climate changes, and increased traveling in tropical countries may contribute to the worldwide diffusion of new fly species. Common risk factors for myiasis are advanced age, poor hygiene, malnourishment, social isolation, diabetes, cancer, and peripheral artery disease. The aim of this study was to review the characteristics of cases of myiasis reported in Europe. Methods A narrative review of cutaneous myiasis was performed using PubMed, EMBASE, Web of Science database, and the search terms “human,” “myiasis,” “cutaneous myiasis,” “maggot,” “Europe,” “wound,” with the combination of “AND” and “OR.” In addition, hospital charts were reviewed to add personal experience to the literature review. Results Overall, 52 articles, both single case reports and case series reporting cutaneous myiasis, were found in the medical literature of the past two decades. A total of 64 patients living in Europe were identified, of whom 36% had wound myiasis. In addition to the literature review, we report the case of a male patient who presented with myiasis within a deep scalp ulcer occurring after radiotherapy for basal cell carcinoma. Conclusion Myasis is rare and possibly under-reported in Europe. The epidemiology of this infestation may be changing in the future due to climate variability, a rise in travel to tropical areas, and the migration of fly species.


2019 ◽  
Vol 2 (1) ◽  
pp. i-ii
Author(s):  
Jayakumar Menon ◽  

Clinical psychiatry has always been more accommodative of the divergent methods of scientific enquiry and focus is back on enhancing the core clinical skills in Psychiatry. We are re-discovering the values of single case reports, case series as much as we look forward to systematic reviews. The standardisation of reporting with the acceptance of guidelines (eg.Equator Network) has helped immensely in ensuring transparency and quality of health research. In this issue of the journal, we have articles that cover diverse areas like First Episode Psychosis, Sleep Disorders, Interface of SLE and Psychiatry, medication adherence in depression, antenatal depression, and epigenetics.


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