Axillary Hidradenitis: Risk Factors for Recurrence after Surgical Excision in 214 Patients

2018 ◽  
Vol 84 (3) ◽  
pp. 422-427 ◽  
Author(s):  
Nkem Nweze ◽  
Afshin Parsikia ◽  
Rakesh Ahuja ◽  
Amit R.T. Joshi
Keyword(s):  
Surgical Treatment ◽  
Age Of Onset ◽  
Surgical Excision ◽  
Chronic Inflammatory Disease ◽  
Sweat Glands ◽  
High Tendency ◽  
History Of ◽  
Risk Factors For Recurrence ◽  
Average Body Mass ◽  
Median Area

Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the apocrine sweat glands. Although the mainstay of surgical treatment is excision, the disease has a high tendency to recur, for reasons that are not well understood. We sought to better characterize the natural history of this disease, focusing on patients who required operative intervention. Two hundred and fourteen patients with axillary HS underwent 293 surgical procedures. We divided the cohort into two groups based on recurrence and then compared them to identify the factors most associated with recurrent axillary HS. Mean age of onset of HS was 32.1 years. The patients were overwhelmingly female (84.1%), black (93%), and obese (average body mass index = 33.4). Of them, 35.5 per cent of the patients had bilateral axillary disease and 8.4 per cent had extra-axillary disease. Of the 214 patients, 22 (10.3%) had recurrent disease. The vast majority of interventions included excision of disease (median area = 78.6 cm2). Closure versus nonclosure was not associated with a proclivity toward recurrence. The patients with HS were overwhelmingly obese and female, and many of them smoked. Surgical excision was the most common intervention and closure was used in roughly half of the patients. Recurrence after excision was not associated with extra-axillary disease and did not seem to correlate with the manner in which the wounds were managed after excision. Weight loss and smoking cessation may play a more significant role in the prevention of recurrence of HS than surgical treatment alone.

scholarly journals Surgical excision of a residual cyst in a patient with previous history of jaw osteonecrosis associated with oral bisphosphonate: A case report

2015 ◽  
Vol 21 (3) ◽  
pp. 191
Author(s):  
Ana Carolina Uchoa Vasconcelos ◽  
Wâneza Dias Borges ◽  
Cláiton Heitz ◽  
Fernanda Gonçalves Salum ◽  
Maria Antonio Zancanaro de Figueiredo ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Previous History ◽  
Surgical Excision ◽  
Osteonecrosis Of The Jaws ◽  
Oral Bisphosphonate ◽  
Prevention And Treatment ◽  
History Of ◽  
Preoperative Procedures ◽  
Jaw Osteonecrosis

Residual cyst is an inflammatory odontogenic cyst resultant from pulp necrosis, where the tooth has already been removed. Bisphosphonates are drugs used in the prevention and treatment of bone metabolism diseases with intense resorption activity, and they have been associated with osteonecrosis of the jaws, an important side effect. The aim of this study was to report a successful surgical treatment of a residual cyst in a patient who had previously developed jaw osteonecrosis associated with sodium alendronate use. We emphasize here the importance of safe preoperative procedures when approaching these patients. 

scholarly journals Natural History of Anterior Shoulder Instability

2017 ◽  
Vol 11 (1) ◽  
pp. 909-918 ◽  
Author(s):  
Eduardo Palma Carpinteiro ◽  
Andre Aires Barros
Keyword(s):  
Surgical Treatment ◽  
Natural History ◽  
Age Of Onset ◽  
Young Patients ◽  
The Body ◽  
Joint Disease ◽  
First Episode ◽  
Anterior Shoulder Instability ◽  
Bone Lesions ◽  
History Of

Background:The shoulder is the most complex joint in the body. The large freedom of motion in this joint is the main cause of instability. Instability varies in its degree, direction, etiology and volition and there is a large spectrum of conditions.Methods:Based on literature research and also in our own experience, we propose to elucidate the reader about the natural history of instability and its importance for the appropriate management of this pathology, by answering the following questions:What happens in the shoulder after the first dislocation? Which structures suffer damage? Who are the patients at higher risk of recurrence? How does the disease evolve without treatment? Will surgical treatment avoid future negative outcomes and prevent degenerative joint disease? Who should we treat and when?Results:80% of anterior-inferior dislocations occur in young patients. Recurrent instability is common and multiple dislocations are the rule. Instability is influenced by a large number of variables, including age of onset, activity profile, number of episodes,delay between first episode and surgical treatment.Conclusion:Understanding the disease and its natural evolution is determinant to decide the treatment in order to obtain the best outcome. It is crucial to identify the risk factors for recurrence. Delay in surgical treatment, when indicated, leads to worse results. Surgical technique should address the type and severity of both soft tissue and bone lesions, when present.

scholarly journals Syringocystadenoma Papilliferum: A Case Report and Review of the Literature

2019 ◽  
Vol 11 (1) ◽  
pp. 36-39
Author(s):  
Khalid Al Hawsawi ◽  
Amani Alharazi ◽  
Abeer Ashary ◽  
Asmaa Siddique
Keyword(s):  
Surgical Excision ◽  
Sweat Glands ◽  
Erythematous Plaque ◽  
Syringocystadenoma Papilliferum ◽  
Clinicopathological Findings ◽  
Adnexal Tumor ◽  
History Of ◽  
Epithelial Sheets ◽  
The Right ◽  
Columnar Cells

Syringocystadenoma papilliferum is a very rare, benign adnexal tumor that originates from the apocrine sweat glands. Herein, we report a 25-year-old male who presented with a 10-year history of an asymptomatic slowly growing skin lesion on his face. Skin examination revealed a solitary rounded 3 × 3 cm erythematous plaque with central crustation on the right side of his face. Punch skin biopsy was taken from the lesion. The epidermis showed downward papillomatous extensions. The dermis showed multiple epithelial sheets and dilated ducts that were lined by columnar cells. On the basis of the above clinicopathological findings, the diagnosis of syringocystadenoma papilliferum was made. The patient was reassured and referred to a surgeon for surgical excision of the lesion.

scholarly journals Endoscopic Diagnosis of Leiomyosarcoma of the Esophagus, a Rare Neoplasm

1998 ◽  
Vol 5 (1) ◽  
pp. 49-52 ◽  
Author(s):  
Mario Ravini ◽  
Massimo Torre ◽  
Giulio Zanasi ◽  
Marco Vanini ◽  
Mario Camozzi
Keyword(s):  
Weight Loss ◽  
Surgical Treatment ◽  
Epigastric Pain ◽  
Surgical Excision ◽  
Endoscopic Examination ◽  
Endoscopic Appearance ◽  
Rare Neoplasm ◽  
History Of ◽  
Histological Confirmation ◽  
Severe Epigastric Pain

We report a case of leiomyosarcoma of the distal third of the esophagus in a 51-year-old woman presenting with a six-month history of severe epigastric pain, disphagia and weight loss. The diagnosis, suspected on endoscopic examination, was preoperatively acheived by biopsy and immunohistological stain. Surgical treatment was undertaken with good results. Differentiation between leiomyosarcoma and more common esophageal neoplasm may be difficult if based on radiographic and endoscopic appearance. Preoperative histological confirmation is therefore mandatory to schedule a wide surgical excision.

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

Subvalvular mitral aneurysm a rare pathology

2021 ◽  
pp. 1-2
Author(s):  
Odete R. Mingas ◽  
Ondina Fortunato ◽  
Sebastiana Gamboa
Keyword(s):  
Surgical Treatment ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Ventricular Aneurysm ◽  
African Child ◽  
Cardiorespiratory Arrest ◽  
Previous Infection ◽  
History Of

Abstract We present a rare and challenging case of left ventricular aneurysm in an African child with no history of previous infection or trauma, admitted for surgical treatment, who presented non reversible cardiorespiratory arrest with cardiorespiratory resuscitation before surgery.

845 Progressive external ophthalmoplegia in sleep apnea presenting as floppy eyelid syndrome

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A329-A329
Author(s):  
Pratibha Anne ◽  
Rupa Koothirezhi ◽  
Ugorji Okorie ◽  
Minh Tam Ho ◽  
Brittany Monceaux ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Surgical Treatment ◽  
Sleep Apnea ◽  
Genetic Disorder ◽  
Deltoid Muscle ◽  
Progressive External Ophthalmoplegia ◽  
Ataxic Gait ◽  
Pressure Setting ◽  
Obstructive Sleep ◽  
History Of

Abstract Introduction Floppy eye lid syndrome (FES) is known to be associated with Obstructive sleep apnea (OSA) and chronic progressive external ophthalmoplegia (CPEO) is a rare genetic disorder with mitochondrial myopathy that may present with isolated eye lid ptosis in the initial stages. In a patient with loud snoring and obesity, treating obstructive sleep apnea may improve Floppy eyelid syndrome. Report of case(s) 52-year-old African – American male with past medical history of Hypertension, obesity, glaucoma, CPEO status bilateral blepharoplasty with failed surgical treatment. Patient was referred to Sleep medicine team to rule out Obstructive Sleep Apnea aa a cause of possible underlying FES and residual ptosis. On exam, patient was noted to have bilateral brow and eyelid ptosis and mild ataxic gait. MRI brain with and without contrast was unremarkable. Deltoid muscle biopsy was suggestive of possible congenital myopathy and mild denervation atrophy. Polysomnogram showed severe OSA with AHI of 74.1 per hour and patient was initiated on Auto CPAP at a pressure setting of 7–20 cm H2O. CPAP treatment improved snoring, OSA and subjective symptoms of excessive day time sleepiness but did not improve the residual ptosis. Conclusion Treatment of severe OSA in a patient previously diagnosed with CPEO and failed surgical treatment with bilateral blepharoplasty, did not alter the course of residual ptosis/ floppy eyelids even though his other sleep apnea symptoms have improved. Support (if any) 1. McNab AA. Floppy eyelid syndrome and obstructive sleep apnea. Ophthalmic Plast Reconstr Surg. 1997 Jun;13(2):98–114. doi: 10.1097/00002341-199706000-00005. PMID: 9185193.

A Brief History of Psoriasis Management in Canada

2020 ◽  
Vol 24 (3) ◽  
pp. 273-277
Author(s):  
Khalad Maliyar ◽  
Patrick Fleming ◽  
Boluwaji Ogunyemi ◽  
Charles Lynde
Keyword(s):  
20Th Century ◽  
Coal Tar ◽  
Historical Review ◽  
Chronic Inflammatory Disease ◽  
Biologic Therapies ◽  
First Line ◽  
Revolutionary Change ◽  
Clinical Presentations ◽  
History Of ◽  
The 19Th Century

Psoriasis is a chronic, inflammatory disease with a varying degree of clinical presentations. Managing psoriasis has always been arduous due to its chronicity and its propensity to relapse. Prior to the development of targeted biologic therapies, there were few effective treatments for psoriasis. Ancient psoriasis therapies included pinetar, plant extracts, psychotherapy, arsenic, and ammoniated mercury. In the 19th century, chrysarobin was developed. Then, in the early half of the 20th century, anthralin and coal tar were in widespread use. In the latter half of the 20th century, treatments were limited to topical first-line therapies, systemic drugs, and phototherapy. However, as the treatment of psoriasis has undergone a revolutionary change with the development of novel biologic therapies, patients with moderate to severe psoriasis have been able to avail therapies with high efficacy and durability along with an acceptable safety profile. This article is a brief historical review of the management of psoriasis prior to the inception of biologics and with the development of novel biologic therapies.

scholarly journals The management of pancreatic metastasis from synovial sarcoma of the soft tissue: A case report

Rare Tumors ◽  
2020 ◽  
Vol 12 ◽  
pp. 203636132098369
Author(s):  
Bouhani Malek ◽  
Sakhri Saida ◽  
Jaidane Olfa ◽  
Kammoun Salma ◽  
Slimene Maher ◽  
...  
Keyword(s):  
Synovial Sarcoma ◽  
English Literature ◽  
Surgical Excision ◽  
Left Thigh ◽  
Pancreatic Tumors ◽  
Pancreatic Metastasis ◽  
Pancreatic Metastases ◽  
Pancreatic Biopsy ◽  
Diagnostic Difficulties ◽  
History Of

Pancreatic metastases are rare, accounting for 2%–3% of pancreatic tumors. The pancreas represents an unusual metastatic site of synovial sarcoma (SS) outside the usual localizations (regional nodes, lung, bone, and liver). The diagnosis is evoked by the personnel medical history of SS and imaging then confirmed by histological examination of the guided pancreatic biopsy. Its therapeutic management is mainly surgical with extensive removal of the lesion. So far only four cases have been reported in the English literature. We reported the case of a male aged 30-year-old who was admitted to our Institute for a local recurrence of SS of the left thigh which was initially treated by surgical excision. The patient underwent a wide surgical excision followed by chemotherapy and radiotherapy. About 15 months later, he experienced a pancreatic metastasis of his SS. He had a caudal splenopancreatectomy with partial resection of the transverse colon followed by chemotherapy. This report highlights the diagnostic difficulties of this rare localization and therapeutic challenge.

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