Pallor Sign: An Indicator of Hemangioma in Evolution

2012 ◽  
Vol 16 (6) ◽  
pp. 451-452
Author(s):  
Muzamil Chisti ◽  
Nusrat Banka ◽  
Abdullah Alfadley

Background: The typical presentation of infantile hemangioma is well known and is easily recognizable. However, it may have many atypical presentations, as reported in the literature. Most of the hemangiomas are not visible at birth and become apparent at about 3 to 4 weeks of age. There are very few case reports of hemangioma presenting as a pale patch in the dermatology literature, and none of them describe the etiopathogenesis of this presentation and its clinical implications. Objective and Conclusion: We report a case of an infantile hemangioma with a trichrome presentation: an erythematous oval patch with a dark red macule at the periphery enclosed by a hypopigmented halo. A brief description of the etiopathogenesis of the pallor sign is also given. Renseignements de base: La présentation typique d'un hémangiome infantile est bien connue et facilement reconnaissable. Toutefois, comme l'indique la documentation, il peut avoir de nombreuses présentations atypiques. La plupart des hémangiomes ne sont pas visibles à la naissance et deviennent apparents à environ 3 à 4 semaines. La documentation dermatologique ne compte que très peu d'observations d'hémangiome se présentant sous forme de plaque pâle, et aucune d'entre elles ne décrit l'étiopathogénie de cette présentation et ses conséquences cliniques. Objectif et conclusion: Nous signalons un cas d'hémangiome infantile avec présentation trichrome: plaque érythémateuse ovale avec une macule rouge foncée en périphérie, entourée d'un halo hypopigmenté. Une brève description de l'étiopathogénie de la pâleur est également donnée.

1986 ◽  
Vol 31 (3) ◽  
pp. 197-201 ◽  
Author(s):  
Robert Johnson ◽  
Jambur Ananth

Undetected physical illnesses in psychiatric patients are common. Why do so many physical illnesses go undetected? These disorders are difficult to detect and need an elaborate consultatory process. Some of the problems may be related to the fact that psychiatrists do not do physical examinations. Clues suggesting an organic etiology may be attributed to psychodynamic issues by many physicians. In this paper, seven case reports are presented to illustrate the following: perform your own physical examination; do not attribute physical signs to dynamic issues; all physical signs should be explained; be alert to atypical presentations; conduct relevant laboratory workup; avoid bias against unattractive patients; and pose specific questions to consultants.


2004 ◽  
Vol 28 (12) ◽  
pp. 438-440 ◽  
Author(s):  
Eromona Whiskey ◽  
David Taylor

Aims and MethodTo review the evidence for this use of pramipexole in the treatment of unipolar and bipolar depression, a literature search on Embase and Medline was conducted in December 2003. The search was updated in July 2004. The reference sections of retrieved papers were searched for further relevant references.ResultsThere are limited data on the clinical use of pramipexole in affective disorders. Only two double-blind trials in bipolar depression and one in unipolar depression were retrieved. Most information is in the form of case reports and open studies. No dose-response relationships have been established and a wide range of doses has been employed in the reports.Clinical ImplicationsIn view of the fact that the evidence for the use of pramipexole is still limited at the time of writing, its routine clinical use cannot be recommended. The data appear promising, but further research is required to determine its role in affective disorders.


2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
T. M. Morgan ◽  
J. M. Colazo ◽  
L. Duncan ◽  
R. Hamid ◽  
K. M. Joos

Background. Oculofaciocardiodental (OFCD) syndrome is due to mutations in BCOR (BCL-6 corepressor). OFCD has phenotypic overlaps with PHACE syndrome (Posterior fossa anomalies, Hemangioma, Arterial anomalies, Cardiac defects, Eye anomalies). Infantile hemangiomas are a key diagnostic criterion for PHACE, but not for OFCD. A previous study reported two cases of infantile hemangiomas in OFCD, but the authors could not exclude chance association. Case Presentation. We describe two novel cases of female patients (one initially diagnosed with PHACE syndrome), both of whom had infantile hemangiomas. Ophthalmological findings were consistent with oculofaciocardiodental (OFCD) syndrome. Upon genetic testing, these two females were determined to have X-linked BCOR mutations confirming OFCD syndrome diagnoses. Conclusion. These case reports add support to the hypothesis that infantile hemangiomas may be a feature of OFCD. BCOR may potentially be within a pathway of genes involved in PHACE syndrome and/or in infantile hemangioma formation.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Kakoullis ◽  
G. D'Souza ◽  
N. Hegde ◽  
G. Tadros

The symptom of abulia is a state of diminished motivation where an individual may appear apathetic, disinterested, asocial and emotionally remote. It can exist independently but more commonly occurs as part of a constellation of symptoms accompanying a specific disorder, normally neurological or psychiatric. Although it is not a normal part of ageing, it has been observed in a number of conditions seen in later life. These include Alzheimer's disease, vascular dementia, Parkinson's disease, dementia with Lewy bodies, and frontotemporal dementia. Abulia and depression are separate entities but abulic patients are often thought to be depressed and experience long periods of anti-depressant treatment without benefit. the key difference is that abulic patients fail to disclose any sign of sadness or negative thoughts and show an obvious lack of concern for their condition.Abulia has significant clinical implications as it is associated with decreased function, poor prognosis and worse carer stress. It is also potentially treatable. the pharmacological agents that have received the most attention are dopaminergic drugs including Carbidopa/Levodopa, Amantadine, Bupropion and Bromocriptine. the research predominantly consists of case reports but no studies have focussed on the elderly. in this paper, the authors review the current literature and describe three cases of abulia in older people that have been successfully treated with Bromocriptine. the cases highlight the importance of recognising abulia and differentiating it from depression. They also show the need to consider treatment.


Author(s):  
James Moyer ◽  
Laura Jacks ◽  
Janel Darcy Hunter ◽  
Gilbert Chan

AbstractSlipped capital femoral epiphysis (SCFE) is a relatively common hip disorder often seen in overweight, peripubertal children. Although the exact etiology is uncertain, it is generally accepted that underlying endocrinopathies play a role in the pathogenesis. Hypothyroidism is the endocrine disorder cited most commonly in association with SCFE, and patients often have no history of thyroid dysfunction at the time of presentation. Despite being a well-recognized risk factor, recommendations for screening thyroid function in patients with typical presentations of SCFE have not been deemed cost-effective; however, there is data to support screening for hypothyroidism in patients with atypical presentations of SCFE or short stature. Hypothyroidism may have a significant impact on healing and bone union after surgical management of SCFE and there is a paucity of case reports in the literature describing potential peri- and postoperative complications. We performed a systematic review of the literature of all reported cases of SCFE with associated hypothyroidism using the search terms, which demonstrated a physiologic relationship between hypothyroidism and SCFE. Two case reports of SCFE in patients with hypothyroidism and associated complications are presented with the literature review. There is a physiologic relationship between thyroid dysfunction and SCFE, and we postulate that profound hypothyroidism may contribute to delayed healing or nonunion in patients undergoing operative management. We support the recommendation to screen patients with short stature, atypical presentation of SCFE, or perisistent nonunion after surgery. In cases of hypothyroidism, we recommend thyroid hormone replacement and laboratory confirmation of return to euthyroid state prior to operative intervention.


2010 ◽  
Vol 124 (11) ◽  
pp. 1205-1208 ◽  
Author(s):  
Z Vourexakis ◽  
M-I Kos ◽  
J-P Guyot

AbstractIntroduction:Malignant otitis externa is a life-threatening infection of the skull base. Its presentation is not always typical.Case reports:We report three cases of malignant otitis externa which illustrate the diversity of its clinical manifestations and the difficulties in its diagnosis.Discussion:The perception of malignant otitis externa as an infection caused by Pseudomonas aeruginosa in diabetic patients is not always correct. The adoption of diagnostic criteria could be helpful in identifying atypical cases.


2006 ◽  
Vol 113 (2) ◽  
pp. 242-246 ◽  
Author(s):  
Heather L. Ratliff ◽  
Mohammed Yousufuddin ◽  
Wesley R. Lieving ◽  
Brent E. Watson ◽  
Amer Malas ◽  
...  

2013 ◽  
Vol 18 (5) ◽  
pp. 519-523 ◽  
Author(s):  
Mark Daniel Anderson ◽  
Sudhakar Tummala

Herpes simplex or herpes zoster reactivation after spinal surgery is rarely reported. This case report and review of the literature describes patients in whom this reactivation occurs to clarify the diagnosis and management. In addition to reporting their case, the authors reviewed case reports and series published between 1980 and 2012 found through a PubMed search. Herpes reactivation is generally confined to a vesicular rash that can be treated with acyclovir. However, occasional dissemination has occurred and has led to myelitis or encephalitis. Atypical presentations led to delays in diagnosis, delayed treatment, and poor neurological outcome. While rare, herpes simplex or herpes zoster reactivation is a complication of spine surgery that must be considered in the face of new-onset focal neurological symptoms in a dermatome pattern without a structural cause, even without a rash.


2010 ◽  
Vol 34 (9) ◽  
pp. 371-375 ◽  
Author(s):  
Denis O'Leary ◽  
Pauline McAvoy ◽  
John Wilson

Aims and methodRelative to workforce numbers, the National Clinical Assessment Service (NCAS) has reported high rates of referrals for performance concerns in psychiatrists. Our aim was to see how these concerns would be distributed across good medical practice (GMP) domains. Such specification would help identify appropriate training and development interventions. Concerns were obtained from consecutive case reports (anonymised) of psychiatrists referred to NCAS between October 2004 and April 2006.ResultsThe proportion of psychiatrists with concerns in any domain was highest (just over 50%) in the domains of good clinical care and working with colleagues. Two-thirds had concerns across multiple domains.Clinical implicationsTraining and development needs of psychiatrists referred to NCAS are more complex and more prevalent in the GMP domain of good clinical care than previously reported.


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