scholarly journals Palisaded neutrophilic and granulomatous dermatitis following a long-standing monoclonal gammopathy: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2097956
Author(s):  
Dorsa Zabihi-pour ◽  
Bahar Bahrani ◽  
Dalal Assaad ◽  
Jensen Yeung
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Connective Tissue ◽  
Monoclonal Gammopathy ◽  
Inflammatory Dermatosis ◽  
Case Summary ◽  
Underlying Causes ◽  
Granulomatous Dermatitis ◽  
Skin Biopsies ◽  
Underlying Diseases

Background: Palisaded neutrophilic granulomatous dermatitis is a rare inflammatory dermatosis with possible underlying systemic conditions including rheumatoid arthritis, autoimmune connective tissue disease, and malignancies. Case Summary: We report a case of an 84-year-old man presenting with a 3-week eruption of asymptomatic annular plaques on his neck, which progressed to involve his back and legs. Skin biopsies confirmed a diagnosis of palisaded neutrophilic granulomatous dermatitis, and he was treated with prednisone. Full workup related to potential underlying causes of palisaded neutrophilic granulomatous dermatitis was completed. Conclusion: Palisaded neutrophilic granulomatous dermatitis may precede the onset of underlying systemic conditions or occur concomitantly. Following the diagnosis, clinicians should perform a comprehensive focused history, physical examination, and laboratory investigation related to the associated underlying diseases.

scholarly journals Eosinophilic Polymyositis: A Rare Cause of Atraumatic Compartment Syndrome of the Forearm

2019 ◽  
Vol 12 (S 01) ◽  
pp. S67-S69
Author(s):  
Michael K. Boyajian ◽  
Lauren O. Roussel ◽  
Galam Khan ◽  
Edward Stopa ◽  
Reena Bhatt
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Compartment Syndrome ◽  
Rare Case ◽  
Chart Review ◽  
Surgical Intervention ◽  
Retrospective Chart Review ◽  
Definitive Diagnosis ◽  
Pertinent Literature ◽  
Case Summary

Abstract Background Eosinophilic polymyositis is a rare disorder in which eosinophils infiltrate muscle and supporting connective tissue structures, resembling autoimmune or immunologically mediated disease. This disorder can be associated with muscle inflammation and death, and can be a cause of atraumatic compartment syndrome. Methods This is a retrospective chart review of a case report as well as review of pertinent literature. Results This report presents a rare case of atraumatic compartment syndrome of the forearm caused by eosinophilic polymyositis. It provides a case summary and histological examination of this patient. Conclusion This is an important case to report because it highlights eosinophilic polymyositis as a unique etiology of compartment syndrome. In appropriate clinical situations where patients do not improve despite standard interventions, one should consider the rare and unusual etiology of compartment syndrome due to eosinophilic polymyositis. Furthermore, primary surgical intervention should not be delayed while waiting to ascertain a definitive diagnosis.

scholarly journals Interstitial Granulomatous Dermatitis (IGD)

2017 ◽  
Vol 5 (4) ◽  
pp. 543-544 ◽  
Author(s):  
Tiberiu Tebeica ◽  
Cristiana Voicu ◽  
James W. Patterson ◽  
Hristo Mangarov ◽  
Torello Lotti ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Male Patient ◽  
Metabolic Diseases ◽  
Giant Cells ◽  
Lymphoproliferative Disorders ◽  
Malignant Tumours ◽  
Skin Changes ◽  
Granulomatous Dermatitis

We report the case of a 42 years old male patient suffering from skin changes , which appeared in the last 7-8 years.  Two biopsies were performed during the evolution of the lesion. Both showed similar findings that consisted in a busy dermis with interstitial, superficial and deep infiltrates of lymphocytes and histiocytes dispersed among collagen bundles, with variable numbers of neutrophils scattered throughout. Some histiocytes were clustered in poorly formed granuloma that included rare giant cells, with discrete Palisades and piecemeal collagen degeneration, but without mucin deposition or frank necrobiosis of collagen. The clinical and histologic findings were supportive for interstitial granulomatous dermatitis. Interstitial granulomatous dermatitis (IGD) is a poorly understood entity that was regarded by many as belonging to the same spectrum of disease or even synonym with palisaded and neutrophilic granulomatous dermatitis (PNGD). Although IGD and PNGD were usually related to connective tissue disease, mostly rheumatoid arthritis, some patients with typical histologic findings of IGD never develop autoimmune disorders, but they have different underlying conditions, such as metabolic diseases, lymphoproliferative disorders or other malignant tumours. These observations indicate that IGD and PNGD are different disorders with similar manifestations.

scholarly journals Interstitial granulomatous dermatitis: a rare case report of dermatological manifestation of rheumatoid arthritis

2020 ◽  
Vol 8 (7) ◽  
pp. 2688
Author(s):  
Jagadeesh Chandrasekaran ◽  
Neetu Mariam Alex
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Fungal Infections ◽  
Histopathological Examination ◽  
Specific Treatment ◽  
Granulomatous Inflammation ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Solid Organ ◽  
Granulomatous Dermatitis

Interstitial granulomatous dermatitis (IGD), a rare dermatological disorder was first described by Ackerman et al, in the year 1993. It is characterized by a heterogeneous clinical spectrum and a specific histopathological pattern. It has been described in association with a number of auto-immune disorders, drugs, fungal infections, and malignancies. It may manifest as papules, patches, plaques, nodules, annular lesions, or less frequently, as described classically, as indurated linear subcutaneous cords. This case is being reported as interstitial granulomatous dermatitis is rare dermatological manifestation of rheumatoid arthritis and presentation as large ulcerated skin lesions is further extremely rare. In this case report we describe a 67-year-old gentleman with Seropositive Rheumatoid arthritis. He presented to our hospital with complaints of multiple well defined skin lesions with pus discharge over lower limbs, trunk and upper limbs. Biopsies from left upper limb and abdomen showed focal necrobiosis with surrounding granulomatous inflammation with rare perivascular granulomas. He was subsequently diagnosed to have interstitial granulomatous dermatitis based on histopathological examination. Interstitial granulomatous dermatitis has been described to be associated with a number of autoimmune conditions and drugs. It is very important for clinicians to have knowledge about this rare skin condition as it may be heralding presentation of a serious underlying condition like lymphoproliferative disorders or solid organ malignancies. There is no specific treatment and causative disease has to be diagnosed and targeted.

scholarly journals Organizing pneumonia as the initial presentation in rheumatoid arthritis – A case report

2021 ◽  
Vol 5 (1) ◽  
pp. 051-053
Author(s):  
Kaur Harveen ◽  
Singh Dilbag ◽  
Pandhi Naveen
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Interstitial Lung Disease ◽  
Connective Tissue ◽  
Lung Injury ◽  
Lung Disease ◽  
Connective Tissue Diseases ◽  
Pulmonary Involvement ◽  
Organizing Pneumonia ◽  
Initial Manifestation

Organizing pneumonia (OP), can be seen in association with lung injury, infection, drug intoxication, and connective tissue diseases. Patients of rheumatoid arthritis (RA) are prone to develop interstitial lung disease (ILD), but the pulmonary involvement usually occurs several years after the joint manifestations. Only in about 10% cases of RA, the initial manifestation of the disease can be in the form of interstitial lung disease. OP as the initial manifestation of RA is extremely uncommon occurrence. Here is presented a case of 52-year-old male who presented with OP as the initial manifestation of RA. On investigation, the RA factor and anti-CCP Antibodies were positive. Based on clinical, radiological and histopathological findings the diagnosis was established.

Odontoid cervical gout causing atlantoaxial instability: case report

2019 ◽  
Vol 30 (4) ◽  
pp. 541-544
Author(s):  
Justin Slavin ◽  
Marcello DiStasio ◽  
Paul F. Dellaripa ◽  
Michael Groff
Keyword(s):  
Rheumatoid Arthritis ◽  
Spinal Cord ◽  
Case Report ◽  
Physical Examination ◽  
Odontoid Process ◽  
Signs And Symptoms ◽  
Cord Compression ◽  
Atlantoaxial Instability ◽  
Posterior Stabilization ◽  
Rotatory Subluxation

The authors present a case report of a patient discovered to have a rotatory subluxation of the C1–2 joint and a large retroodontoid pannus with an enhancing lesion in the odontoid process eventually proving to be caused by gout. This patient represented a diagnostic conundrum as she had known prior diagnoses of not only gout but also sarcoidosis and possible rheumatoid arthritis, and was in the demographic range where concern for an oncological process cannot fully be ruled out. Because she presented with signs and symptoms of atlantoaxial instability, she required posterior stabilization to reduce the rotatory subluxation and to stabilize the C1–2 instability. However, despite the presence of a large retroodontoid pannus, she had no evidence of spinal cord compression on physical examination or imaging and did not require an anterior procedure to decompress the pannus. To confirm the diagnosis but avoid additional procedures and morbidity, the authors proceeded with the fusion as well as a posterior biopsy to the retroodontoid pannus and confirmed a diagnosis of gout.

Subepithelial Connective Tissue Graft for Gingival Recession Coverage: A Case Report

2020 ◽  
Author(s):  
Anita Mehta
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Tooth Brushing ◽  
Vulnerable Area ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Subepithelial Connective Tissue Graft ◽  
Dentinal Hypersensitivity

The Gingival recession is considered a multi-factorial. The etiology may be an anatomically vulnerable area, faulty tooth brushing, high frenum attachment. In cases where there is progressive recession, aesthetics concern or increasing dentinal hypersensitivity, we can do recession coverage. Depending upon the presence or absence of adequate keratinized tissue we can choose the technique. In case of adequate width of keratinized tissue, usually we can do displaced flap and in case where there is inadequate width, we can do gingival grafting.

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