scholarly journals A rare case of Sweet syndrome secondary to melioidosis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sahathevan Vithoosan ◽  
Balendran Thanushah ◽  
Paramarajan Piranavan ◽  
Dayal Gamlaksha ◽  
Harindra Karunatilake ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Burkholderia Pseudomallei ◽  
Skin Lesions ◽  
Upper Limbs ◽  
Cutaneous Manifestations ◽  
Sweet Syndrome ◽  
Emerging Infection ◽  
Oral Ulcers ◽  
First Case ◽  
The Face

Abstract Background Melioidosis is an emerging infection in South Asia caused by Burkholderia pseudomallei with various clinical presentations that include pneumonia, bacteraemia, arthritis, and deep-seated abscesses. Various cutaneous manifestations have been described in association with melioidosis. However Sweet Syndrome secondary to melioidosis has not been reported in the literature. Herein we describe the first case of Sweet syndrome secondary to melioidosis. Case presentation A 53-year-old previously healthy Sri Lankan female presented with high-grade fever, painful oral ulcers, odynophagia and multiple bilateral cervical lymphadenopathies for 1 month. She also had a loss of appetite and weight. She had oral ulcers and bilateral blepharitis. Dermatological examination revealed multiple tender papules with a mamillated appearance and targetoid lesions with a yellowish centre over the face, upper trunk and upper limbs. She also had multiple tender subcutaneous nodules over the extensor aspect of upper limbs. Her inflammatory markers were significantly elevated. Aspirate from a submental lymph node abscess revealed the growth of Burkholderia pseudomallei. Melioidosis antibody titer was > 10,240. The histology of the skin lesions of the face and left forearm showed a prominent neutrophilic infiltrate in the dermis and the morphological features were in favour of Sweet syndrome with panniculitis. She was started on intravenous meropenem 2 g daily and showed rapid clinical improvement with the disappearance of skin lesions as well as a reduction in inflammatory markers. Conclusion Sweet syndrome is an uncommon inflammatory disorder known to be associated with upper respiratory tract and gastrointestinal infections, malignancies and the use of certain drugs. Melioidosis is an emerging infection with various cutaneous manifestations. This is the first case of melioidosis causing the secondary sweet syndrome. It emphasizes the importance of considering melioidosis as a potential aetiology in patients with Sweet syndrome.

scholarly journals Blue Rubber Bleb Nevus Syndrome Showing Vascular Skin Lesions Predominantly on the Face

2015 ◽  
Vol 7 (2) ◽  
pp. 194-198 ◽  
Author(s):  
Ayumi Korekawa ◽  
Koji Nakajima ◽  
Takayuki Aizu ◽  
Hajime Nakano ◽  
Daisuke Sawamura
Keyword(s):  
Gastrointestinal Tract ◽  
Histopathological Examination ◽  
Past History ◽  
Subcutaneous Fat ◽  
Skin Lesions ◽  
Upper Limbs ◽  
Normal Epithelium ◽  
X Ray ◽  
The Face ◽  
Dark Blue

An 81-year-old Japanese man presented with dark blue papules and nodules on his face. There were multiple soft papules and nodules, dark blue in color, compressive, and ranging in size from 2 to 10 mm. A few similar lesions were seen on the patient's right dorsal second toe and right buccal mucosa. There were no skin lesions on his trunk and upper limbs. The patient's past history did not include gastrointestinal bleeding or anemia. Histopathological examination showed dilated vascular spaces lined by the normal epithelium extending beneath the dermis and into the subcutaneous fat. Endoscopy of the gastrointestinal tract to check for colon involvement was not performed. X-ray images of the limbs revealed no abnormalities in the bones or joints. Laboratory investigations did not show anemia. Although we failed to confirm a diagnosis by endoscopy, the skin lesions, histopathological findings, lack of abnormal X-ray findings, and the presence of oral lesions as a part of gastrointestinal tract guided the diagnosis of blue rubber bleb nevus syndrome (BRBNS). Skin lesions of BRBNS occur predominantly on the trunk and upper limbs. However, the present case showed multiple skin lesions predominantly on the face. Therefore, it is important for clinicians to know about a possible atypical distribution of skin lesions in BRBNS.

scholarly journals Cutaneous Manifestation of Disseminated Cryptococcosis Mimicking Herpes Zoster

2021 ◽  
pp. 77-81
Author(s):  
Hoon Choi ◽  
Dong Hyun Shim ◽  
Min Sung Kim ◽  
Bong Seok Shin ◽  
Chan Ho Na
Keyword(s):  
Herpes Zoster ◽  
Skin Lesions ◽  
Fungal Culture ◽  
Cutaneous Manifestations ◽  
Systemic Involvement ◽  
Early Markers ◽  
The Face ◽  
Intravenous Amphotericin ◽  
Systemic Symptoms ◽  
Cutaneous Cryptococcosis

Cutaneous cryptococcosis is classified either as localized cutaneous cryptococcosis, in which the lesions are confined to one area of the skin, or as disseminated cryptococcosis, in which cutaneous manifestations are more widespread. We report a case of fatal disseminated cryptococcosis with characteristic cutaneous manifestations. An 84-year-old woman with diabetes presented with crusted plaques and ulcers that were painful, diffuse, and erythematous to crusted and on only the left side of her face, neck, and upper chest. She was referred to our hospital from a local clinic, where herpes zoster had been suspected. She had no specific systemic symptoms. Histological examination of the skin lesion revealed granulomatous reactions and purple to reddish encapsulated spores. Cryptococcus neoformans was identified in fungal culture, and hospitalization was recommended. Oral fluconazole was prescribed, and she was admitted to another hospital. After 2 weeks, the patient's condition deteriorated, and she was transferred to our hospital. C. neoformans antigen was detected in the blood and urine during the evaluation for systemic involvement. The patient was treated with intravenous amphotericin B and fluconazole; however, she died 10 days after admission. Cutaneous manifestations of disseminated cryptococcosis can appear in various forms and mimic molluscum contagiosum, Kaposi's sarcoma, and cellulitis. In this case, the skin lesions occurred on only the left side of the face, neck, and chest, as in herpes zoster. Cutaneous cryptococcosis can occur before the onset of symptoms of systemic involvement; therefore, diagnosis is important. Systemic evaluation may reveal early markers of disseminated cryptococcosis.

Bortezomid-Induced Sweet Syndrome.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5128-5128
Author(s):  
Aline A. Schmidt-Tanguy ◽  
Martine M. Avenel-Audran ◽  
Séverine S. Lissandre ◽  
Mammoun M. Dib ◽  
Anne A. Croue ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Skin Lesions ◽  
Pulmonary Complications ◽  
Neutrophilic Dermatosis ◽  
High Dose ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Sweet Syndrome ◽  
The Third ◽  
Periorbital Oedema

Abstract Bortezomid (VELCADE®) is a potent proteasome inhibitor used in patients with relapsed and/or refractory multiple myeloma (MM). Numerous undesirable effects are known including thrombocytopenia, neuropathy, various gastrointestinal disorders, fatigue, or rare pulmonary complications. Cutaneous complications have also been described. We reported here a case of Bortezomid-induced Sweet syndrome. A 72-year-old man received Bortezomid for a second relapse of MM previously treated with VAD (vincristine, adriamycin, dexamethasone), double high dose melphalan and autologous transplant, and thalidomide. Bortezomid was given at the dose of 1.3 mg/m2 on days 1, 4, 8, and 11 every 21 days. Dexamethasone was associated with the first cycle at the dose of 20mg/d given on days 1, 2, 4, 5, 8, and 9. On day 11 of the third cycle, a partial response was observed. However, the patient presented a painful skin eruption without any fever. Centimetric erythematous, oedematous papulo-nodular plaques were observed on his back and a periorbital oedema. Spontaneous partial regression was noted on the first day of the following cycle but major analgesic drug were necessary. These cutaneous lesions on the back and the dorsal of fingers recurred on the fourth and fifth cycles with a maximum on day 11. Histopathological examination of a lesion showed oedeme of the dermis and a perivascular polymorphic dermal infiltrate of lymphocytes, neutrophils and eosinophils with some leukocytoclasia, but without parietal necrosis or vasculitis. This findings were consistent with neutrophilic dermatosis. During the sixth Bortezomid cycle, the administration of dexamethasone 20 mg/d on days 1, 2, 4, 5, 8, 9, 11, and 12 prevents the reoccurrence of the skin lesions but the periorbital oedema persists. A variety of cutaneous manifestations has been described in MM. Sweet syndrome has been described in two untreated MM or in some patients receiving granulocyte-colony stimulating factor. Bortezomid has been associated with rash, pruritus, erythema, periorbital oedema, urticaria, alopecia, skin nodules. Few cases of non-necrotising cutaneous vasculitis with perivascular lymphocytic infiltrates have also been reported. Bortezomid-induced Sweet syndrome has been reported in three other patients at the second and third injection of the second cycle for two of them while the eruption occurred after the first injection in the third case. The recurring skin lesions after each bortezomid cycle strongly suggests Bortezomid responsibility’s in the occurrence of Sweet syndrome. Unlike classic hypersensitivity type reactions, this vasculitis rash may not necessary prompt cessation of drug as the administration of dexamethasone prevents its recurrence.

scholarly journals Graham-Little-Piccardi-Lassueur Syndrome: Two Case Reports and Review of the Literature

2020 ◽  
Vol 47 (4) ◽  
pp. 58-62
Author(s):  
L. Dourmishev ◽  
N. Mironova ◽  
I. Popov ◽  
D. Rusinova ◽  
M. Balabanova ◽  
...  
Keyword(s):  
Hair Loss ◽  
Marked Improvement ◽  
Case Reports ◽  
Skin Lesions ◽  
Review Of The Literature ◽  
Lichen Planopilaris ◽  
Normal Limits ◽  
First Case ◽  
The Face ◽  
Laboratory Examinations

AbstractGraham-Little-Piccardi-Lassueur syndrome (GLPLS) is a rare syndrome characterized by the triad of cicatricial alopecia of the scalp, non-cicatricial alopecia of the axilla and groin and follicular lichen planus eruptions on the trunk and extremities. GLPLS is considered to be a variant of lichen planopilaris. We report two cases that have fulfilled all of the criteria for GLPLS. The first case was a 71-year-old woman, admitted to the Department of Dermatology for pruritic perifollicullar erythema and scaling of the scalp, cicatricial scalp alopecia and hair loss of the axilla and pubic region for five months. Subsequently, follicular hyperkeratotic eruptions and hyperpigmented macules on the skin of the chest and abdomen appeared. The second case was a 48-year-old man with pruritic follicular papules on the face, trunk and extremities for four months. All of the laboratory examinations in both patients were within normal limits. No alternation in the general condition of the patients was observed. Histological examinations in both patients confirmed the diagnosis GLPLS. The patients were treated with systemic and local corticosteroid resulting in marked improvement of the skin lesions; however, cicatricial scalp alopecia showed no response to the treatment.

Primary ocular melioidosis due to a single genotype of Burkholderia pseudomallei in two cats from Arnhem Land in the Northern Territory of Australia

2009 ◽  
Vol 11 (10) ◽  
pp. 856-863 ◽  
Author(s):  
Helen M. Parkes ◽  
Catherine M. Shilton ◽  
Ian V. Jerrett ◽  
Suresh Benedict ◽  
Brian G. Spratt ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Burkholderia Pseudomallei ◽  
Current Knowledge ◽  
Geographical Area ◽  
Sudden Onset ◽  
First Case ◽  
Arnhem Land ◽  
The Face ◽  
Focus Of Infection ◽  
Amoxicillin Clavulanate

Melioidosis was diagnosed in two domestic crossbred cats presented for unilateral ocular disease. One patient was born and bred in Nhulunbuy, Arnhem Land, while the other had moved there 6 months previously from Townsville, Queensland. Both patients were presented with sudden onset of a ‘red eye’ and blepharospasm, which progressed to an enlarged, painful, firm globe with loss of pupillary light reflexes and vision. An obvious primary focus of infection outside the eye was not detected in either cat. In both patients, the affected eye was surgically removed and vitreal culture revealed a pure growth of Burkholderia pseudomallei. In each instance, the infection had penetrated the sclera to produce retrobulbar cellulitis, and in one case frank retrobulbar abscessation. Histologically, there was a pyogranulomatous uveitis with extensive destruction of intraocular structures. The first case was still alive approximately 1 year following enucleation and limited antimicrobial therapy using amoxicillin clavulanate and doxycycline. The second was euthanased when a localised abscess developed on the same side of the face as the healed surgical incision, despite appropriate antimicrobial therapy. Both cases were caused by the same multilocus sequence type of B pseudomallei (ST 116), which had only been isolated previously from two human patients, both living in the same isolated geographical area as the cats of this report. Apart from the geographical clustering, no epidemiological links were evident between the two cats and/or the two people. The presumptive pathogenesis of these infections is discussed in relation to current knowledge about melioidosis in northern Australia.

scholarly journals Linear discoid lupus erythematosus mimicking en coup de sabre morphea: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1988284 ◽  
Author(s):  
Mahdi Hassan ◽  
Kevin A Watters ◽  
Elena Netchiporouk
Keyword(s):  
Lupus Erythematosus ◽  
Calcineurin Inhibitors ◽  
Skin Lesions ◽  
Discoid Lupus Erythematosus ◽  
Topical Steroids ◽  
First Case ◽  
Full Physical Examination ◽  
Linear Configuration ◽  
The Face

Discoid or chronic lupus erythematosus is an autoimmune disease that produces skin lesions on the face and scalp. Rarely do lesions present with linear configuration, but when they do, the lesions often follow the lines of embryologic migration. A 24-year-old man presented with a slowly progressing asymptomatic violaceous linear patch running from the root of his frontal scalp to the nasal tip. A Doppler ultrasound and skin biopsy were performed and the histological findings demonstrated characteristic findings of discoid lupus erythematosus. A full physical examination, review of systems and laboratory investigations showed no indication of systemic lupus. High potency topical steroids and calcineurin inhibitors were prescribed along with photoprotection. At 4-month follow-up, all his lesions had mostly cleared. We report here the first case, to our knowledge, of discoid lupus erythematosus with en coup de saber presentation mimicking morphea.

Pemetrexed-induced Sweet Syndrome: First case report in the medical literature

2020 ◽  
pp. 107815522096317
Author(s):  
Mustafa Korkmaz ◽  
Melek Karakurt Eryılmaz ◽  
Mustafa Karaağaç ◽  
Aykut Demirkıran ◽  
Murat Araz ◽  
...  
Keyword(s):  
Case Report ◽  
Skin Biopsy ◽  
Lung Adenocarcinoma ◽  
Topical Steroid ◽  
Skin Lesions ◽  
Neutrophilic Dermatosis ◽  
Sweet Syndrome ◽  
Systemic Corticosteroids ◽  
First Case ◽  
Metastatic Lung

Introduction Sweet Syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disease characterized by the sudden emergence of painful, edematous, and erythematous papules, plaques, or nodules on the skin, which usually fully responsive to systemic corticosteroids. Skin lesions are often accompanied by fever and leukocytosis. Here we present a case of Sweet Syndrome caused by pemetrexed in metastatic lung adenocarcinoma. Case report A 52-year-old patient with metastatic lung adenocarcinoma received multiple lines of chemotherapy. The patient presented with extensive skin lesions after performing of pemetrexed chemotherapy. He had a fever and elevations in blood levels of C-reactive protein (CRP), sedimentation, leucocytes, and neutrophils. Neutrophil predominant perivascular and interstitial dermatitis, focal micropustule formation, and severe neutrophilic dermatosis were reported in skin biopsy. Topical steroid and oral antihistamine treatment were started as initial treatment. Discussion and conclusions: Cutaneous side effects related to pemetrexed are often reported as ‘skin rash,' which is a non-specific term. Therefore, the diagnosis of Sweet Syndrome must be confirmed by skin biopsy. It is essential to exclude the presence of an infection and medication history. Recovery in drug-induced Sweet Syndrome occurs after the drug that caused it was discontinued. Systemic corticosteroids are the first-line treatment for most cases.

scholarly journals A Case of Diffuse Cutaneous Leishmaniasis in a HIV Positive Patient

1970 ◽  
Vol 29 (2) ◽  
pp. 106-108
Author(s):  
I Patwary ◽  
M Rahman ◽  
M Ahmed ◽  
S Ahmedm ◽  
MSR Choudhury
Keyword(s):  
Weight Loss ◽  
Skin Biopsy ◽  
Plasma Cells ◽  
External Genitalia ◽  
Skin Lesions ◽  
Hiv Positive ◽  
Left Cheek ◽  
First Case ◽  
The Face ◽  
Trunk Skin

A cultivator of 30 years of age presented with fever, cough, diarrhoea, anorexia and weight loss for 6 months and papulonodular skin lesions for one month. Skin lesions appeared on the face, first over the left cheek and gradually involved whole of his face, extremities and external genitalia sparing the trunk. Skin biopsy from the nodule showed collection of histiocytes, lymphocytes & plasma cells with plenty of LD bodies inside the histiocytes. Screening test for HIV was positive and it was confirmed with western blot. Probably this is the first case Leishmaniasis/ HIV co infection reported from Bangladesh. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7957 (J Bangladesh Coll Phys Surg 2011; 29: 106-108)

Who Was the ‘Heroine’ of Freud's First Case History? Problems and Issues in the Identification of Freud's patients

2017 ◽  
Vol 19 (1) ◽  
pp. 7-54 ◽  
Author(s):  
Richard Skues
Keyword(s):  
Case History ◽  
The Real ◽  
Hypnotic Suggestion ◽  
Social Circle ◽  
First Case ◽  
The Face ◽  
Historical Investigation

In 1892–3 Freud published his first substantial case history, which concerned a patient treated by means of hypnotic suggestion. For some years this has been one of the few remaining of Freud's dedicated cases histories where the patient has not been identified. More recently, however, two publications independently arrived at the conclusion that the patient was none other than Freud's wife, Martha. This paper sets out the reasons why this identification should always have been treated with suspicion, even if the real identity was not known. Nevertheless, the paper goes on to offer a more plausible identification from among Freud's known social circle. The second part of the paper questions the circumstances under which the original misidentification could plausibly have been sustained in the face of such glaring evidence to the contrary. It concludes that, among other reasons, recent tendencies in controversies about Freud's trustworthiness have the hazard of leading to unreliable assumptions about Freud's honesty being taken as a basis for sound historical investigation.

scholarly journals Cutaneous manifestations of COVID-19 in Mexican patients: A case series and review of literature

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Juan Carlos Palomo-Pérez ◽  
Maria Elisa Vega-Memije ◽  
David Aguilar-Blancas ◽  
Erik González-Martínez ◽  
Lucia Rangel-Gamboa
Keyword(s):  
Respiratory Symptoms ◽  
Case Series ◽  
Signs And Symptoms ◽  
Skin Lesions ◽  
World Health ◽  
Medical Community ◽  
Atypical Pneumonia ◽  
Cutaneous Lesions ◽  
Cutaneous Manifestations ◽  
Mexican Patients

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.

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