scholarly journals Successful Use of the 308-nm Excimer Laser in Early Patch Stage Mycosis Fungoides

2019 ◽  
Vol 10 (3) ◽  
pp. 251-253
Author(s):  
Andrew M. Armenta ◽  
Krystal M. Jones ◽  
Jason S. Reichenberg
Keyword(s):  
Case Report ◽  
Skin Cancer ◽  
Mycosis Fungoides ◽  
Excimer Laser ◽  
Early Stage ◽  
Treatment Options ◽  
Rare Condition ◽  
Dysplastic Nevi ◽  
Increased Risk ◽  
History Of

Introduction: Mycosis fungoides (MF), a type of cutaneous T-cell lymphoma, is a rare condition with a variety of treatment options. A frequently utilized method in the treatment of early-stage MF is phototherapy. Full body phototherapy can be associated with photoaging of the skin and an increased risk of developing skin cancer. Targeted phototherapy, with a 308-nm excimer laser, may be just as effective and of a lower risk. This makes it especially useful in the treatment of patients with dysplastic nevi (DN) or other conditions which can put them at a higher risk of developing skin cancer. There are currently limited data on the treatment of early-stage MF with an excimer laser. Case Report: This study reports on a 43-year-old female patient presented to the clinic with early-stage (Ia) MF. Given her history of DN, she wished to pursue targeted phototherapy with an excimer laser. Localized light treatment was performed via a 308-nm excimer laser, 3 times weekly, for a total of 17 treatments to affected lesions. Following excimer laser treatment, she had a clinical resolution of her patches. On the follow-up clinic visits, she maintained her excellent response 12 months out. Conclusion: Targeted phototherapy with a 308-nm excimer laser may be a safer and equally effective alternative to generalized phototherapy in the treatment of early-stage MF. This case report demonstrates its efficacy and advantages over traditional generalized phototherapy.

scholarly journals Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  
Keyword(s):  
Case Report ◽  
Bacterial Infections ◽  
Treatment Options ◽  
Female Child ◽  
Correct Choice ◽  
Blood Cultures ◽  
Microbial Culture ◽  
Acinetobacter Baumanii ◽  
Inappropriate Use ◽  
History Of

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.

scholarly journals Bilateral Congenital Humeroradial Synostostis Presenting with Bilateral Proximal Radius Fractures: A Case Report

2021 ◽  
pp. 29-32
Author(s):  
Elsiddig E. Mahmoud
Keyword(s):  
Case Report ◽  
Elbow Joint ◽  
Parental Education ◽  
Functional Disability ◽  
Congenital Abnormalities ◽  
Rare Condition ◽  
Radius Fractures ◽  
Proximal Radius ◽  
History Of ◽  
Uncommon Condition

Congenital bilateral humeroradial synostosis (HRS) is a rare condition. It is generally divided into 2 categories. In the first group, which is mainly sporadic, additional upper limb hypoplasia typically coexists. In the second group, which is classically familial, HRS is commonly an isolated upper extremity anomaly. HRS can lead to variable degrees of functional disability. The clinical case reported here illustrates a possibly avoidable presentation of this uncommon condition. In this case report, we present a 6-week-old male who presented with bilateral radius fractures. Radiography revealed congenital HRS at both elbows. No other associated congenital abnormalities were detected, and there was no family history of similar conditions in any first-degree relatives. In cases of congenital HRS, movement at the elbow joint is not possible. Parents who are unaware of this information might try to straighten their infant’s elbows, which in turn may result in fractures of the proximal radius. Hence, early diagnosis and proper parental education could prevent fractures as a sequela of HRS.

scholarly journals Shallow Water Diving-Associated Alveolar Hemorrhage in an Active Duty Sailor: A Case Report

2021 ◽  
Author(s):  
Brannon L Inman ◽  
Rachel E Bridwell ◽  
Amber Cibrario ◽  
Sarah Goss ◽  
Joshua J Oliver
Keyword(s):  
Case Report ◽  
Lung Injury ◽  
Active Duty ◽  
Service Members ◽  
Breath Hold ◽  
Common Complication ◽  
Special Operations ◽  
Increased Risk ◽  
History Of ◽  
And Function

ABSTRACT Breath-hold diving is a common practice as a part of military dive training. An association between prior lung injury and a propensity for lung barotrauma may have the potential to impact mission readiness for combat divers, Pararescue, Combat Controllers, Army Engineer divers, and various units in Naval Special Warfare and Special Operations. Barotrauma is a common complication of diving, typically occurring at depths greater than 30 m (98.4 ft). Individuals with abnormal lung anatomy or function may be at increased risk of barotrauma at shallower depths than those with healthy lungs, rendering these service members unfit for certain missions. We describe the case of a 25-year-old male, with a remote history of polytrauma and resultant pulmonary pleural adhesions, whose dive training was complicated by lung barotrauma at shallow depths. In missions or training utilizing breath-hold diving, the association with secondary alterations in lung or thoracic anatomy and function may limit which service members can safely participate.

scholarly journals Proven pulmonary aspergillosis in a COVID-19 patient: A case report

2021 ◽  
Author(s):  
Sadegh Khodavaisy ◽  
Nasim Khajavirad ◽  
Seyed Jamal Hashemi ◽  
Alireza Izadi ◽  
Seyed Ali Dehghan Manshadi ◽  
...  
Keyword(s):  
Case Report ◽  
Fungal Infections ◽  
Left Lung ◽  
Aspergillus Species ◽  
Pulmonary Aspergillosis ◽  
Biopsy Material ◽  
Cavitary Lesion ◽  
Healthcare Settings ◽  
Increased Risk ◽  
History Of

Background and Purpose: Coronavirus disease 2019 (COVID-19) has become a significant clinical challenge in healthcare settings all over the world. Critically ill COVID-19 patients with acute respiratory distress syndrome may be at increased risk of co-infection with pulmonary aspergillosis. This study aimed to describe a clinical case of proven pulmonary aspergillosis caused by Aspergillus tubingensis in a 59-year-old man with a history of hospitalization due to COVID-19 infection. Case report: The Covid-19 infection was confirmed by positive nasopharyngeal polymerase chain reaction. He had a cavitary lesion measured 20 mm in diameter with intracavitary soft tissue density in the left lung in the first chest computerized tomography scan. After 25 days, he showed two cavitary lesions in both lungs which raised suspicion of fungal infection; hence, the patient underwent a trans-thoracic biopsy of the cavitary lesion. The direct examination and culture of the biopsy material revealed Aspergillus species. To confirm the Aspergillus species identification, the beta-tubulin region was sequenced. The patient was treated with oral voriconazole. Conclusion: This report underlined the importance of early diagnosis and management of invasive fungal infections in severe COVID-19 patients

DEPRESSION UNFOLDING GENDER DYSPHORIA: AN UNUSUAL CASE OF RURAL INDIA.

2021 ◽  
pp. 59-60
Author(s):  
Prabhmeet Singh ◽  
Purushottam Jangir ◽  
Priti Singh
Keyword(s):  
Rural Areas ◽  
Gender Dysphoria ◽  
Rating Scale ◽  
Treatment Options ◽  
Rare Condition ◽  
Supportive Psychotherapy ◽  
Adolescents And Adults ◽  
History Of ◽  
The Individual ◽  
Structural Levels

BACKGROUND: Gender dysphoria is a rare condition, rarer in females and rarest in rural areas of India. From the surface case presented with depressive features, but inside the core diagnosis of gender dysphoria was met. The objective of index case is highlighting presentation of a female with stigmatizing condition and role of various available treatment options and utilization of services. Case presentation: A 20-year-old female from rural background demonstrating symptoms of low mood, easy fatiguability and ideas of selfharm from past few months with a long -standing history of distress and incongruence between experienced and assigned gender. According to DSM-5, diagnosis of gender dysphoria was made and further evaluated on Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA) and Hamilton depression rating scale. SSRI was started along with supportive psychotherapy sessions and various treatment options for gender dysphoria discussed. DISCUSSION: This case illustrates importance of history taking which becomes paramount in case of rare disorders like gender dysphoria. Multi-level interventions at the individual, interpersonal, and structural levels to reduce stigma toward transgenders, better acceptability would lead to further clarify hypothesis and early diagnosis of the disorder.

scholarly journals Muir-Torre Syndrome: case report and molecular characterization

2014 ◽  
Vol 132 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Carolina Alejandra Rios ◽  
Ricardo Villalon ◽  
Jorge Munoz ◽  
Monica Acuna ◽  
Lucia Cifuentes
Keyword(s):  
Case Report ◽  
Autosomal Dominant ◽  
Treatment Options ◽  
Skin Lesions ◽  
Molecular Techniques ◽  
Causative Mutation ◽  
Colorectal Tumors ◽  
History Of ◽  
Repair Genes ◽  
Microsatellite Instability Analysis

CONTEXT: Muir-Torre syndrome is a rare autosomal dominant genodermatosis caused by mutations in the mismatch repair genes. It is characterized by the presence of sebaceous skin tumors and internal malignancies, affecting mainly the colon, rectum and urogenital tract. Awareness of this syndrome among physicians can lead to early diagnosis of these malignancies and a better prognosis. CASE REPORT: We report the case of a Chilean patient who, over the course of several years, had multiple skin lesions, endometrial cancer and colon cancer. The syndrome was diagnosed using molecular techniques such as microsatellite instability analysis, immunohistochemistry and DNA sequencing, which allowed us to find the causative mutation. CONCLUSION: Molecular diagnostics is a highly useful tool, since it allows clinicians to confirm the presence of mutations causing Muir-Torre syndrome. It is complementary to the analysis of the clinical data, such as dermatological presentation, presence of visceral malignancies and family history of colorectal tumors, and it provides important knowledge to help physicians and patients choose between treatment options.

scholarly journals An unusual cause of delayed hematoma after carotid endarterectomy: a case report

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yi Zhao ◽  
Zhichao Lai ◽  
Xiaojun Song ◽  
Rong Zeng ◽  
Changwei Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Carotid Endarterectomy ◽  
Early Stage ◽  
Prostatic Hyperplasia ◽  
Surgical Patients ◽  
Blood Products ◽  
Case Presentation ◽  
Life Threatening ◽  
History Of

Abstract Background Neck hematoma is a complication of carotid endarterectomy, usually occurring in the comparatively early stage postoperatively. Case presentation We described a patient developing life-threatening hemorrhage and non-clotting hematoma at a comparatively later stage after CEA. DIC was diagnosed according to the lab results, and the patient underwent re-operation and was supported with blood products until the coagulopathy was corrected. The patient had a history of prostatic hyperplasia and experienced malaise during the hospitalization. Prostate cancer with bone metastases was diagnosed. Conclusions This case report describes a rare underlying cause of hematoma after CEA, which reminds us to pay attention to prostate symptoms or related medical history, especially malignancy, in surgical patients, which may result in severe complications.

scholarly journals P747 Adherence to ECCO guidelines for cancer surveillance is associated to the detection of early cancer: A retrospective, single-centre, cohort study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S598-S599
Author(s):  
T L PARIGI ◽  
G Roda PhD ◽  
M Allocca ◽  
F Furfaro ◽  
L Loy ◽  
...  
Keyword(s):  
Family History ◽  
Skin Cancer ◽  
Disease Duration ◽  
Early Cancer ◽  
Cancer Surveillance ◽  
Early Cancer Diagnosis ◽  
Increased Risk ◽  
Significant Difference ◽  
History Of ◽  
The Impact

Abstract Background Patients with inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn’s disease (CD) are at increased risk of developing gastrointestinal (GI) malignancies. The aim of this study is to assess the risk of malignancies in IBD patients and the impact of cancer screening according to the ECCO guidelines in a tertiary referral centre. Methods We retrospectively analysed the electronic database of all IBD patients followed by the IBD Centre of Humanitas Research Hospital, Milan, from January 2010 to October 2019, and collected all new diagnoses of solid and haematological tumours since 2010. The annual standardised incidence rate (SIR), rate of mortality and early cancer diagnosis were calculated and a descriptive analysis of drug exposure, disease duration, family history of any cancer, smoking habits was made. Results We included 5239 patients, with a total 19820 patient-years follow-up. Eighty-four malignancies in 81 patients were retrieved, 71 were included in the final analysis (38 CD, 32 UC, 31 females). Average age at tumour diagnosis was 52.9 years (range 19–78). 64% of patients were former or active smokers, 31% had a family history of cancer or IBD. Sixty-two per cent of patients were previously exposed or had 5-ASA at the time of cancer, 40% azathioprine, 43% anti-TNF or vedolizumab. The annual SIR for all kinds of malignancy was 0.358%. GI malignancies were the most frequent (n = 17, 23.9%, 47% UC, 53% in CD). Six over 8 GI tract malignancies in UC patients were found in the colon or rectum (mean disease duration 22.5 years), whereas in CD patients 5/9 were in the small-bowel (mean disease duration 7.0 years). Melanoma and breast cancer (n = 8 each) were the most common non-GI cancers, followed by prostate (n = 7) and bladder (n = 6). No significant difference in incidence was found between CD or UC. Non-Hodgkin lymphomas and leukaemia (3 and 1, respectively) only occurred in CD patients. Other tumours included thyroid (n = 5), lungs (n = 4), testicle (n = 3), ovary (n = 2), kidney (n = 2), head-nose-throat (n = 2), pancreas (n = 1), brain (n = 1), and non-melanoma skin cancer (n = 1). Death occurred in 11% of patients, 8 of them for late stage cancer. Only 2 were related to the concomitant IBD (1 colo-rectal and 1 anal cancer). In patients regularly screened according to the ECCO Guidelines (GI cancer, haematological and skin cancer), there was a significantly higher number of detection of early cancer (28 vs. 1, p = 0.003), although no differences in mortality rates were reported in the two groups (2 vs. 2, p = 0.10). Conclusion The overall incidence of cancer in our cohort was not different from the current literature available. Adherence to the ECCO Guidelines for cancer surveillance improves the detection of early cancer in IBD patients.

scholarly journals Mycosis fungoides with a dramatic course in a patient with a history of pyoderma gangrenosum – a case report

2017 ◽  
Vol 5 ◽  
pp. 544-554
Author(s):  
Julia Nowowiejska ◽  
Magdalena Świstak ◽  
Anna Baran ◽  
Iwona Flisiak
Keyword(s):  
Case Report ◽  
Mycosis Fungoides ◽  
Pyoderma Gangrenosum ◽  
History Of

Rupture of sinus of Valsalva aneurysm: case report and review of contemporary literature

Perfusion ◽  
2020 ◽  
pp. 026765912096691
Author(s):  
Jean-Luc Duval ◽  
Richard AE Ramsingh ◽  
Natasha C Rahaman ◽  
Risshi D Rampersad ◽  
Gianni D Angelini ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiac Failure ◽  
Congenital Heart ◽  
Contemporary Literature ◽  
Rare Condition ◽  
Aneurysm Rupture ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
History Of ◽  
High Index Of Suspicion

Sinus of Valsalva aneurysm rupture is a rare condition with a great potential for morbidity and mortality if not promptly diagnosed and managed. We present an unusual non-infected sinus of Valsalva aneurysm rupture in a 47-year-old female. This case report, a likely presentation of a late congenital heart defect, highlights the need for a high index of suspicion in a patient with atypical history of congestive cardiac failure.

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