scholarly journals Lyell´s syndrome provoked by external drug use

2021 ◽  
Vol 24 (1) ◽  
pp. 25-34
Author(s):  
Alexandr B. Krivosheev ◽  
Tamara V. Ermachenko ◽  
Pavel P. Khavin ◽  
Inga A. Krivosheeva ◽  
Dmitry V. Morozov
Keyword(s):  
Mucous Membrane ◽  
Multiorgan Failure ◽  
The Elderly ◽  
Skin Lesions ◽  
Distinctive Features ◽  
Right Hand ◽  
First Case ◽  
Age Related ◽  
Specialized Department ◽  
The Right

Lyells syndrome is rare. Up to 10 cases are registered per million population per year. The mortality rate for Lyells syndrome is 512%. Two patients were observed aged, respectively, 38 years and 72 years with Lyells syndrome. The disease manifested itself against the background of local application of drugs. In one case ― Dolobens gel as an analgesic at the site of a bruise of the right hand. In another case, a 20% solution of chlorohxidin biogluconate as a mouth rinse for stomatitis. The first symptoms of the disease occurred locally at the site of application of these medicines. In the first case, the skin of the right hand, in the second ― the mucous membrane of the mouth. The outcome of the disease depended on early diagnosis, urgent hospitalization in a specialized department, from the area of skin lesions, the appointment of adequate therapy. Lyells syndrome can occur at any age, and the risk of developing the disease increases in those over the age of 40. In the elderly, SL in terms of the first symptoms and rate of disease progression, the nature of skin and mucous membrane lesions does not have any fundamental differences with those in younger patients. The distinctive features and risk factors of Lyells syndrome in the elderly include, firstly, its occurrence against the background of the already formed comorbid age-related pathology of internal organs, secondly, the concomitant age-related pathology during the development of an acute toxic-allergic reaction is decompensated, a multiorgan failure is formed, which is the cause of more severe Lyells syndrome and higher mortality. In young people, a comorbid viral infection can be considered a risk factor, especially the combination of HIV-infection and chronic hepatitis C.

Paraneoplastic pemphigus associated with rapidly progressing endophthalmitis caused by Morganella Morganii: A case report

2021 ◽  
pp. 112067212110334
Author(s):  
Abdullah I Almater ◽  
Mohammed M Abusayf ◽  
Saeed Alshahrani ◽  
Abdullah M Alfawaz ◽  
Hind M Alkatan ◽  
...  
Keyword(s):  
Positive Culture ◽  
Skin Lesions ◽  
Stevens Johnson Syndrome ◽  
Corneal Perforation ◽  
Morganella Morganii ◽  
Paraneoplastic Pemphigus ◽  
First Case ◽  
Johnson Syndrome ◽  
Acute Necrotizing ◽  
The Right

Introduction: The ocular presentation of paraneoplastic pemphigus (PNP) has rarely been reported in the literature. In this report, we describe a 61-year-old male presenting with eruptive skin lesions associated with underlying non-Hodgkin’s lymphoma who had rapid progressive corneal perforation with secondary endophthalmitis in the setting of PNP. Case description: A 61-year-old male presented to the emergency department complaining of skin eruption mimicking Stevens–Johnson syndrome, which was later found to be related to PNP. Initially, the patient complained of progressive ocular surface dryness in both eyes. Meanwhile, he developed mild pain in the right eye associated with blurry vision in both eyes and was managed with lubricants and topical antibiotics. A few days later, he was found to have corneal perforation with features suggestive of left endophthalmitis with possible early panophthalmitis. Intravenous antibiotic was administered, and primary evisceration of the left globe was performed. Histopathology revealed acute necrotizing keratitis and endophthalmitis. Vitreous analysis showed numerous gram-negative bacilli and a positive culture of Morganella morganii. The patient continued to be managed with frequent lubrications and punctual plugs in the fellow eye during the follow-up period. Conclusion: We describe the first case of endophthalmitis developing secondary to PNP-induced corneal melting and perforation. Anticipating unusual infectious sequelae in the setting of PNP might be warranted to actively detect and successfully manage dry eye disease before devastating complications develop.

scholarly journals Recovery of Range of Motion and Decrease in Pain after Progression of Supraspinatus Tendon Tear: A Case Report

2019 ◽  
Vol 13 (1) ◽  
pp. 84-88
Author(s):  
Yoshihiro Hagiwara ◽  
Junichiro Hamada ◽  
Akira Ando ◽  
Kenji Kanazawa ◽  
Yutaka Yabe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
The Elderly ◽  
Supraspinatus Tendon ◽  
Operative Management ◽  
Rotator Cuff Tears ◽  
Tendon Tear ◽  
Duration Of Symptoms ◽  
First Case ◽  
The Right

Rotator cuff disease is one of the most prevalent shoulder disabilities especially in the elderly population. Tear progression is significantly greater in the symptomatic patients than in the asymptomatic ones. From these aspects, shoulder surgeons interpret surgical indications and counsel patients regarding the risk of non-operative treatments. However, there were a few reports that pain and duration of symptoms were not strongly associated with severity of rotator cuff tears, and non-operative management with physical therapy was effective. There have remained controversies for the treatment of rotator cuff tears.A 59-year-old man with a sedentary work life experienced right shoulder pain with abduction at night. However, the pain kept worsening after two months, and he finally visited our clinic three months after the onset of pain. Magnetic resonance imaging in the coronal and axial planes showed effusion around the subacromial and subcoracoid bursae and joint-side tear of the supraspinatus tendon. A range of motion in the right shoulder was severely restricted at the initial visit of our clinic. After sufficient rehabilitation, the symptoms were not changed and an arthroscopic rotator cuff repair was scheduled. However, during waiting for surgery, he felt something popped in the right shoulder while wearing a jacket. Immediately after this, pain during motion and at night decreased, and he experienced no difficulty with activities of daily living and the surgery was cancelled. This is the first case with a recovery of range of motion and a decrease in pain after progression of a supraspinatus tendon tear.

Relationship between Manual Midline Crossing and Hand Preference

1987 ◽  
Vol 7 (3) ◽  
pp. 131-145 ◽  
Author(s):  
Janet M. Stilwell
Keyword(s):  
Hand Preference ◽  
Progressive Increase ◽  
Developmental Trend ◽  
Weak Preference ◽  
Midline Crossing ◽  
Right Hand ◽  
Age Related ◽  
Integration Test ◽  
Contralateral Hand ◽  
The Right

The relationship between manual midline crossing and hand preference was studied in 200 2- to 6-year-old children. Performance patterns of right-, left-, and mixed-handed children were compared. Right- and left-handed children exhibited significantly greater frequency of preferred than nonpreferred hand use for total hand use and for contralateral hand responses. The right-handed group showed a developmental trend for contralateral hand responses, with age-related changes due to a progressive increase in frequency of contralateral right (preferred) hand responses. The mixed-handed group displayed a weak preference toward use of the right hand for total hand use and for contralateral hand responses. A general reduction in frequency of midline crossing cited within the mixed-handed group was due to reduced frequency of contralateral right-hand responses. The theoretical significance of the research findings and their implications for sensory integration test interpretation are discussed.

scholarly journals Disseminated Superficial Actinic Porokeratosis in the Elderly: A Case Report

2020 ◽  
Vol 12 (2) ◽  
pp. 47-53
Author(s):  
Miloš Nišavić ◽  
Marina Jovanović ◽  
Zoran Golušin ◽  
Nada Vučković ◽  
Ljuba Vujanović ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical History ◽  
Sun Exposure ◽  
The Elderly ◽  
Skin Lesions ◽  
Dependent Diabetes Mellitus ◽  
The Third ◽  
Age Related ◽  
Disseminated Superficial Actinic Porokeratosis ◽  
Fourth Decade

AbstractCurrently, most authors believe that disseminated superficial actinic porokeratosis (DSAP) is an inherited or acquired dermatologic disorder of keratinization that occurs in genetically predisposed individuals after adequate exposure to ultraviolet (UV) rays, or immunosuppression. Lesions in DSAP start in sun-exposed areas most commonly in the third or fourth decade of life. The lesions are pink to brownish papules and plaques with a raised scaling ridge, histologically seen as a column of parakeratotic keratinocytes, the cornoid lamella. DSAP is not only the most common, but also the most often overlooked form of porokeratosis (P). Here we present a 77-year-old male with DSAP, who sporadically developed initial skin lesions at the age of 67, at the time when his personal and medical history were significantly long for chronic intensive sun exposure and type 1 insulin dependent diabetes mellitus. We established the diagnosis of DSAP based on personal and medical history, clinical presentation, auxiliary methods such as dermoscopy, and confirmed with pathohistological findings. We advised the patient to avoid sun exposure and to apply photo-protective sunscreens, emollients and keratolytics. After five years of monitoring his changes, we continue to control his lesions for any possible alteration. Although mutations in several genes and data on sun exposure may be responsible for the onset of the disease, most cases of DSPA occur sporadically and without involving the facial skin, as in our case. Lesions usually begin in the third or fourth decade of life. In the elderly, an additional trigger may be present, such as e.g. age-related decreased immune competence. Diabetes mellitus may also be associated with immunodeficiency in the elderly. Recently, DSPA has been a special subtype of DSPA in the elderly. Malignant alteration can occur in DSPA, most commonly in lesions that are long lasting, large, in the elderly, or in lesions in immunocompromised individuals. In conclusion, this is the case of a 77-year-old male person, who sporadically developed the so-called subtype DSPA in the elderly. In addition to UV radiation, the relevant suggestive trigger factors were the immunosuppressive effects of diabetes mellitus and chronological aging.

scholarly journals A case of envenomation by the false fer-de-lance snake Leptodeira annulata (Linnaeus, 1758) in the department of La Guajira, Colombia

Biomédica ◽  
2020 ◽  
Vol 40 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Teddy Angarita-Sierra ◽  
Alejandro Montañez-Méndez ◽  
Tatiana Toro-Sánchez ◽  
Ariadna Rodríguez-Vargas
Keyword(s):  
Index Finger ◽  
Public Health Problem ◽  
Dorsal Surface ◽  
Complete Recovery ◽  
Right Hand ◽  
First Case ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
The Right ◽  
Work Capability

Envenomations by colubrid snakes in Colombia are poorly known, consequently, the clinical relevance of these species in snakebite accidents has been historically underestimated. Herein, we report the first case of envenomation by opisthoglyphous snakes in Colombia occurred under fieldwork conditions at the municipality of Distracción, in the department of La Guajira. A female biologist was bitten on the index finger knuckle of her right hand when she tried to handle a false fer-de-lance snake (Leptodeira annulata). Ten minutes after the snakebite, the patient started to have symptoms of mild local envenomation such as edema, itching, and pain in the wound. After 40 minutes, the edema reached its maximum extension covering the dorsal surface of the right hand and causing complete loss of mobility. The clinical treatment focused on pain and swelling control. No laboratory tests were performed. The patient showed good progress with the total regression of the edema 120 hours after the snake-bite accident and complete recovery of the movement of the limb in one week. Venomous bites of “non-venomous snakes” (opisthoglyphous colubrid snakes) must be considered as a significant public health problem because patients lose their work capability during hours or even days and they are forced to seek medical assistance to treat the envenomation manifestations.

Age-related differences in corticospinal control during functional isometric contractions in left and right hands

2005 ◽  
Vol 99 (4) ◽  
pp. 1483-1493 ◽  
Author(s):  
Martin V. Sale ◽  
John G. Semmler
Keyword(s):  
Older Adults ◽  
Precision Grip ◽  
Silent Period ◽  
Isometric Contractions ◽  
Age Difference ◽  
Left Hand ◽  
Right Hand ◽  
Age Related ◽  
Left And Right ◽  
The Right

The purpose of the study was to examine age-related differences in electromyographic (EMG) responses to transcranial magnetic stimulation (TMS) during functional isometric contractions in left and right hands. EMG responses were recorded from the first dorsal interosseus muscle following TMS in 10 young (26.6 ± 1.3 yr) and 10 old (67.6 ± 2.3 yr) right-handed subjects. Muscle evoked potentials (MEPs) and silent-period durations were obtained in the left and right hands during index finger abduction, a precision grip, a power grip, and a scissor grip, while EMG was held constant at 5% of maximum. For all tasks, MEP area was 30% ( P < 0.001) lower in the left hand of old compared with young subjects, whereas there was no age difference in the right hand. The duration of the EMG silent period was 14% ( P < 0.001) shorter in old (150.3 ± 2.9 ms) compared with young (173.9 ± 3.0 ms) subjects, and the age differences were accentuated in the left hand (19% shorter, P < 0.001). For all subjects, the largest MEP area (10–12% larger) and longest EMG silent period (8–19 ms longer) were observed for the scissor grip compared with the other three tasks, and the largest task-dependent change in these variables was observed in the right hand of older adults. These differences in corticospinal control in the left and right hands of older adults may reflect neural adaptations that occur throughout a lifetime of preferential hand use for skilled (dominant) and unskilled (nondominant) motor tasks.

scholarly journals P63-negative pulmonary NUT carcinoma arising in the elderly: a case report

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Satoe Numakura ◽  
Koji Saito ◽  
Noriko Motoi ◽  
Taisuke Mori ◽  
Yuichi Saito ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Clinical Symptoms ◽  
Incidental Finding ◽  
The Elderly ◽  
Tumor Location ◽  
Small Cells ◽  
First Case ◽  
Or Gene ◽  
Nut Carcinoma ◽  
The Right

Abstract Background Pulmonary NUT carcinoma is rare, but lethal, thus, must not be overlooked. The definitive diagnosis is made by a NUT monoclonal antibody or gene analysis, but these are not always routinely available. Therefore, the diagnosis depends on this rare disease being suspected from the clinical and pathological findings. Generally, NUT carcinoma of the lung occurs near the hilum in younger adults with severe subjective symptoms. Histologically, it is characterized by the monomorphic growth of small cells which showed positivity of p63 immunohistochemistry. Case presentation An 82-year-old man was referred for an incidental finding of an abnormal shadow at the peripheral apex of the right lung on computed tomography for a regular follow-up examination of renal cancer. Microscopically, small cell carcinoma was initially suspected; however, immunohistochemistry was not typical. NUT carcinoma with BRD4-NUT fusion was ultimately diagnosed using a NUT monoclonal antibody, fluorescence in situ hybridization, and RNA-seq. p63 and p40 protein expression was not detected. Conclusions This is the first case of pulmonary NUT carcinoma to show negativity for p63 and is the oldest among previously reported cases. The present case suggests that NUT carcinoma should be suspected when the morphology of monomorphic growth of small cells without lineage-specific differentiation, regardless of age, clinical symptoms, the tumor location, or p63 expression.

scholarly journals SUBCUTANEOUS PHEOHYPHOMYCOSIS CAUSED BY Phoma cava: REPORT OF A CASE AND REVIEW OF THE LITERATURE

1997 ◽  
Vol 39 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Clarisse ZAITZ ◽  
Elisabeth Maria HEINS-VACCARI ◽  
Roseli Santos de FREITAS ◽  
Giovana Letícia Hernández ARRIAGADA ◽  
Ligia RUIZ ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Amphotericin B ◽  
Male Patient ◽  
Histopathological Examination ◽  
Corticosteroid Treatment ◽  
Skin Lesions ◽  
Pulmonary Sarcoidosis ◽  
Review Of The Literature ◽  
Right Hand ◽  
The Right

We report a case of subcutaneous pheohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by different Phoma species, is presented. The patient healed after therapy with amphotericin B, followed by itraconazole

scholarly journals P63-Negative Pulmonary NUT Carcinoma Arising in the Elderly: A Case Report.

2020 ◽  
Author(s):  
Satoe Numakura ◽  
Koji Saito ◽  
Noriko Motoi ◽  
Taisuke Mori ◽  
Yuichi Saito ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Incidental Finding ◽  
The Elderly ◽  
Tumor Location ◽  
First Case ◽  
Abnormal Shadow ◽  
Nut Carcinoma ◽  
The Right

Abstract Background: We herein describe a rare case of primary pulmonary NUT carcinoma with unusual clinical and pathological presentations. NUT carcinoma of the lung occurs near the hilum in younger adults with severe symptoms and is positive for p63. This is the first case to show negativity for p63 and is the oldest among previously reported cases of pulmonary NUT carcinoma. Case presentation: An 82-year-old man was referred for an incidental finding of an abnormal shadow at the peripheral apex of the right lung on computed tomography for a regular follow-up examination of renal cancer. Microscopically, small cell carcinoma was initially suspected; however, immunohistochemistry was not typical. NUT carcinoma with BRD4-NUT fusion was ultimately diagnosed using a NUT monoclonal antibody, fluorescence in situ hybridization, and RNA-seq. p63 protein expression was not detected. Conclusions: NUT carcinoma is rare, but lethal, and, thus, must not be overlooked. The present case suggests the importance of NUT immunohistochemistry in cases of small round cell tumors without clear lineage-specific differentiation, regardless of age, clinical symptoms, the tumor location, or p63 expression.

scholarly journals African histoplasmosis: report of the first case in Brazil and treatment with itraconazole

1993 ◽  
Vol 35 (3) ◽  
pp. 295-299 ◽  
Author(s):  
Leonardo Abrucio Neto ◽  
Maria Denise Fonseca Takahashi ◽  
Alberto Salebian ◽  
Luiz Carlos Cucé
Keyword(s):  
Skin Lesion ◽  
Skin Lesions ◽  
Histopathologic Examination ◽  
First Case ◽  
African Histoplasmosis ◽  
The Right

We report the first case of African histoplasmosis diagnosed in Brazil. The patient was an immigrant from Angola who had come to Brazil six months after the appearance of the skin lesion. The skin of the right retroauricular area was the only site of involvement. The diagnosis was established by direct mycologic examination, culture and by histopathologic examination of the lesion. The patient was successfully treated with Itraconazole 100mg a day for 52 days. No recurrent skin lesions were observed during the ten month follow-up period.

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