scholarly journals A localized non-healing ulcer: an unusual clinical presentation of pemphigus vulgaris

2020 ◽  
Vol 6 (3) ◽  
pp. 413
Author(s):  
Sukhmani K. Brar ◽  
Gauri N. Bhale ◽  
Balvinder K. Brar
Keyword(s):  
Differential Diagnosis ◽  
Inflammatory Infiltrate ◽  
Clinical Presentation ◽  
Topical Steroid ◽  
Oral Prednisolone ◽  
Pemphigus Vulgaris ◽  
Healing Ulcer ◽  
Lupus Vulgaris ◽  
Recurrent Herpes ◽  
One Year

<p>Pemphigus vulgaris is an autoimmune blistering disorder commonly involving oral mucosa and skin<strong> </strong>with characteristic acantholysis that results in formation of fluid filled blisters and painful erosions. Herein we report a case distinguished by its unusual clinical presentation.<strong> </strong>A twenty-five year old man, presented to our outpatient department of dermatology, complaining of ulcer on   forehead in the last one year. Examination revealed single ulcer covered with crust on right side of forehead.  Clinically lupus vulgaris, pyoderma gangrenosum, recurrent herpes simplex, leishmaniasis and pemphigus vulgaris were kept as differential diagnosis. Tzanck smear revealed multiple acantholytic cells and mild neutrophilic inflammatory infiltrate. Histological examination of biopsy sample showed suprabasal clefting, acantholytic cells and mild perivascular dermal lymphocytic infiltrate. Features were suggestive of pemphigus vulgaris. Significant improvement   occurred after three months of treatment with oral prednisolone, azathioprine and topical steroid. Although oral and skin involve­ment is common, in the form of flaccid blisters and erosions, but non healing ulcer is unusual. This may represent a period of limited activity during this chronic disease. There is paucity of data in literature regarding this. So, this<strong> </strong>case report highlights a, perhaps unique, clinical presentation of this autoimmune disease.<strong></strong></p>

scholarly journals Creutzfeldt-Jakob Disease Presenting with Dementia and Mimic a Stroke During One Year: Case Report and Review of Literatures

2019 ◽  
Vol 8 ◽  
pp. e1357
Author(s):  
Alireza Vakilian ◽  
Mohaddaseh Fekri ◽  
Habib Farahmand
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Rare Disease ◽  
Clinical Manifestation ◽  
Clinical Presentation ◽  
Chief Complaint ◽  
The Other ◽  
Progressive Dementia ◽  
Jakob Disease ◽  
One Year

Background: Creutzfeldt-Jakob disease (CJD) is a progressive and fatal prion disease in human and its annual incidence is estimated one per million. Sporadic form of CJD is the most common form of the disease that involved 85% of cases. Case Report: We presented two cases of CJD with the different clinical presentation; a 58-year-old woman who referred with amnesia, depression and a 59-year-old woman with ataxia as her chief complaint. Based on the findings and roled-out the other differential diagnosis, the CJD was confirmed. Both of them died before 12 months after diagnosis. Conclusion: Although CJD is a rare disease with different clinical manifestation, it is considered as one the differential diagnosis of progressive dementia.[GMJ.2019;8:e1357]  

scholarly journals Pemphigus Vulgaris in Old Patient

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Bassel Tarakji
Keyword(s):  
Differential Diagnosis ◽  
Autoimmune Disease ◽  
Oral Mucosa ◽  
Oral Prednisolone ◽  
Pemphigus Vulgaris ◽  
The Other ◽  
Oral Lesions ◽  
Oral Medicine ◽  
Mucous Membranes ◽  
Blistering Disease

Pemphigus vulgaris (PV) is a chronic, autoimmune, intraepidermal blistering disease of the skin and mucous membranes. The first clinical manifestation is often the development of intraoral lesions, and later, the lesions involve the other mucous membranes and skin. The etiological factors of this disease still remain unknown, although the presence of autoantibodies is consistent with an autoimmune disease. A 73-year-old man had bullous lesions on gingiva, oral mucosa first, then scalp, trunk, and face. An oral medicine specialist suspects the lesion in differential diagnosis in the first presentation of oral lesions and follows up the patient, and then these bullous lesions presented on the skin. In this article, a patient had received oral prednisolone (80 mg/kg/day) and azathioprine, then tapered oral prednisolone to 40 mg/day, with a reduction of 5 mg/day every three weeks. The patient shows remission of these lesions, and complication of this treatment includes osteoporosis, hyperglycemia, and hypertension.

Creutzfeldt-Jakob Disease Presenting with Dementia and Mimic a Stroke During One Year: Case Report and Review of Literatures

2019 ◽  
Vol 8 ◽  
pp. 1357
Author(s):  
Alireza Vakilian ◽  
Mohaddaseh Fekri ◽  
Habib Farahmand
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Rare Disease ◽  
Clinical Manifestation ◽  
Clinical Presentation ◽  
Chief Complaint ◽  
The Other ◽  
Progressive Dementia ◽  
Jakob Disease ◽  
One Year

Background:  Creutzfeldt-Jakob disease (CJD) is a progressive and fatal prion disease in human and its annual incidence is estimated one per million. Sporadic form of CJD is the most common form of the disease that involved 85% of cases. Case Report: We presented two cases of CJD with the different clinical presentation; a 58-year-old woman who referred with amnesia, depression and a 59-year-old woman with ataxia as her chief complaint. Based on the findings and rolled-out the other differential diagnosis, the CJD was confirmed. Both of them died before 12 months after diagnosis. Conclusion: Although CJD is a rare disease with different clinical manifestation, it is considered as one the differential diagnosis of progressive dementia.[GMJ.2019;inpress;e1357]

scholarly journals Post biologic scenario in pemphigus patients at a tertiary care institution

2019 ◽  
Vol 6 (1) ◽  
pp. 104
Author(s):  
Ramesh A. ◽  
Sampath V. ◽  
Shabari A.
Keyword(s):  
Complete Remission ◽  
Immunosuppressive Agents ◽  
Tertiary Care ◽  
Treatment Protocol ◽  
Oral Prednisolone ◽  
Pemphigus Vulgaris ◽  
Infectious Complications ◽  
Pemphigus Foliaceus ◽  
Long Duration ◽  
One Year

<p class="abstract"><strong>Background:</strong> Rituximab is increasingly used for the treatment of pemphigus. Data derived from single center studies following a uniform treatment protocol are limited. The effect of demography and disease type on treatment response is poorly characterized. Aim of this study was to assess the efficacy, adverse effects of rituximab, adjuvants and follow up in pemphigus patients.</p><p class="abstract"><strong>Methods:</strong> Author undertook a retrospective review of records of 26 pemphigus patients (pemphigus vulgaris 25 and pemphigus foliaceus 1) who had received rituximab infusion. Oral prednisolone was administered in doses up to 0.5 mg/kg of body weight after infusion and tapered over the next 3-4 months according to the disease activity. However, other immunosuppressive agents such as cyclophosphamide and AZT were continued for one year after clinical remission was achieved.<strong></strong></p><p class="abstract"><strong>Results:</strong> Complete remission was observed in 23 (88.5%) patients. The mean time to disease control and complete remission was 1.10 and 4.36 months, respectively. Three patients experienced relapse after a mean duration of 26 months. Infectious complications like candidiasis and furunculosis developed in two patients. Two patients had hypotension during infusion.</p><p class="abstract"><strong>Conclusions:</strong> Rituximab is an effective agent in the treatment of pemphigus and also for a long duration of remission with a lower initial dose of oral prednisolone. Severe side effects were rare.</p>

scholarly journals Atypical Granulomatosis with Polyangiitis Presenting with Meibomitis, Scleritis, Uveitis and Papillary Bladder Tumor: A Case Report and Literature Review

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 680
Author(s):  
Takashi Kojima ◽  
Murat Dogru ◽  
Eisuke Shimizu ◽  
Hiroyuki Yazu ◽  
Aya Takahashi ◽  
...  
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Early Stage ◽  
Topical Steroid ◽  
Granulomatous Inflammation ◽  
Oral Prednisolone ◽  
Meibomian Gland ◽  
Clinical Findings ◽  
Meibomian Gland Dysfunction ◽  
Oral Steroids ◽  
Atypical Cells

Granulomatosis with polyangiitis (GPA) presents with a variety of systemic findings, sometimes with ocular findings initially, but is often difficult to diagnose at an early stage. An 85-year-old male had complaints of ocular dryness and redness and was diagnosed with meibomian gland dysfunction with meibomitis. Despite an initial treatment with topical steroid and antibiotics, the meibomitis did not improve and the left eye developed scleritis and iridocyclitis. The patient was administered topical mydriatics and oral steroids. During follow-up, the patient developed left hearing difficulty and reported a darker urine. Urinalysis revealed microscopic hematuria. A blood test showed an elevated erythrocyte sedimentation rate, positivity for perinuclear anti-neutorophil cytoplasmic antibody, and elevations in blood urea nitrogen and serum creatinine. Nasal mucosal biopsy showed a non-necrotizing granulomatous inflammation. Renal biopsy revealed focal glomerulosclerosis. Cystoscopy and bladder wash followed by a planned transurethral resection revealed atypical cells and apical papillary tumors which were resected. Iridocyclitis and scleritis responded well to oral prednisolone with 0.1% topical betamethasone and prednisolone ointment. The patient is tumor free with no recurrences 24 months after resection. GPA may present atypically with meibomian gland dysfunction without showing representative clinical findings. Early detection and treatment are essential for visual recovery.

scholarly journals OSAHS in adolescents: clinical presentation and differential diagnosis

2018 ◽  
Vol 21 (1) ◽  
pp. 106
Author(s):  
N. Beydon
Keyword(s):  
Obstructive Sleep Apnea ◽  
Differential Diagnosis ◽  
Sleep Apnea ◽  
Clinical Presentation ◽  
Transitional Period ◽  
Alternative Diagnosis ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

Adolescent experiment widespread changes as he/ she goes through this transitional period from childhood to adulthood. Sleep is no exception to this changeover with, as consequences, modifications of the clinical pre- sentation of subjects with Obstructive Sleep Apnea- Hypopnea Syndrome (OSAHS) and potential different alternative diagnosis.

scholarly journals Metastatic Melanoma Presenting as Intussusception in an 80-Year-Old Man: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Sarah Alghamdi ◽  
Yumna Omarzai
Keyword(s):  
Differential Diagnosis ◽  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Metastatic Melanoma ◽  
Clinical Presentation ◽  
Gastrointestinal Symptoms ◽  
Common Site ◽  
Neoplastic Process ◽  
History Of ◽  
Uncommon Neoplasm

Malignant melanoma of the gastrointestinal tract is an uncommon neoplasm that could be primary or metastatic. Small intestine represents the most common site for the metastatic melanoma; however, it could be found anywhere in the gastrointestinal tract. Intussusception is a rare cause of intestinal obstruction in adults compared to children. In 90% of the cases, the underlying cause can be found, and in 65% of the cases, intussusception is caused by the neoplastic process. The majority of the neoplasms are benign, and about 15% are malignant. Metastatic melanoma is one of the most common metastatic malignancies to the gastrointestinal tract; however, the premortem diagnosis is rarely made. Here, we report an uncommon clinical presentation of metastatic melanoma causing intussusception in an 80-year-old man. This diagnosis should be considered in a differential diagnosis in any patient who presents with gastrointestinal symptoms and a history of melanoma.

Placental Mesenchymal Dysplasia

2007 ◽  
Vol 131 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Zahida Parveen ◽  
Jane Elaine Tongson-Ignacio ◽  
Cory R. Fraser ◽  
Jeffery L. Killeen ◽  
Karen S. Thompson
Keyword(s):  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Data Sources ◽  
Molar Pregnancy ◽  
Close Attention ◽  
Normal Fetus ◽  
Fetal Complications ◽  
Microscopic Features ◽  
Placental Mesenchymal Dysplasia

Abstract Context.—Placental mesenchymal dysplasia is characterized by placentomegaly and may be mistaken for molar pregnancy both clinically and macroscopically because of the presence of “grapelike vesicles.” It may be associated with a completely normal fetus, a fetus with growth restriction, or a fetus with features of Beckwith-Wiedemann syndrome. Objective.—To review the etiology, molecular pathology, gross and microscopic features, clinical presentation, complications, and differential diagnosis of placental mesenchymal dysplasia. Data Sources.—The PubMed and the Medline databases were systematically searched for articles between 1970 and 2006. The following keywords were used: placental mesenchymal dysplasia, mesenchymal hyperplasia, molar pregnancy, pseudomolar pregnancy, Beckwith-Wiedemann syndrome, and placentomegaly. Relevant references from review articles were also searched. Conclusions.—Placental mesenchymal dysplasia should be considered in the differential diagnosis when the ultrasonographic findings show a cystic placenta. Close attention should be paid to fetal morphology for early recognition of fetal complications and to prevent unnecessary termination of pregnancy in cases associated with a normal fetus.

scholarly journals Meningiomas of pineal region in children

2007 ◽  
Vol 65 (4a) ◽  
pp. 1000-1006 ◽  
Author(s):  
Hamilton Matushita ◽  
Fernando Campos Pinto ◽  
José Píndaro Pereira Plese
Keyword(s):  
Clinical Presentation ◽  
Complete Removal ◽  
Pineal Region ◽  
Total Resection ◽  
Long Term Follow Up ◽  
One Year ◽  
Velum Interpositum ◽  
Transtentorial Approach

Meningiomas are uncommon tumors in children and either more rarely encountered in the pineal region. We report two cases of meningioma of the pineal region in children. One of these cases was a five years-old girl and the other a one year-old boy. No specific clinical presentation or tomographic examinations findings was identified before treatment, suggestive of a diagnosis of menigioma. The clinical and laboratory features were very similar to the most common tumors of the pineal region. Prior to the surgery, the histology of these tumors was not suspected. Both patients underwent direct surgery and complete removal was achieved by a suboccipital transtentorial approach. The tumors originated from velum interpositum in both cases. At the follow up, one case presented with recurrence six years later, and she underwent a reoperation with total resection without morbidity. Long-term follow up presented no other recurrences.

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