scholarly journals Successful treatment of granuloma faciale

2020 ◽  
Vol 7 (1) ◽  
pp. 129
Author(s):  
Sahar H. Alsharif ◽  
Reda H. Saifaldeen ◽  
Logain G. Alghanemi
Keyword(s):  
Successful Treatment ◽  
Topical Steroids ◽  
Erythematous Plaque ◽  
Gradual Improvement ◽  
Topical Tacrolimus ◽  
Therapeutic Modalities ◽  
Granuloma Faciale ◽  
The Face ◽  
History Of

<p class="abstract">Granuloma faciale (GF) is a chronic condition characterized by asymptomatic erythematous plaque with prominent telangiectasia presenting usually over the face. Although the condition is benign, its treatment is often unsatisfactory. Therapeutic modalities that have been tried include topical steroids and topical tacrolimus sometimes enhanced with topical dapsone. Others include intralesional corticosteroids, antimalarials, isoniazid and pulsed-dye laser. We report a case of a 58 years old female with a 1 year history of a solitary slowly progressive plaque over the nose. Diagnosis of GF was made based on the histopathological findings. The patient was started on the combination of topical tacrolimus, intralesional corticosteroids injection and oral doxycycline for 3 months. The patient showed gradual improvement in 3 months without any side effects. This case supports previous papers of successful treatment of GF with topical tacrolimus. There was no recurrence at follow-up 18 months later. It also supports the use of combination therapy especially in resistant cases.</p>

Topical Tacrolimus in the Treatment of Erosive Pustular Dermatosis of the Scalp

2007 ◽  
Vol 11 (6) ◽  
pp. 222-225 ◽  
Author(s):  
Marta J. Cenkowski ◽  
Shane Silver
Keyword(s):  
Light Exposure ◽  
Therapeutic Option ◽  
Rare Condition ◽  
Initial Therapy ◽  
Topical Steroids ◽  
Topical Tacrolimus ◽  
History Of ◽  
Prevention Of Relapse

Background: Erosive pustular dermatosis of the scalp (EPDS) is a rare condition characterized by chronic, sterile, pustular erosions leading to scarring alopecia. Although the etiology is unknown, it appears to be associated with ultraviolet light exposure and trauma. Histologic findings include nonspecific atrophy of the epidermis and chronic inflammation. Case History: A 71-year-old female presented with a 1-year history of a boggy, erythematous, friable plaque on the vertex of her scalp. A diagnosis of EPDS was made based on presentation, negative cultures, and histologic findings. Initial therapy with intralesional and topical steroids and oral antibiotics resolved the inflamed plaques; however, steroid-induced atrophy became prominent after 5 months of use. The treatment was discontinued, resulting in recurrence of disease. Topical tacrolimus 0.1% ointment was initiated, which has been successfully controlling the lesions with reversal of skin atrophy and clinical evidence of hair growth. Conclusion: This is the fourth reported case of the successful treatment of EPDS with topical tacrolimus for the resolution of atrophy and the prevention of relapse of inflammation. Although its long-term use warrants close follow-up for side effects, tacrolimus may constitute a novel therapeutic option for the treatment of EPDS.

Medical management of silicone oil associated acute postoperative ocular inflammation

2021 ◽  
Vol 14 (7) ◽  
pp. e242251
Author(s):  
Mariya Bashir Doctor ◽  
Deepika Chennapura Parameswarappa ◽  
Padmaja Kumari Rani
Keyword(s):  
Medical Management ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Ocular Inflammation ◽  
Intraocular Inflammation ◽  
Topical Steroids ◽  
Gradual Improvement ◽  
Batch Number ◽  
Oil Injection

We report a case of a 57-year-old man, who underwent right eye silicone oil injection as a part of his surgical treatment for rhegmatogenous retinal detachment. Following this, on the first postoperative day, he developed acute postoperative intraocular inflammation. There was circumciliary congestion, diffuse corneal oedema, anterior chamber (AC) reaction, hypopyon and a pupillary membrane. The AC had not been entered during the surgery. No patients, who had been operated on the same day, or with the materials having the same batch number, developed similar reactions. We started the patient on hourly topical steroids and cycloplegics after which the patient’s condition showed gradual improvement. At the 2 weeks follow-up appointment, his pupillary membrane had completely contracted and the AC was quiet. This case highlights a clinical picture of acute postoperative silicone oil-induced ocular inflammation, which was resolved through medical management.

scholarly journals Hydroxychloroquine-Induced Hyperpigmentation: A Case Report

2020 ◽  
Author(s):  
Mona Talaschian ◽  
Anahita Sadeghi ◽  
Sara Pakzad
Keyword(s):  
Skin Diseases ◽  
Antimalarial Agents ◽  
The Face ◽  
History Of ◽  
Inflammatory Drugs ◽  
Skin Discoloration ◽  
Anti Inflammatory ◽  
One Year ◽  
Rheumatoid Diseases

Antimalarial agents, including chloroquine and hydroxychloroquine, have been used for the treatment of various rheumatoid diseases and skin diseases because of their anti-inflammatory and immune-modulating properties. Cutaneous adverse effects such as exacerbation of psoriasis, pruritus, and hyperpigmentation have been reported as side-effects of antimalarial drugs. In this case, we report a middle-aged man with a history of rheumatoid arthritis who was treated with non-steroidal anti-inflammatory drugs and hydroxychloroquine. He complainedof hyperpigmentation of the face after one year of initiating the hydroxychloroquine. It was discontinued and methotrexate was started. Skin biopsy was confirmed drug reaction. Aftermore than 10 years of follow up, his skin discoloration had not been improved.

scholarly journals Unusual mandible fracture caused by metallic spear: case report and literature review

2020 ◽  
Vol 26 (2) ◽  
pp. 20
Author(s):  
Samuel Macedo Costa ◽  
Bruna Campos Ribeiro ◽  
Bernardo Barcelos Greco ◽  
Rodolfo César Gual ◽  
Alessandro Oliveira de Jesus ◽  
...  
Keyword(s):  
Unusual Case ◽  
Mandible Fracture ◽  
Operative Care ◽  
Surgical Incisions ◽  
The Face ◽  
Gun Shot ◽  
History Of ◽  
One Year ◽  
Water Sports

Spear gun projectiles injuries are are very rare and are usually related to lack of attention during water- sports or fishing practices. This study aims to describe an unusual case of facial injury associated with a mandibular fracture after a spear gun shot. A 38-years-old man was admitted with a history of penetrating injury on the face caused by an accidental shot from a spear gun. After the initial stabilization and examination, the patient was taken to the surgical room for the removal of the projectile. The post-operative care was uneventful and the patient was discharged with no concerns, being in follow-up for one year with no signs of infection or malocclusion. The surgical procedure should be done as soon as possible and the removal of the spear must be done carefully, under direct vision, with or without surgical incisions. Major complications can occur after spear injuries, therefore, the patient must be observed in the postoperative period and should maintain follow up until the end of the rehabilitative process.

scholarly journals 699. A Retrospective Review of the Progression of Cardiac Vegetations with treatment

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S401-S401
Author(s):  
Roomana Khan ◽  
Saleeha Asghar ◽  
Vivek Kak
Keyword(s):  
Successful Treatment ◽  
Retrospective Review ◽  
Injection Drug Users ◽  
Drug Users ◽  
Primary Outcome ◽  
P Value ◽  
Initial Size ◽  
Adequate Treatment ◽  
History Of

Abstract Background The purpose of our study was to assess the natural history of cardiac vegetations in native valves(NVIE) including changes in size and/or resolution with adequate treatment, as well as analyze factors that influence initial size. Methods We did a retrospective review of 102 patients discharged with a diagnosis NVIE at a community hospital. These patients were then screened to see if they received an adequate course of antimicrobial therapy and had follow up echocardiograms. The primary outcome measured was the change in vegetation size. We also assessed secondary measures including pathogen identified, the valve involved, complications, and associated IDU and any co-infections. Results 31 patients fulfilled the study criteria and showed an initial mean vegetation size of 170mm upon initial echocardiography. The follow-up size after antibiotic treatment was 78mm suggesting a statistically significant relationship between antibiotic completion and reduction in vegetation size. (p-value 0.005). T-Test was used for subgroup analysis and showed that the initial size of vegetations was significantly larger in IDUs (311) when compared to non-IDU (92)(p-value= 0.026).Patients who had embolic phenomena had significantly larger initial vegetations than those with no embolic complication. Initial vegetation size was significantly larger for people with embolic complications (308 mm vs 82.65 mm, p-value 0.013).We also found that patients with Staphylococcal endocarditis had larger vegetations than those with non-staphylococcal endocarditis (264 vs 39, p-value 0.001). and treatment led to a larger decrease in vegetation size (152 vs 7, p value 0.007) Conclusion Our small study suggests that successful treatment of NVIE does lead to a decrease in vegetation size though resolution of the vegetation does not occur. We also found that embolic phenomenon tended to occur with larger vegetations with our study suggesting that a vegetation &gt; 3 cm was more likely to embolize. Our study also shows that vegetations in NVIE in injection drug users were larger than those in non-IDU and vegetation size is larger in patients with staphylococcal endocarditis however successful treatment in these patients also leads to a larger decrease in size of these vegetations Disclosures All Authors: No reported disclosures

scholarly journals Case report : Use of Phototherapy for Acrodermatitis Continua of Hallopeau in Childhood: Case Report and Review of the Literature

2018 ◽  
Vol 2 (4) ◽  
pp. 01-02
Author(s):  
M. Napolitano ◽  
T. Cirillo ◽  
C. Patruno ◽  
P. Gisonni ◽  
M. Megna ◽  
...  
Keyword(s):  
Case Report ◽  
Color Doppler ◽  
Distal Portion ◽  
Prior History ◽  
Topical Steroids ◽  
Variable Degree ◽  
Cutaneous Tissue ◽  
History Of ◽  
Microbiological Infection

A 6-year-old girl presented to our attention with a 7-month history of erythema and pustules on the distal portion of her left first finger, which deeply affected the beginning of her scholar activity. On examination, her digit was swollen, markedly erythematous, and littered with several small pustules; nail was strikingly dysmorphic. The other digits showed variable degree of onychodystrophy (Fig. 1A). There were neither prior history of psoriatic lesions nor familiarity for psoriasis. Microscopic and cultural examination did not show any microbiological infection. Histological sample showed psoriasiform hyperplasia, with a collection of granulocytes in the context of parakeratosis as well as in the intraepithelial area (Munro-like microabscesses), and focal spongiosis with absent granular layer. The dermis showed increased vascularity within the dermal papillae. Ultrasonography highlighted cutaneous and sub-cutaneous thickness increase with intra-articular synovial effusion (Fig. 1C); at color Doppler, increase of vascularization was present in sub-cutaneous tissue (Fig. 1D). On the basis of these findings, a diagnosis of acrodermatitis continua of Hallopeau (ACH) was performed. Past treatment only consisted of topical steroids. A cycle of clobetasol 0.05% ointment under occlusion and narrow band UVB (310 -311 nm) was prescribed for 30 days. The improvement observed at follow-up visit (Fig. 1B), increased after the subsequent 2 months of therapy, without relapse. The young patient is still under treatment and no relapse was notead at 3.5 months follow-up.

scholarly journals A retrospective study to analyze local flaps for coverage of facial defects

2020 ◽  
Vol 7 (12) ◽  
pp. 4052
Author(s):  
Dinesh Chaudhary ◽  
Ashutosh Soni ◽  
Sanjeev Agarwal ◽  
J. L. Kumawat
Keyword(s):  
Cell Carcinoma ◽  
Malignant Tumors ◽  
Local Flaps ◽  
Additional Advantage ◽  
Expression Of Emotion ◽  
Facial Defects ◽  
The Face ◽  
History Of ◽  
Functional Morbidity

Background: Face is the center of attention during communication and the expression of emotion. Facial defects resulting from trauma and the excision of skin malignancies are relatively common. How this defect is treated is determined by a variety of factors including the location, size and the underlying cause of the defect, the projected functional morbidity, the medical history of the patient, and feasibility of surgery. Aim was to study various local flaps using for coverage of defect, outcomes and complications.Methods: This was a retrospective cohort study. Our study shows result of 92 patients during January 2016 to December 2019 who had facial defects were taken up for the study. Reconstructive options were selected depending on defect size, location. Follow-up of patients ranged from 6 months to 1 year.Results: The most common malignant tumors of the face are basal cell carcinoma, squamous cell carcinoma and melanoma. Local flap is always preferable than skin grafts as it produces a superior match in color and texture with the additional advantage of producing a vascularized soft tissue cover for skeleton and resistant to contractures.Conclusions: In our study, variety of local flaps were used to cover the facial defects of the 92 patients with minimal post-operative complications.

The Significance of Atypical Urine Cytology in the Face of Normal Investigations—Is Extended Investigation and Follow-Up Required?

2008 ◽  
Vol 1 (3) ◽  
pp. 131-135 ◽  
Author(s):  
E.H. Streeter ◽  
G.D.H. Turner ◽  
R. McCormick ◽  
I.S. Roberts ◽  
J. Crew
Keyword(s):  
Natural History ◽  
Urine Cytology ◽  
Urinary Cytology ◽  
Upper Tract ◽  
The Face ◽  
Urothelial Malignancy ◽  
History Of ◽  
Clinical Records ◽  
First Time

Objective: To examine the natural history of patients identified with atypical urine cytology in the face of normal investigations, and thus provide guidance on the need for extended follow-up and investigation of such patients. Patients and methods: All patients identified over a 2-year period to have atypical urine cytology on Cytospin analysis and Papanicolaou staining were audited over a 5-year follow-up period. Clinical records, histopathology and radiology databases were independently searched. Patients were intensively investigated with cystoscopy and a range of upper tract imaging. Results: 126 patients were identified to have atypical urine cytology, and 77 of these had no urothelial tumour found. In these normal patients, only 12/48 who had further samples taken showed persistent atypia. 11/77 normal patients had another urological pathology which may have explained their atypical urine cytology. No patient presenting for the first time later went on to develop urothelial malignancy in the face of negative initial investigations. Conclusion: In the group of patients in which cystoscopy and urography show no urothelial malignancy, the finding of atypical urinary cytology does not predict the development of later urothelial tumour, and does not require prolonged follow-up, repeat cytological testing or further imaging.

scholarly journals Granuloma Faciale – A Difficult Diagnosis? – A Case Report / Facijalni granulom – da li ga je teško dijagnostikovati? – Prikaz slučaja

2012 ◽  
Vol 4 (1) ◽  
pp. 32-38
Author(s):  
Suzana Nikolovska ◽  
Đorđi Gocev ◽  
Katerina Damevska
Keyword(s):  
Leukocytoclastic Vasculitis ◽  
Pyogenic Granuloma ◽  
Topical Steroids ◽  
Eosinophilic Infiltrate ◽  
Biopsy Specimens ◽  
Discontinuation Of Treatment ◽  
Granuloma Faciale ◽  
The Face ◽  
Inflammatory Skin Disorder ◽  
Localized Form

Abstract Granuloma faciale is an uncommon inflammatory skin disorder clinically characterized by single or multiple, reddishbrown nodules or plaques primarily occurring on the face of middle-aged men. Occasionally, extra-facial involvement has been reported, usually on sun-exposed areas. Although the etiology is somewhat unclear, granuloma faciale is considered a localized form of chronic leukocytoclastic vasculitis with a prominent eosinophilic infiltrate and fibrosis in the later stages of the disease. Histological examination of lesions reveals a dense polymorphous inflammatory infiltrate that consists mainly of eosinophils and neutrophils separated from the epidermis by a narrow band zone with normal collagen, deprived of cells. Leukocytoclastic vasculitis is often seen. Clinical diagnosis is suspected in few cases, so definite diagnosis of granuloma faciale requires a biopsy. The disease is notoriously resistant to many therapies and often tends to relapse after treatment is discontinued. We present a female patient with granuloma faciale on the back and on the tip of the nose, misdiagnosed clinically as basall cell carcinoma and granuloma annulare. Her original histological diagnosis, made by a pathologist, was pyogenic granuloma. After revision of histologic findings of the biopsy specimens, granuloma faciale was diagnosed by a dermatopathologist. The treatment with cryotherapy and topical steroids was unsuccessful. Improvement of lesions was observed after use of tacrolimus 0.1% ointment, but lesion recurred after discontinuation of treatment.

scholarly journals Intralymphatic Histiocytosis: An Unusual Presentation

2021 ◽  
pp. 1-6
Author(s):  
Timothy J. Blackwell ◽  
Zachary Ingersoll ◽  
Martin Blackwell
Keyword(s):  
Inflammatory Disease ◽  
Topical Steroids ◽  
Anterior Neck ◽  
Lower Lip ◽  
Topical Tacrolimus ◽  
Multiple Biopsies ◽  
Primary Disorder ◽  
History Of ◽  
Legionnaires Disease ◽  
Intralymphatic Histiocytosis

Intralymphatic histiocytosis (ILH) is a rare cutaneous condition initially described in 1994 by O’Grady et al. It often appears as a red to violaceous, livedoid patch or plaque usually on the extremities. We present a 71-year-old female with a history of psoriasis, 50 pack years smoking and recent Legionnaires disease who came to us complaining of a red to violaceous, blanching, edematous, mildly tender lesion covering the left lower lip and extending to the chin and anterior neck. After multiple biopsies, ILH was confirmed and the patient was initially started on tacrolimus 0.1% ointment b.i.d., but there was no response. Then, she was started on oral pentoxifylline and intermittent topical steroids, as well as continuing the topical tacrolimus. There was again no response, so now she is taking a TNF-ɑ inhibitor as it appears to be a granulomatous process. These ILH cases are very rare and there is limited literature that describes one treatment as a cure. Treatment of ILH is very difficult, but several different therapies have been reported with varying success. If the disease is secondary to an underlying inflammatory disease or malignancy, then treatment of the primary disorder can lead to resolution of the ILH.

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