scholarly journals Loxoscelismo Cutâneo em Portugal: Causa Rara de Dermonecrose

2014 ◽  
Vol 27 (5) ◽  
pp. 654 ◽  
Author(s):  
Inês Coutinho ◽  
Sónia Rocha ◽  
Maria Eugénia Ferreira ◽  
Ricardo Vieira ◽  
Margarida Robalo Cordeiro ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Skin Necrosis ◽  
Skin Diseases ◽  
Ulcer Formation ◽  
Definite Diagnosis ◽  
Erythematous Plaque ◽  
Bites And Stings ◽  
Spider Bite ◽  
The Right ◽  
Causative Link

<p>Cutaneous loxoscelism is an exceptional diagnosis in Portugal, regardless of the documented presence of Loxosceles rufescens.<br />We report a 33-year old female patient presenting to our clinic after having visualized a bite from a spider in the inner aspect of the right thigh. Afterwards, she developed a warm, painful erythematous plaque, progressing to skin necrosis and torpid ulcer formation. Considering the failure of conservative measures, surgical debridement of the ulcer followed by repair using an O-Z plasty achieved good functional outcome. Definite diagnosis of cutaneous loxoscelism may be difficult since it relies on the visualization of the bite, capture of the spider for identification and typical clinical features. This case meets several criteria that allow the establishment of a causative link between spider bite and dermonecrosis. It is, to the best of our knowledge, the first diagnosis of loxoscelism reported in Portugal.</p><p><br /><strong>Keywords:</strong> Skin Diseases; Bites and Stings; Spider Venoms; Portugal.</p>

Abstract T P238: Microglial CX3CR1 Required for M2 Polarization and Recovery After Intracerebral Hemorrhage

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Roslyn A Taylor ◽  
Matthew D Hammond ◽  
Youxi Ai ◽  
Lauren H Sansing
Keyword(s):  
Bone Marrow ◽  
Flow Cytometry ◽  
Intracerebral Hemorrhage ◽  
Gait Analysis ◽  
Functional Outcome ◽  
Cylinder Test ◽  
M2 Microglia ◽  
Inflammatory Phenotype ◽  
Peripheral Leukocytes ◽  
The Right

Introduction: Intracerebral hemorrhage (ICH) results in the activation of microglia, the resident immune cells of the central nervous system. Microglia may polarize into an M1, pro-inflammatory phenotype, or an M2 phenotype associated with repair. CX3CR1 is a chemokine receptor on microglia and monocyte subsets. CX3CR1-null microglia have been shown to have dysregulated inflammation. We hypothesize that CX3CR1-null microglia have a prolonged M1 phenotype, contributing to worse functional outcome after ICH. Methods: ICH was modeled by injection of 20μl of blood into the right striatum. Neurological deficit was quantified using digital gait analysis, cylinder test, and beam walking. Mice were sacrificed 14 days after ICH; brains were harvested for flow cytometry and immunohistochemistry (IHC). C57BL/6 (WT) and CX3CR1 GFP/GFP (CX3CR1-null) mice were irradiated and reconstituted with bone marrow from WT mice carrying the congenic marker CD45.1 to generate bone marrow chimeras (CD45.1WT or CD45.1CX3CR1-null). M1 microglia were identified as expressing MHCII and M2 microglia with CD206. Results: The CD45.1CX3CR1-null mice show worse functional outcome 14 days after ICH by cylinder test (p=0.002), beam walking (p=<0.001) and gait analysis (p=0.02). By flow cytometry, few peripheral leukocytes remain in the brain at 14 days, indicating that F4/80 + and CD11b + cells visualized by IHC are likely microglia, not peripheral macrophages. By IHC, CD45.1 CX3CR1-null mice have significantly more amoeboid F4/80 + MHCII + cells per field (M1 microglia) than CD45.1WT mice (p=0.02). CD45.1 CX3CR1-null mice have significantly fewer CD11b + CD206 + cells per field (M2 microglia) compared to CD45.1WT mice (p=0.04). Conclusions: Our results suggest microglial CX3CR1 signaling is necessary for microglia to transition from M1 to M2 and contribute to recovery after ICH.

scholarly journals Alternative Leprosy Treatment Using Rifampicin Ofloxacin Minocycline (ROM) Regimen – Two Case Reports

2019 ◽  
Vol 11 (3) ◽  
pp. 89-93
Author(s):  
Yohanes Widjaja ◽  
Khairuddin Djawad ◽  
Saffruddin Amin ◽  
Widyawati Djamaluddin ◽  
Dirmawati Kadir ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Alternative Treatment ◽  
Histopathological Examination ◽  
Case Reports ◽  
Erythematous Plaque ◽  
First Case ◽  
Satisfactory Outcome ◽  
Significant Clinical Improvement ◽  
The Right

Abstract Introduction. Leprosy is a disease that predominantly affects the skin and peripheral nerves, resulting in neuropathy and associated long-term consequences, including deformities and disabilities. According to the WHO classification, there are two categories of leprosy, paucibacillary (PB) and multibacillary (MB). The standard treatment for leprosy employs the use of WHO MDT (Multi Drug Treatment) regimen, despite its multiple downsides such as clofazimine-induced pigmentation, dapsone-induced haematological adverse effects, poor compliance due to long therapy duration, drug resistance, and relapse. Multiple studies and case reports using ROM regimen have reported satisfactory results. Nevertheless, there are still insufficient data to elucidate the optimum dosage and duration of ROM regimen as an alternative treatment for leprosy. Previous experience from our institution revealed that ROM regimen given three times weekly resulted in a satisfactory outcome. Case Reports. We report two cases of leprosy treated with ROM regimen from our institution. The first case was PB leprosy in a 64-year-old male who presented with a single scaly plaque with erythematous edge on the right popliteal fossa. Sensibility examination showed hypoesthesia with no peripheral nerve enlargement. Histopathological examination confirmed Borderline Tuberculoid leprosy. ROM regimen was started three times weekly for 6 weeks and the patient showed significant clinical improvement at the end of the treatment with no reaction or relapse until after 6 months after treatment. The second case was MB leprosy in a 24-year-old male patient with clawed hand on the 3rd-5th phalanges of the right hand and a hypoesthetic erythematous plaque on the forehead. Histopathology examination confirmed Borderline leprosy. The patients received ROM therapy 3 times a week with significant clinical improvement after 12 weeks. Conclusion. ROM regimen given three times weekly for 6 weeks in PB leprosy and 12 weeks in MB leprosy resulted in a significant clinical improvement. Thus, ROM regimen could be a more effective, safer, faster alternative treatment for leprosy.

scholarly journals African Skin: Different Types, Needs and Diseases

2019 ◽  
pp. 1-13
Author(s):  
Olumayowa Abimbola Oninla ◽  
Samuel Olorunyomi Oninla ◽  
Bolaji Ibiesa Otike-Odibi ◽  
Mufutau Muphy Oripelaye ◽  
Fatai Olatunde Olanrewaju ◽  
...  
Keyword(s):  
Skin Color ◽  
Skin Diseases ◽  
Skin Pigmentation ◽  
Geographical Location ◽  
Skin Care ◽  
Skin Type ◽  
Protective Properties ◽  
Tropical Regions ◽  
The Right

Microscopic structures in the skin are basically the same in all races. Differences are found in histology and physiology of the skin resulting in different skin types, needs and prevailing skin diseases. Skin pigmentation (with the photo-protective properties), and the barrier function of the stratum corneum are the main differences between African and Caucasian skin. The geographic distribution of UV radiation (UVR) has a positive correlation with geographical location. The darker-skinned populations are closer to the equator where there are high amounts of UVR especially in the tropical regions of the world. African skin has the greatest variability in skin color. Africa has both white and dark skinned individuals with the darker-skinned populations being mostly around the equator.          Leslie Baumann introduced four parameters that more accurately characterized skin types than previous classification of dry, oily, normal and combination skin. These are dry or oily – D/O; sensitive or resistant – S/R; pigmented or non-pigmented – P/N, and wrinkled or unwrinkled skin – W/T. Combinations of these further produced sixteen skin phenotypes.  Dark skinned individuals often have the PT types while the light skinned mostly have the NW types. Skin needs basically depends on the type. Identifying the skin type is fundamental to providing the right skin care. According to Baumann, the fundamental elements of skin care are mild cleansing, hydrating (moisturization with humectants and emollients), replenishing (with lipids, ceramides and fatty acids) and skin protection (UV protection and increased humidity). Skin diseases are associated with skin type. Eczema is more typical in people with DS combinations while acne is associated with OS skin type (especially OSNT and OSPT). Prevalence of skin diseases varies within African communities from 35% to 87% with skin infections affecting 22-46% and eczemas 13-21% of patients in various studies.

Foot Macrodactyly Associated with Klippel-Trenaunay Syndrome

2021 ◽  
Vol 23 (5) ◽  
pp. 375-380
Author(s):  
Maurizio De Pellegrin ◽  
Désirée Moharamzadeh ◽  
Giacomo Placella ◽  
Vincenzo Salini
Keyword(s):  
Functional Outcome ◽  
Congenital Malformation ◽  
Patient’S Satisfaction ◽  
Length Difference ◽  
Custom Made ◽  
The Difference ◽  
The Right ◽  
Klippel Trenaunay Syndrome

Klippel-Trenaunay syndrome is a rare congenital malformation which may be associated with macrodactyly. The main problem is the need for custom-made shoes. We describe the case of a female newborn affected by Klippel-Trenaunay syndrome, with a larger and longer right foot; the difference increased progressively and, at 5 years of age, the right foot was 50% larger and 38% longer than the left one. Due to the progression of the deformity, reduction surgery was advised to reduce the foot’s width. Resection of the second ray and 2nd cuneiform was performed. The result was excellent and there were no complications during a 10-year follow-up period with a decrease of width and length difference to 10% and 4%, respectively, in comparison to the contralateral foot. There were no gait anomalies. Abnormal foot width and length represented the main problems and guided the surgical strategy. Second ray resection was effective, without complications and with a good long-term functional outcome. Possibility of wearing fashionable conventional shoes without insoles was achieved to the patient’s satisfaction

Rapidly Spreading Deep Dissecting Hematoma Occurring One Month After A Minor Trauma: A Case Report.

2021 ◽  
Author(s):  
Rémy Hamdan ◽  
Narcisse Zwetyenga ◽  
Yvan Macheboeuf ◽  
Patrick Ray
Keyword(s):  
Skin Necrosis ◽  
Clinical Signs ◽  
International Normalized Ratio ◽  
Blood Collection ◽  
Minor Trauma ◽  
Surgical Emergency ◽  
Superficial Skin ◽  
Muscle Fascia ◽  
The Right ◽  
A Minor

Abstract Background: Deep dissecting hematoma (DDH) is a rapidly extending blood collection that splits the hypodermis from muscle fascia, constituting a medical surgical emergency. The natural history of this condition includes trauma (even minor physical injury) shortly before onset of the lesion, occurring in a patient with advanced dermatoporosis. A delay of several weeks between the appearance of a superficial haematoma following a minor trauma and its sudden decompensation into a rapidly spreading DDH has been scarcely mentioned in the medical literature. Case presentation: We report the admission of a 70-year-old woman under anticoagulation to the emergency department of our hospital for the sudden appearance of a rapidly evolving hematoma one month after a negligible trauma to the right leg. A complete skin examination revealed clinical signs (spontaneous superficial skin haematomas, lacerations, wrinkles, stellate pseudo-scars) of advanced dermatoporosis, especially on the forearms. The initial biological testing disclosed an International Normalized Ratio of 3.15. The clinical aspect of the haematoma, its rapid extension and the cutaneous signs of dermatoporosis on the forearms allowed the diagnosis of DDH. Bedside ultrasound examination was used to eliminate differential or additional diagnoses and to assess the main features of the hematoma (dimensions, existence of blood supply). Due the extent of the lesion and the risk of extended skin necrosis, surgical debridement and hematoma drainage were performed. The operative report confirmed the diagnosis of DDH. Wound healing was obtained spontaneously after three months. Conclusion: DDH is the most serious complication of dermatoporosis. Given its rapid horizontal extension and the risk of skin necrosis it induces, DDH is a medical-surgical emergency and must be diagnosed early. This observation emphasises that in patients with severe dermatoporosis, on the occasion of a Vitamin K Antagonist overdose, a limb-threatening DDH can develop suddenly, even several weeks after a minor impact.

Crusts, scabs, and eschars

2020 ◽  
pp. 393-402
Keyword(s):  
Bacterial Infections ◽  
Tinea Capitis ◽  
Viral Infections ◽  
Skin Diseases ◽  
Systemic Disease ◽  
Clinical Images ◽  
Pityriasis Lichenoides ◽  
Appropriate Treatment ◽  
Bites And Stings ◽  
Skin Conditions

Definitions and clinical images are used in this short chapter to permit differentiation between crusts, scabs, and eschars and their likely causes. These are listed as skin infections, trauma, or skin conditions such as eczema or blistering disorders. There are brief descriptions with appropriate treatment and there is cross-referencing to other chapters. Short summaries of diseases causing eschars are provided. These include bacterial infections (e.g. ecthyma, anthrax), viral infections (e.g. cowpox, orf), fungal (e.g. Tinea capitis), and protozoal (e.g. Leishmaniasis) conditions. Also included are skin diseases such as pityriasis lichenoides, toxins/allergens (from various bites and stings), and systemic disease such as autoimmune vasculitis, haematological disorders, or tumours.

Chronic myeloid leukaemia and priapism in a boy: A dramatic case with favourable functional outcome

1998 ◽  
Vol 65 (1) ◽  
pp. 120-122
Author(s):  
L.F. Martino ◽  
R. Gemelli ◽  
M. De Pasquale ◽  
V. Arcuri ◽  
O.L. Sicuro ◽  
...  
Keyword(s):  
Intensive Care ◽  
Chronic Myeloid Leukaemia ◽  
Functional Outcome ◽  
Myeloid Leukaemia ◽  
Doppler Examination ◽  
Corpora Cavernosa ◽  
The Right

In this work the authors describe a case of priapism lasting approx. 15 hours presenting chronic myeloid leukaemia in a 15-year-old boy. Aspiration of the corpora cavernosa was carried out and the boy remained in intensive care for 2 months, after which a Doppler examination was performed. This showed a moderate flow in the left artery and a poorer situation in the right.

Improvement in neurological outcome after administration of atorvastatin following experimental intracerebral hemorrhage in rats

2004 ◽  
Vol 101 (1) ◽  
pp. 104-107 ◽  
Author(s):  
Donald Seyfried ◽  
Yuxia Han ◽  
Dunyue LU ◽  
Jieli Chen ◽  
Ali Bydon ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Autologous Blood ◽  
Cell Loss ◽  
Study Data ◽  
Content Type ◽  
Ipsilateral Striatum ◽  
The Right ◽  
Higher Doses ◽  
Fine Print

Object. Atorvastatin, a β-hydroxy-β-methylglutaryl coenzyme A reductase inhibitor, improves neurological functional outcome, reduces cerebral cell loss, and promotes regional cellular plasticity when administered after intracerebral hemorrhage (ICH) in rats. Methods. Autologous blood was stereotactically injected into the right striatum in rats, and atorvastatin was administered orally beginning 24 hours after ICH and continued daily for 1 week. At a dose of 2 mg/kg, atorvastatin significantly reduced the severity of neurological deficit from 2 to 4 weeks after ICH. The area of cell loss in the ipsilateral striatum was also significantly reduced in these animals. Consistent with previous study data, higher doses of atorvastatin (8 mg/kg) did not improve functional outcome or reduce the extent of injury. Histochemical stains for markers of synaptogenesis, immature neurons, and neuronal migration revealed increased labeling in the region of hemorrhage in the atorvastatin-treated rats. Conclusions. Analysis of the data in this study indicates that atorvastatin improves neurological recovery after experimental ICH and may do so in part by increasing neuronal plasticity.

A painful erythematous plaque on the right labium majora

2019 ◽  
Vol 220 (2) ◽  
pp. 204
Author(s):  
Qian-Nan Jia ◽  
Sergio Vano-Galvan ◽  
Dong-Lai Ma
Keyword(s):  
Erythematous Plaque ◽  
Labium Majora ◽  
The Right

Lengthening of a One-Bone Forearm

1998 ◽  
Vol 23 (4) ◽  
pp. 453-456 ◽  
Author(s):  
C. W. C. TONG ◽  
L. K. HUNG ◽  
J. C. Y. CHENG
Keyword(s):  
Activities Of Daily Living ◽  
Functional Outcome ◽  
Upper Limb ◽  
Daily Living ◽  
Callus Distraction ◽  
The One ◽  
The Right

An 8-year-old girl presented with marked shortening of the right forearm due to destruction of both the radius and ulna secondary to neonatal osteomyelitis. A one-bone forearm operation was performed to achieve a stable forearm. Two years later, the one-bone forearm was lengthened for 6 months by callus distraction (callotasis) achieving 12 cm of extra length. The patient was last followed up at the age of 16. The appearance and functional outcome of the right upper limb had been improved and she was independent in all activities of daily living.

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