scholarly journals Necrobiosis lipoidica: a rare clinical and pathomorphological case

2021 ◽  
Vol 17 (8) ◽  
pp. 651-655
Author(s):  
Z.P. Nizhynska-Astapenko ◽  
M.V. Vlasenko ◽  
V.S. Vernygorodsky ◽  
L.P. Kholod ◽  
O.V. Shvedka
Keyword(s):  
Mechanical Damage ◽  
Epidemiological Data ◽  
Giant Cells ◽  
Granuloma Annulare ◽  
Diabetic Microangiopathy ◽  
Histological Structure ◽  
Necrobiosis Lipoidica ◽  
Humoral Immune ◽  
Patients With Diabetes ◽  
Low Prevalence

According to modern scientific researches, necrobiosis lipoidica (NL) is a disease characterized by focal disorganization and lipid collagen dystrophy. It is believed that the basis of skin changes in this dermatosis is diabetic microangiopathy that is accompanied by sclerosis and obliteration of blood vessels, which leads to necrobiosis with subsequent deposition of lipids in the dermis. This pathology is registered relatively rarely, in 1 % of patients with diabetes mellitus (DM) on average. The combination of NL with DM, according to the literature data, ranges from 25 to 70 %; more often (in 40–60 % of cases) DM is preceded by NL, and in 10–25 % of cases they occur simultaneously. In addition, in 10–50 % of cases NL is diagnosed in people without concomitant diabetes. The variability of clinical, epidemiological features and the relatively low prevalence of this pathology is often the cause for misdiagnosis or late diagnosis. The described clinical case is typical in terms of the epidemiological data: sex, age, presence of DM. At the same time, it is rare in terms of the clinical picture: it is not classically diabetic by localization (symmetrical areas of the legs are typical), by appearance of necrobiosis areas — granulomatous type of necrobiosis in the form of granuloma annulare, by histological structure — area of chronic perivascular lymphoplasmocytic inflammation with the involvement of single giant cells, which required additional clinical and anamnestic data for an objective report of the pathologist. Biopsy in this case was used as a differential diagnosis between granuloma annulare and necrobiotic necrogranuloma. In addition, this method of diagnosis has played an additional therapeutic role. This case may have demonstrated the activation of the cellular and humoral immune response in the area of chronic inflammation in response to a mechanical damage and the resolution of inflammation with complete tissue repair.

scholarly journals Penggunaan Ester Asam Fumarat Oral Dalam Pengobatan Kasus Dermatologi

2020 ◽  
Vol 8 (2) ◽  
pp. 50-59
Author(s):  
Elina Rahma ◽  
Dwi Indria Anggraini
Keyword(s):  
Literature Review ◽  
Granuloma Annulare ◽  
Necrobiosis Lipoidica

Pendahulan: Ester asam fumarat oral (FAE) merupakan senyawa yang menarik dalam bidang dermatologi. FAE bekerja pada sel kulit dan jaringan sitokin. Sejauh ini hanya campuran dimethylfumarate (DMF) dan monoethylfumarate (MEF) yang telah mendapatkan persetujuan untuk perawatan oral psoriasis jenis plak sedang hingga parah. Tujuan: Untuk mengetahui penggunaan Ester asam fumarat oral (FAE) dalam tatalaksana di bidang dermatologi Metode: Artikel disusun menggunakan metode literature review, melibatkan 34 literatur bersumber dari buku dan jurnal. Hasil: DMF tampaknya menjadi komponen aktif utama. Penting untuk menekankan perbedaan antara asam fumarat dan ester asam fumarat. Formulasi asam fumarat tersedia sebagai suplemen kesehatan dan sering dipasarkan sebagai obat alternatif alami untuk mengobati psoriasis. Namun buruk diserap oleh usus dan diekskresikan melalui urin tanpa memiliki efek terapi apa pun. Pembahasan: Meskipun mode aksi FAE dan mekanisme kerja dalam terapi psoriasis masih belum jelas, bukti menunjukkan bahwa itu tidak ada hubungannya dengan siklus Krebs dan senyawa aktif utama DMF.Ada bukti bahwa FAE tidak hanya efektif dan aman pada psoriasis tetapi juga penyakit non-infeksi granulomatosa seperti granuloma annulare, necrobiosis lipoidica, dan sarkoidosis. Penelitian in vitro dan hewan menunjukkan beberapa aktivitas dalam melanoma ganas juga. Simpulan: Ester asam fumarat oral (FAE) banyak digunakan dalam beberapa kasus dermatologi   Kata kunci: Asam fumarat, dermatologi, psoriasis, sarkoidosis

scholarly journals Endocrine Disorders in a Specialized Hospital in Guyana

2019 ◽  
pp. 30-31
Author(s):  
Yaquelin Gonzalez Ricardo ◽  
Yaritza Lopez Diaz ◽  
Ravendra Johnaton Dudnauth ◽  
Maritza Oliva Perez
Keyword(s):  
Diabetes Mellitus ◽  
Pituitary Tumors ◽  
Obstetric Care ◽  
Endocrine Disorders ◽  
Patients With Diabetes ◽  
Sheehan Syndrome ◽  
One Year ◽  
The One ◽  
Low Prevalence ◽  
Endocrinology Clinic

Background: Endocrine diseases are characterized by hormonal alterations (excess or defect). Due to the low prevalence (less than five case 5 / 10 000 inhabitants), a large number of them, qualify to be classified as rare diseases such as those of organs like: hypophysis, adrenal glands, gonads as well as some congenital thyroid diseases. Others like Diabetes are considering almost epidemic. Objective: To define the types of diseases observed in the only Endocrinology Clinic in Guyana. Methods: The diagnoses of all patients who attended the endocrinology clinic of the Georgetown Public Hospital Corporation from June 1, 2016 to May 31, 2017, were analyzed. Results: During the one year of this study, approximately 639 patients attended the endocrinology clinic. Of this, 178 patients had thyroid-related diseases with 80 of these having thyrotoxicosis, 49 having hypothyroidism followed by 110 patients with diabetes mellitus. Pituitary tumors were also diagnosed with 2 of acromegaly and 6 of prolactinomas. Cases of hypoadrenalism (n = 5), hypogonadism (n = 4), and pheochromocytoma (n = 6) were not rare; gonadal disease were also found in 17 patients. Thyroid disease was the most frequent diagnosis followed by diabetes mellitus. New emerging endocrine disorders such as hyperlipidemia (n = 1) were rare. Some persons attending the clinic were also noted to be overweight /obese however this was not the primary reason for joining the clinic. Traditional diseases such as Sheehan Syndrome have become rare due to improvements in Obstetric care. 

scholarly journals Giant Cells Tumors of Synovial Sheaths of the Hand are Benign Tumors with a Good Prognosis

2017 ◽  
Vol 1 (3) ◽  
pp. 01-03
Author(s):  
Cesar Edgar ◽  
Trey Rafael ◽  
Robert Mason ◽  
Diego Luis
Keyword(s):  
Retrospective Study ◽  
Tumor Resection ◽  
Tumor Development ◽  
Epidemiological Data ◽  
Recurrence Risk ◽  
Giant Cells ◽  
Good Prognosis ◽  
Benign Tumors ◽  
Macroscopic Appearance ◽  
Quick Dash

Introduction: The giant cells tumors (GCT) of the hand are common benign tumors that pose a recurrence problem. The aim of our study is to analyze epidemiological and clinical data, evaluate results and determine the recurrence risk factors. Materials and Methods: This is a retrospective study of 50 patients operated between 2003 and 2015 for a (GCT) of the hand, we observed epidemiological data, clinical outcome (quotation TAM score Kapandji and quick DASH), the appearance of recurrence, the histological appearance, localization, excision margins and invasion of adjacent anatomical structures were analyzed. Results: We report a retrospective study over thirteen years of 50 cases of GCT of the hand, with a mean age of 42 years and a sex ratio of 1/3. The motive for consulting was the presence of a digital mass, followed by discomfort bending in 20%. Palmar localization was found in 54%, especially at the second ray (30%) and facing the distal phalanx (38%). The radiograph showed soft tissue opacity in 60% of cases. All patients underwent surgery, the macroscopic appearance showed an encapsulated, lobed and yellow chamois tumor in 80% of cases. The mean follow up was 30 months with extremes of 2 months to 10 years. We noted 5 recurrences one of which recurred twice; the average time to recurrence was 22 months and ranged from 6 months to 36 years. In each subsequent offense we noted an intra-articular tumor development in 4 cases and tendon erosion in one case. Functional complications type of stiffness in flexion in 2 cases and hypoesthesia of a finger in 2 cases. The quick way DASH was 2.2 on 100. Conclusion: The GCT of synovial sheaths of the hand are a benign tumors with a good prognosis, the main problem is the risk of recurrence that depends on the type of tumor, intra articular tumor development and quality of tumor resection.

Concomitant Granuloma annulare and Necrobiosis lipoidica

Dermatology ◽  
1991 ◽  
Vol 183 (3) ◽  
pp. 225-229 ◽  
Author(s):  
D.L. Crosby ◽  
D.T. Woodley ◽  
D.D. Leonard
Keyword(s):  
Granuloma Annulare ◽  
Necrobiosis Lipoidica

scholarly journals Fatal squamous cell carcinoma from necrobiosis lipoidica diabeticorum in a diabetic patient

2019 ◽  
Vol 2019 ◽  
Author(s):  
Yael Lefkovits ◽  
Amanda Adler
Keyword(s):  
Diabetes Mellitus ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Central Area ◽  
Clinical Suspicion ◽  
High Index ◽  
List Type ◽  
Necrobiosis Lipoidica ◽  
Patients With Diabetes

Summary Necrobiosis lipoidica diabeticorum (NLD) is a chronic granulomatous dermatitis generally involving the anterior aspect of the shin, that arises in 0.3–1.2% of patients with diabetes mellitus (1). The lesions are often yellow or brown with telangiectatic plaque, a central area of atrophy and raised violaceous borders (2). Similar to other conditions with a high risk of scarring including burns, stasis ulcers and lupus vulgaris, NLD provides a favourable environment for squamous cell carcinoma (SCC) formation (3). A number of cases of SCC from NLD have been recorded (3, 4, 5); however, our search of the literature failed to identify any cases of either metastatic or fatal SCC which developed within an area of NLD. This article describes a patient with established type 1 diabetes mellitus who died from SCC which developed from an area of NLD present for over 10 years. Currently, there are a paucity of recommendations in the medical literature for screening people with NLD for the early diagnosis of SCC. We believe that clinicians should regard non-healing ulcers in the setting of NLD with a high index of clinical suspicion for SCC, and an early biopsy of such lesions should be recommended. Learning points: Non-healing, recalcitrant ulcers arising from necrobiosis lipoidica diabeticorum, which fail to heal by conservative measures, should be regarded with a high index of clinical suspicion for malignancy. If squamous cell carcinoma is suspected, a biopsy should be performed as soon as possible to prevent metastatic spread, amputation or even death. Our literature search failed to reveal specific recommendations for screening and follow-up of non-healing recalcitrant ulcers in the setting of necrobiosis lipoidica diabeticorum. Further research is required in this field.

Survival, cardiovascular morbidity, and reinterventions after elective endovascular aortic aneurysm repair in patients with and without diabetes: A nationwide propensity-adjusted analysis

2019 ◽  
Vol 24 (6) ◽  
pp. 539-546 ◽  
Author(s):  
Soumia Taimour ◽  
Tarik Avdic ◽  
Stefan Franzén ◽  
Moncef Zarrouk ◽  
Stefan Acosta ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Endovascular Aneurysm Repair ◽  
Total Mortality ◽  
Epidemiological Data ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Adjusted Analysis ◽  
Patients With Diabetes ◽  
Aneurysm Repair

Epidemiological data indicate decreased risk for development and growth of abdominal aortic aneurysm (AAA) among patients with diabetes mellitus (DM). On the other hand, DM adds to increased cardiovascular (CV) morbidity and mortality. In a nationwide observational cohort study of patients registered in the Swedish Vascular Register and the Swedish National Diabetes Register, we evaluated potential effects of DM on total mortality, CV morbidity, and the need for reintervention after elective endovascular aneurysm repair (EVAR) for AAA. We compared 748 patients with and 2630 without DM with propensity score-adjusted analysis, during a median 4.22 years of follow-up for patients with DM, and 4.05 years for those without. In adjusted analysis, diabetic patients showed higher rates of acute myocardial infarction (AMI) during follow-up (relative risk (RR) 1.44, 95% CI 1.06–1.95; p = 0.02), but lower need for reintervention (RR 0.12, CI 0.02–0.91; p = 0.04). There were no differences in total (RR 0.88, CI 0.74–1.05; p = 0.15) or CV (RR 1.58, CI 0.87–2.86; p = 0.13) mortality, or stroke (RR 0.95, CI 0.68–1.32; p = 0.75) during follow-up. In conclusion, patients with DM had higher rates of AMI and lower need for reintervention after elective EVAR than those without DM, whereas neither total nor CV mortality differed between groups. The putative protective effects of DM towards further AAA enlargement and late sac rupture may help explain the lower need for reintervention and absence of excess mortality.

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