Aphthous Vulvar Ulcers in Adolescent Girls: Case Report and Review of the Literature

2010 ◽  
Vol 14 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Kimberly Lai ◽  
Emily Lambert ◽  
Mary Gail Mercurio

Background: Aphthous vulvar ulcers are painful ulcerations on the genital mucosa frequently accompanied by systemic symptoms. They are most commonly reported in young women and adolescents without a history of sexual contact. Diagnosis is made by exclusion of more common causes, and treatment for this self-limited condition is mainly symptomatic. Objective: Clinicians should be aware of this rare condition to avoid misdiagnoses and unwarranted investigations into sexual abuse or false accusations of sexual activity. Methods: We report a case of an 11-year-old girl with systemic symptoms and vulvar ulcers of unknown etiology. Results: The patient's illness was consistent with previous reports that vulvar ulcers can occur without sexual transmission or a documented infectious cause. Conclusion: A lack of general knowledge regarding this entity may lead to its exclusion from the differential diagnosis of vulvar ulcers in this patient population. Aphthous ulcers should be strongly considered in any adolescent with vulvar ulcers.

2020 ◽  
Vol 12 (3) ◽  
pp. 231-235
Author(s):  
Carl Maximilian Thielmann ◽  
Wiebke Sondermann

Erythromelanosis follicularis faciei et colli, a rare condition of unknown etiology, was first described by Kitamura et al. from Japan in 1960. It is characterized by a triad consisting of well-demarcated erythema, hyperpigmentation, and follicular papules. We report the case of a 50-year-old Caucasian male, who had asymptomatic symmetrical facial lesions since the age of 42. His family history was unremarkable. Published erythromelanosis follicularis faciei et colli cases of the last 10 years are summarized in this report to demonstrate the variability and differences in the clinical presentation of this uncommon diagnosis.


2020 ◽  
Vol 54 (7) ◽  
pp. 650-655
Author(s):  
Ali Ahmet Arıkan ◽  
Fatih Avni Bayraktar ◽  
Emre Selçuk

Atherosclerotic true aneurysms of the superficial femoral artery (SFA) and profunda femoris artery (PFA) are rare and difficult to detect. The synchronous presence of SFA and PFA aneurysms is even rarer. Herein, we present a case with ipsilateral true SFA and PFA aneurysms diagnosed with rupture. A review of the international literature is made, and the diagnosis and treatment options of this rare condition are discussed. A 75-year-old male was admitted to our hospital with an aneurysm on the distal SFA and the ipsilateral PFA, as well as a hematoma around the PFA. It was difficult to determine the source of the rupture before surgery, even with proper imaging. Successful ligation of the PFA and an aneurysmectomy followed by a bypass grafting for the SFA were performed. An intraoperative examination revealed that the SFA aneurysm had ruptured. In elderly males with a history of ectasia or aneurysm on the aorta or peripheral arteries, a synchronous aneurysm on the SFA or the PFA should be suspected.


2014 ◽  
Vol 12 (4) ◽  
pp. 531
Author(s):  
Joaquim Custódio da Silva Junior ◽  
Helton Estrela Ramos

<p class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;"><em><span style="font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ansi-language: EN-US;" lang="EN-US">Thyrotoxic periodic paralysis (TPP) is a rare condition related to hyperthyroidism, with specific clinical and physiopathological features. In this article, we discuss a case report of a patient that develops TPP with no previous history of thyroid illness, highlighting semiological characteristics that can help Emergency physicians to suspect of this condition. Subsequently, we review the recent articles about TPP, with focus in the molecular basis of ion channelopathies and predisposing factors, and discuss the therapeutic approach at acute phase of TPP and prevention of crisis recurrence.</span></em></p>


2021 ◽  
Author(s):  
Lília Tereza Diniz Nunes ◽  
Flávia S. Silva ◽  
Karyme G. Aota ◽  
Maria Beatriz Miranda S. B. de Assis ◽  
João Fellipe B. Bento ◽  
...  

Context: Tolosa-Hunt Syndrome (STH) is a rare condition with unknown etiology, it affects both genders equally. It is manifested by inflammation of the cavernous sinus and involvement of some cranial nerves pairs. Case report: MSR, 39 years, male, diver in the mining zone, history of recurrent otitis with acute pain and gradual hearing loss that progressed. He was admitted to the General Hospital of Palmas with symptoms of retrorbital headache. After physical exams it was found an ophthalmoplegia with right amaurosis and ipsilateral pain. The neurological examination showed a right eye with loss of photomotor reflex and presence of consensual reflex and eyelid ptosis. After 38 days in hospital, a probable septic thrombosis of the cavernous sinus was found, antibiotic and corticosteroids therapy was initiated. The patient also reports significant improvement in headache and partially in vision, he is currently hospitalized with clinical care and antibiotic therapy, awaiting results of the image examination report. Conclusions: Painful ophthalmoplegia in most cases is not diagnosed as STH. The differential diagnosis for this pathology is most often through brain magnetic ressonance and the ICHD-3 beta diagnostic criteria, STH should be suspected, but it is still necessary to close the diagnosis by exclusion, due to the lack of a specific diagnosis.


2020 ◽  
Vol 15 (3) ◽  
pp. 144-153
Author(s):  
Hosam Al-Jehani ◽  
May Adel Alhamid ◽  
Yousef Alkhalaf ◽  
Faisal Alabbas

Free-floating thrombus (FFT) is a rare condition with unknown etiology as described by many case reports presented in previous literature. The patients usually present symptomatically while the other few patients remain asymptomatic and are usually discovered incidentally on computed tomography angiography (CTA). Most of the cases reported in the literature are of FFT in the internal carotid artery. We present a 59-year-old female as a case of FFT in the vertebral artery which was coincidently discovered on CTA in a patient initially presenting with an anterior circulation stroke. This case highlights the importance of early contrast-based vascular imaging in patients presenting with large vessel strokes that are cardioembolic in nature and the unique utilization of a direct aspiration first pass technique (ADAPT) for revascularization. Included herein an extensive review of the literature about the decision making in patients with FFT and a devised proposed practical approach to this entity.


2020 ◽  
Vol 4 (3) ◽  

Eagle’s Syndrome is a rare condition with unknown etiology that mainly affects female patients between the third and sixth decade of life. It was first described in 1937 by Dr. Watt W. Eagle, in a study carried out in a group of patients whose main symptom was cervicopharyngeal pain caused by elongation of the styloid process and/or calcification of the stylohyoid ligament [1]. The diagnosis of this pathology is based on the anamnesis and physical examination together with imaging exams of the patients. Cervicofacial pain, palpation of the styloid process in the tonsillar fossa and limitation in neck mobility are the most classic signs and symptoms of this disease [2]. Due to the nonspecific symptoms present in these patients, this disease is usually underdiagnosed and confused with temporomandibular disorders, cervical myalgias, and even being diagnosed as atypical trigeminal neuralgias [3]. For this reason, clinical examination and imaging exams, are indispensable for the correct diagnosis and evaluation of anatomical structures [3]. We present a case of a woman with a history of eagle syndrome which was diagnosed and treated at the Hospital clinico metropolitano El Carmen Santiago, Chile.


2019 ◽  
Vol 09 (01) ◽  
pp. e15-e22
Author(s):  
Ernesto Figueiró-Filho ◽  
Richard Horgan ◽  
Nidal Muhanna ◽  
Jacqueline Parrish ◽  
Jonathan Irish ◽  
...  

Objective To describe the clinical presentation and obstetrical outcomes of nonthyroid head and neck cancers (HNCs), and to review literature on this rare condition in pregnancy. Study Design Pregnant women with nonthyroid HNC were identified retrospectively from 1990 to 2017. Maternal, neonatal, pregnancy, and demographic data were collected. A review of the literature from January 1980 to May 2018 was performed. Results Over the 27-year time period, 16 women with history of nonthyroid HNC were identified (9 diagnosed during and 7 diagnosed before current pregnancy). The cases were analyzed in detail and the most updated review of management of each type of HNC was provided. Conclusions HNCs are rare with diagnosis and management challenges during pregnancy. In this series, the cases diagnosed and managed previously to pregnancy presented better perinatal outcomes than the cases presented during pregnancy. The maternal outcomes appeared similar for HNC diagnosed before or after pregnancy.


2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher B. Toomey ◽  
Andrew Gross ◽  
Jeffrey Lee ◽  
Doran B. Spencer

Intraocular coccidioidomycosis is a rare condition, with the most commonly reported presentation being an idiopathic iritis in patients who live in or have traveled thorough endemic areas. A paucity of reports exists describing the chorioretinal manifestations of coccidioidomycosis. Here we report a case of unilateral coccidioidal chorioretinitis and meningoencephalitis in an AIDS patient that led to near complete unilateral loss of vision. A 48-year-old Hispanic female with poorly controlled HIV/AIDS in southern California presented with a three-week history of headache, nausea, vomiting, right eye blurry vision, and a one-day history of subjective fever. Examination of the right eye revealed vitritis and several large chorioretinal lesions scattered throughout the periphery and macula with optic disc pallor. Serum coccidioidomycoses complement fixation (CF) was positive (titers of 1 : 256). Neuroimaging revealed a new area of enhancement in the left anterior frontal lobe consistent with meningoencephalitis. The patient was treated with intravenous fluconazole and intravitreal voriconazole with resolution of systemic symptoms and vitritis but persistence of unilateral, severe chorioretinal scarring and vision loss. In conclusion, in spite of the rarity of intraocular coccidioidomycosis, one must carry a degree of suspicion for this vision- and life-threatening condition as a potential etiology of chorioretinitis in individuals with pertinent risk factors.


2021 ◽  
Vol 14 (2) ◽  
pp. e240378
Author(s):  
Oman Rai ◽  
Sanju Lama ◽  
Sanjay Wazir Pandita

We present an adolescent girl with a 1-day history of acute urinary retention and lower abdominal pain. She was admitted to the paediatric ward for ongoing treatment and investigations. Due to a myriad of factors including pain and anxiety, challenges posed included an incomplete initial abdominal and external genital examination. This case report highlights the importance of a focused history and performing an appropriate sensitive examination at the time of presentation. Furthermore, we explore the common causes of new onset urinary retention and unravel the case as it unfolds. We also highlight differential diagnoses (however, uncommon), which must be considered and not overlooked to avoid unnecessary investigations and to ensure timely management.


2014 ◽  
Vol 71 (3) ◽  
pp. 307-310 ◽  
Author(s):  
Olivera Levakov ◽  
Branislava Gajic

Introduction. Erosive pustular dermatosis of the scalp (EPDS) is a rare disorder of unknown etiology that usually occurs in the elderly and is characterized by multiple pustules, erosions and crusts that appear on the scalp leading to scarring alopecia. The histopathology and laboratory tests are not specific which is the reason that EPDS is a frequently misdiagnosed condition. Case report. We presented two patients with EPDS. The first patient had the known history of local trauma, both patients had chronic recidivant process, classic clinical presentations, and nonspecific histological findings. Each patient had prompt therapeutical response to potent topical steroids. Conclusion. The diagnosis of EPDS can be made if a condition fulfills the following criteria: atrophic or actinic damaged skin, clinical association of erosions, pustules, scales and crusts, no specific histopathology, no infectious agent found responsible for the condition, and chronic course leading to scarring alopecia, and prompt response to the treatment with topical steroids. The history of chemical or physical trauma is often present.


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