scholarly journals An Atypical Presentation of Pemphigus Vegetans in the Umbilicus

2020 ◽  
Vol 4 (5) ◽  
pp. 452-455
Author(s):  
Antonio Jimenez ◽  
Paige Hoyer ◽  
Michael Wilkerson
Keyword(s):  
African American Woman ◽  
American Woman ◽  
Atypical Presentation ◽  
Treatment Resistant ◽  
Oral Ulcers ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease ◽  
Mucous Membranes ◽  
Pemphigus Vegetans ◽  
Desmoglein 3

Pemphigus is a chronic, autoimmune bullous disease that affects the skin and mucous membranes. Pemphigus vegetans is a rare variant of pemphigus and presents as oral ulcerations with associated verrucous lesions in intertriginous or flexural areas. A 38-year-old African American woman presented to the clinic with a chief complaint of oral ulcers. She carried a diagnosis of Behcet’s disease and was referred by rheumatology for evaluation of treatment-resistant mucosal ulcerations. At the time of her dermatology visit, she also reported an enlarging umbilical mass that had been present for several months.  Further examination of the umbilical lesion identified an exophytic, vegetative mass. Histologic assessment of the lesion identified acanthosis and acantholysis with dermal eosinophils consistent with pemphigus vegetans. A pemphigus antibody panel was done and resulted positive for IgG desmoglein-3 antibodies. The patient was treated with prednisone and rituximab with improvement of her lesions. We present an atypical presentation of pemphigus vegetans involving the umbilicus. This diagnosis should be considered in patients who present with oral erosions and concomitant vegetative lesions, regardless of location or prior diagnoses.

scholarly journals Citrobacter freundii sepsis in an immunosuppressed patient with pemphigus vulgaris

2018 ◽  
Vol 11 (1) ◽  
pp. e227091 ◽  
Author(s):  
Martina Ferranti ◽  
Giulia Tadiotto Cicogna ◽  
Andrea Sattin ◽  
Mauro Alaibac
Keyword(s):  
Immunosuppressive Agents ◽  
Pemphigus Vulgaris ◽  
Immunosuppressed Patient ◽  
Citrobacter Freundii ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease ◽  
Systemic Corticosteroids ◽  
Mucous Membranes ◽  
Current Therapies ◽  
Anti Cd20

Pemphigus vulgaris is an autoimmune bullous disease that involves the skin and mucous membranes. Current therapies aim to decrease antibody production by means of the use of systemic corticosteroids, immunosuppressive agents and, recently, rituximab, an anti-CD20 monoclonal antibody. However, the chronic immune suppression could entail complications, like infections and secondary malignancies. We describe a case of a patient with pemphigus who developed a sepsis due to Citrobacter freundii infection.

Bullous Scabies Simulating Pemphigoid

2011 ◽  
Vol 15 (1) ◽  
pp. 55-57 ◽  
Author(s):  
T. Roxana Stan ◽  
Stefano Piaserico ◽  
Matteo Bordignon ◽  
Roberto Salmaso ◽  
Edoardo Zattra ◽  
...  
Keyword(s):  
Skin Lesion ◽  
Bullous Pemphigoid ◽  
Steroid Treatment ◽  
Social Conditions ◽  
Direct Immunofluorescence ◽  
Benzyl Benzoate ◽  
Bullous Disease ◽  
Autoimmune Bullous Disease ◽  
Skin Specimen ◽  
Desmoglein 3

Background: Scabies is a contagious infestation affecting subjects of all ages, races, and social conditions. Objective: We report a case of a 79-year-old man who developed a bullous pemphigoid-like eruption. He presented to our unit 4 months after the onset of symptoms. An autoimmune bullous disease was suspected. Direct immunofluorescence on a skin specimen and anti-desmoglein 1, anti-desmoglein 3, and anti-bullous pemphigoid antigen 180 were negative. Surprisingly, the histology of a skin lesion demonstrated the presence of scabies, which was successfully treated with benzyl benzoate 20%. Conclusion: The diagnosis of bullous scabies should be considered for any bullous eruptions accompanied by papules and itching resistant to steroid treatment and with negative immunopathologic findings.

Merle’s travel: A Quest For Completeness In Paule Marshall’s The chosen place, the timeless people.

2019 ◽  
Vol 5 (4) ◽  
pp. 36-42
Author(s):  
Dr. K. Radah ◽  
G. Gayathri
Keyword(s):  
African American ◽  
Social Context ◽  
African American Women ◽  
African American Woman ◽  
American Woman ◽  
Community Level ◽  
Dominant Culture ◽  
True Self ◽  
American Women ◽  
Human Need

African American women have been silenced and kept ignorant by the dominant culture and it is the human need to create and maintain a true self in a social context. However, such an endeavor becomes an ordeal for those who are doubly oppressed, for those who are muted and mutilated physically and psychically through the diabolic crossfire of caste/race, sex and colonialism. This paper focuses on, an African American Woman, throughout her journey of life, seeking completeness in terms of family, society and community level.

Self-Reflective Insights on What I Have Learned in an Evolving Academic Career Model: Accounting Scholarship, Administration, and Diversity

2018 ◽  
Vol 33 (3) ◽  
pp. 5-16 ◽  
Author(s):  
Carolyn M. Callahan
Keyword(s):  
African American Woman ◽  
Academic Career ◽  
American Woman ◽  
Vantage Point ◽  
Business College ◽  
Personal Experiences ◽  
Career Model ◽  
Accounting Model ◽  
The Impact

ABSTRACT In this paper, I offer personal insights based on my experiences (thus far) in an evolving academic accounting career model. While I value all aspects of an academic career responsibilities (teaching, research, and service), this narrative focuses primarily on the role of accounting scholarship and, broadly, the impact of diversity on the same. I offer these perspectives and personal experiences from the unique vantage point as an African American woman, focused first on contributing to top-tired accounting scholarship, and more recently on roles as an administrator of an accounting department and business college. While my academic journey is unique by objective measures (often dubbed “trailblazing” by others), I offer suggestions that may be useful to any academic who is dedicated to success in our field. Given the evolving accounting model and challenges ahead, my overriding goal remains to encourage junior accounting colleagues to persevere, as an accounting academic career is richly rewarding.

Extra-nodal Rosai-Dorfman Disease Confined to Breast

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S41-S42
Author(s):  
E Ozluk ◽  
R Shackelford
Keyword(s):  
Plasma Cells ◽  
African American Woman ◽  
American Woman ◽  
Lymphocytic Infiltration ◽  
Needle Aspiration ◽  
Left Breast ◽  
Unknown Etiology ◽  
Diagnostic Challenge ◽  
Ductal Cells ◽  
Rosai Dorfman Disease

Abstract Introduction/Objective First described by Rosai and Dorfman in 1969, Rosai-Dorfman Disease (RDD) is an uncommon, idiopathic, reactive lymph node process with an unknown etiology. It may involve extra-nodal organs including the skin, bone, soft tissue, and eyes. However, breast involvement is rare and RDD confined to breast without nodal involvement is extremely uncommon. Methods Here we present a case of RDD confined to breast. The patient was a 51-year-old African American woman who was found to have an irregular, solid left breast mass on routine mammogram, which had speculated irregular margins and measured of 37.0 x 32.0 x 32.0 mm. She did not have any symptoms, nor any palpable lymph nodes. The clinician stated that the lesion was highly suspicious for a breast malignancy and requested a fine needle aspiration (FNA) of the mass, followed by total excision. Results An FNA was interpreted as atypical histiocytic cells in a mixed lymphoid background. Histopathologic examination revealed an ill-defined mass with sheets of histiocytes, plasma cells, and a mixed lymphocytic population, with occasional germinal centers. Some of the histiocytes were spindle shaped and associated with storiform collagen deposition. The histiocytes had single and multiple nuclei and exhibited occasional emperipolesis. Immunohistochemical staining with S100 diffusely highlighted the histiocytes, whereas CD1a was negative. CD3 and CD20 immunostains were positive for mixed-type lymphocytic infiltration. Cytokeratin staining was performed and reassuringly stained only the benign ductal cells. A diagnosis of RDD of the breast was made, based on these histopathologic findings. Conclusion We report an example of an extra-nodal RDD involving the mammary gland that was initially suspected to be breast carcinoma. RDD may still be a diagnostic challenge, especially in a patient with suspected carcinoma. It is the pathologist’s role to lead the clinician to the proper diagnosis and render a correct histopathologic diagnosis.

scholarly journals False elevations in urinary metanephrines: under-recognised pitfall with 24-hour urinary volume collection

2021 ◽  
Vol 14 (2) ◽  
pp. e241147
Author(s):  
Terry Shin ◽  
Thanh Duc Hoang ◽  
Mary Thomas Plunkett ◽  
Mohamed K M Shakir
Keyword(s):  
African American Woman ◽  
Urine Volume ◽  
American Woman ◽  
Secondary Hypertension ◽  
Reference Laboratory ◽  
Urine Collection ◽  
Urinary Volume ◽  
Normal Limits ◽  
Incorrect Diagnosis ◽  
Urinary Metanephrines

One pitfall in 24-hour urine collection is the input of incorrect urinary volume by the reference laboratory. This may lead to an incorrect diagnosis of pheochromocytoma or paraganglioma. A 48-year-old African-American woman was seen in the clinic for an elevated 24-hour urine metanephrine screen during workup for secondary hypertension. Urine volume was found to be incorrectly inputted by the lab as 9750 mL rather than 975 mL. The urinary metanephrines were then recalculated and the 24-hour urinary metanephrines resulted within normal limits. This case highlights this unique and potentially under-recognised error in testing with 24-hour urine volume collection.

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