scholarly journals Rare Presentation of Concomitant Alopecia Areata and Vitiligo in a Teenager

2021 ◽  
Vol 5 (3) ◽  
pp. 293-296
Author(s):  
Antonio Roberto Jimenez ◽  
Paige Hoyer ◽  
Lindy Ross
Keyword(s):  
Alopecia Areata ◽  
Skin Diseases ◽  
Cytotoxic T Cells ◽  
Concomitant Disease ◽  
Rare Presentation ◽  
Dermatology Clinic ◽  
Pulse Dose ◽  
Patient Reported ◽  
History Of ◽  
Hair Depigmentation

Introduction: Alopecia areata (AA) and vitiligo are two chronic, autoimmune skin diseases. While these two conditions are common, their co-existence is rare. Case Presentation: A 13-year-old Caucasian female presented to the dermatology clinic with a 1-2-month history of hair loss on her occipital scalp. The patient was diagnosed with AA and prescribed topical mometasone 1% lotion twice daily and pulse-dose prednisolone solution 12 mL 1 day per month for 3 months. At her 3-month follow-up, the patient reported new-onset hair depigmentation. On physical examination, the patient’s occipital scalp and right eyelash demonstrated a depigmented patch of hair, concerning for vitiligo. The patient was diagnosed with concomitant disease and topical tofacitinib was added to her treatment regimen. Discussion/Conclusion: The colocalization of AA and vitiligo is rare, and the presentation suggests an underlying pathogenic link between the two skin diseases. While the definitive immunologic pathway remains unknown, researchers have narrowed down inflammatory markers involved in the development of both conditions, including CD8+ cytotoxic T-cells, interferon gamma (IFN-ɣ), and IFN-ɣ-induced chemokines. We present a 13-year-old female patient who presented to the clinic with scalp alopecia and later developed overlying scalp and eyelash vitiligo. The rare nature of the patient’s presentation makes concomitant disease a therapeutic challenge and can impose significant psychological distress to a pediatric patient. 

scholarly journals P.2.04 Occupational skin disease in a tertiary occupational dermatologic clinic: a retrospective analysis from 2010 to 2017

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A88.2-A88
Author(s):  
Heng-Hao Chang ◽  
Bour-Jr Wang ◽  
How-Ran Guo ◽  
I-Ru Lee
Keyword(s):  
Contact Dermatitis ◽  
Patch Testing ◽  
Skin Disease ◽  
Skin Diseases ◽  
Potassium Dichromate ◽  
University Hospital ◽  
Occupational Skin Disease ◽  
Duration Of Symptoms ◽  
Dermatology Clinic ◽  
Patient Reported

BackgroundOccupational skin disease (OSD) is one of the most common occupational disorders in Taiwan. As reporting OSD was not compulsory, there was limited information on the exact causes and patient characteristics. The objective of this study was to investigate the causes and common allergens among OSD patients in Taiwan.MethodsWe recruited patients from Occupational Dermatology Clinic in National Cheng Kung University Hospital, a tertiary referral center in Tainan city, between 1 January 2010 and 31 July 2017. Patch testing with European baseline series, additional occupation-oriented series, and personal material exposed at work or during daily life was carried out if the patients were suspected of allergic skin diseases.ResultsAmong the 273 patients who received patch testing, 51 (18.7%) patients had a final diagnosis of OSD. 82.4% of the 51 patients were diagnosed with allergic contact dermatitis (ACD), 11.8% with irritant contact dermatitis (ICD), while the rest 5.9% with both. Patient reported 3.0 years of skin problem prior to the clinic visit. The vast majority of patients suffered from hand eczema. Epoxy resin workers, food workers, hairdressers and beauty salon beauticians were the most common occupations related to OSD. The most important allergens were nickel, fragrance mix I, potassium dichromate and paraben mix. Around half of the patients showed allergic reaction to their personal material.DiscussionAs worker compensation statistics may not accurately estimate the characteristics of OSD patients, our study was crucial to identify the high-risk groups as well as the common allergens related to their work. Although the results might not represent the proportion of patients of OSD in other clinic, drawing information from patch testing may reflect those patients of severer or longer duration of symptoms. Future occupational measures should be taken on these industries for the detection and prevention of OSD.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Indian Dermoscopic Study of One Thirty Eight Cases of Alopecia Areata

2018 ◽  
Vol 3 (02) ◽  
Author(s):  
Rahul Kumar Sharma, Divya Sharma, Rajendra Kumar Sharma
Keyword(s):  
Alopecia Areata ◽  
Smart Phone ◽  
Cotton Wool ◽  
Exclusion Criteria ◽  
Dermatology Clinic ◽  
Exclamation Mark ◽  
Single Feature ◽  
Males And Females ◽  
Vellus Hairs ◽  
Difficult Cases

Alopecia areata (AA) is a type of non-scarring alopecia first described by Cornelius Celsus, characterized by hair loss without any clinical inflammatory signs and affecting both males and females equally. The activity of AA is by the presence of black dots, broken hair, and tapering, furthermore black dots and yellow dots are equated to severity of AA. Aim - To study dermoscopic features of untreated cases of alopecia areata. Study subjects-All the patients who attended the dermatology clinic from March 2015 to March 2017 with the clinical diagnosis of alopecia areata and who fulfilled the inclusion and exclusion criteria. Study period - Two year (from March 2015 to March 2017). Methodology - All the patients who attended the dermatology clinic from March 2015 to March 2017 with the diagnosis of alopecia areata and who fulfilled the inclusion and exclusion criteria were recruited for the study. Trichoscopy was performed with DL4 dermatoscope. The images were further magnified with smart phone. Results - We got various dermoscopic signs in different combinations in our study. Yellow dots were seen in 10 cases, White dots in cotton wool pattern were seen in 3 cases, Black dots were seen in 25 cases, Dermoscopic coudability sign was demonstrated in 38 cases, Pigtail hairs were present in 2 cases, five cases showed short vellus hairs, Short broken hairs were found in 18 cases, Exclamation mark hairs were very common and were detected in 131 patients out of 138. Discussion - Single feature is not leading to the diagnosis so we should use combination of features which will help in difficult cases like AA incognito. Dermatoscope is an indispensible valuable tool in trichology practice which helps in prognosticating and making early diagnosis of AA. It also helps to differentiate it from trichotillomania and other causes of alopecia. In our study the incidence of AA was almost similar in both sexes. Our study revealed that exclamation mark hair is very common and sensitive dermoscopic marker of AA.

Clinical Characteristics of Patients Diagnosed with Strongyloidiasis in a United States Urban Outpatient Dermatology Department: A Case Series

2017 ◽  
Vol 1 (3) ◽  
pp. 156-160
Author(s):  
Jacqueline Watchmaker ◽  
Sean Legler ◽  
Dianne De Leon ◽  
Vanessa Pascoe ◽  
Robert Stavert
Keyword(s):  
United States ◽  
Case Series ◽  
The United States ◽  
Screening Tools ◽  
Dermatology Department ◽  
Cutaneous Manifestations ◽  
Serologic Testing ◽  
Patient Reported ◽  
History Of ◽  
Endemic Areas

Background: Although considered a tropical disease, strongyloidiasis may be encountered in non-endemic regions, primarily amongst immigrants and travelers from endemic areas.  Chronic strongyloides infection may be under-detected owing to its non-specific cutaneous presentation and the low sensitivity of commonly used screening tools. Methods: 18 consecutive patients with serologic evidence of strongyloides infestation who presented to a single urban, academic dermatology clinic between September 2013 and October 2016 were retrospectively included.  Patient age, sex, country of origin, strongyloides serology titer, absolute eosinophil count, presenting cutaneous manifestations, and patient reported subjective outcome of pruritus after treatment were obtained via chart review.  Results: Of the 18 patients, all had non-specific pruritic dermatoses, 36% had documented eosinophila and none were originally from the United States. A majority reported subjective improvement in their symptoms after treatment. Conclusion:  Strongyloides infection and serologic testing should be considered in patients living in non-endemic regions presenting with pruritic dermatoses and with a history of exposure to an endemic area.Key Points:Chronic strongyloidiasis can be encountered in non-endemic areas and clinical manifestations are variableEosinophilia was not a reliable indicator of chronic infection in this case series Dermatologists should consider serologic testing for strongyloidiasis in patients with a history of exposure and unexplained pruritus

Patients With a History of Oronasal Fistula Repair Exhibit Lower Oral Health Measured With Patient-Centric Outcomes Measures

2020 ◽  
pp. 105566562098133
Author(s):  
Alyssa Fritz ◽  
Diana S. Jodeh ◽  
Fatima Qamar ◽  
James J. Cray ◽  
S. Alex Rottgers
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Cleft Palate ◽  
Fistula Repair ◽  
Old Patients ◽  
Oronasal Fistula ◽  
Patient Reported ◽  
History Of ◽  
The Impact

Introduction: Oronasal fistulae following palatoplasty may affect patients’ quality of life by impacting their ability to eat, speak, and maintain oral hygiene. We aimed to quantify the impact of previous oronasal fistula repair on patients’ quality of life using patient-reported outcome psychometric tools. Methods: A cross-sectional study of 8- to 9-year-old patients with cleft palate and/or lip was completed. Patients who had a cleft team clinic between September 2018 and August 2019 were recruited. Participants were divided into 2 groups (no fistula, prior fistula repair). Differences in the individual CLEFT-Q and Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) Oral Health scores between the 2 groups were evaluated using a multivariate analysis controlling for Veau classification and syndromic diagnosis. Results: Sixty patients with a history of cleft palate were included. Forty-two (70%) patients had an associated cleft lip. Thirty-two (53.3%) patients had no history of fistula and 28 (46.7%) patients had undergone a fistula repair. CLEFT-Q Dental, Jaw, and Speech Function were all higher in patients without a history of a fistula repair; however, none of these differences were statistically significant. The COHIP-SF 19 Oral Health score demonstrated a significantly lower score in the fistula group, indicating poorer oral health ( P = .05). Conclusions: One would expect that successful repair of a fistula would result in improved function and patient satisfaction, but the consistent trend toward lower CLEFT-Q scores and significantly increased COHIP-SF 19 Oral Health scores in our study group suggests that residual effects linger and that the morbidity of a fistula may not be completely treated with a secondary correction.

Prolapsed Nasal Polyp Causing Acute Airway Obstruction: An Exceptional Presentation

ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Krupa R. Patel ◽  
Ashton E. Lehmann ◽  
Aria Jafari ◽  
Daniel L. Faden
Keyword(s):  
Airway Obstruction ◽  
Nasal Polyp ◽  
Nasal Polyposis ◽  
Upper Airway ◽  
Rare Presentation ◽  
First Case ◽  
Acute Airway Obstruction ◽  
History Of ◽  
Sinonasal Symptoms ◽  
Or History

Although nasal polyposis is a common clinical entity, there is limited literature describing the rare presentation of sudden prolapse of a massive nasal polyp resulting in an airway emergency in an adult. We present the first case report to our knowledge of a patient without any preceding sinonasal symptoms or history of anticoagulation who experienced acute upper airway obstruction due to sudden hemorrhage and prolapse of a large nasal polyp. Based on our experience treating this patient, we discuss special considerations in all phases of care to ensure safe and effective management of such an exceptional clinical scenario.

scholarly journals Depth Electrode Guided Anterior Insulectomy: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Mauricio Mandel ◽  
Layton Lamsam ◽  
Pue Farooque ◽  
Dennis Spencer ◽  
Eyiyemisi Damisah
Keyword(s):  
Right Hemisphere ◽  
Preoperative Evaluation ◽  
Epileptiform Activity ◽  
Neurological Deficits ◽  
Depth Electrodes ◽  
Depth Electrode ◽  
Patient Reported ◽  
Frontal Operculum ◽  
History Of ◽  
Electroencephalogram Eeg

Abstract The insula is well established as an epileptogenic area.1 Insular epilepsy surgery demands precise anatomic knowledge2-4 and tailored removal of the epileptic zone with careful neuromonitoring.5 We present an operative video illustrating an intracranial electroencephalogram (EEG) depth electrode guided anterior insulectomy.  We report a 17-yr-old right-handed woman with a 4-yr history of medically refractory epilepsy. The patient reported daily nocturnal ictal vocalization preceded by an indescribable feeling. Preoperative evaluation was suggestive of a right frontal-temporal onset, but the noninvasive results were discordant. She underwent a combined intracranial EEG study with a frontal-parietal grid, with strips and depth electrodes covering the entire right hemisphere. Epileptiform activity was observed in contact 6 of the anterior insula electrode. The patient consented to the procedure and to the publication of her images.  A right anterior insulectomy was performed. First, a portion of the frontal operculum was resected and neuronavigation was used for the initial insula localization. However, due to unreliable neuronavigation (ie, brain shift), the medial and anterior borders of the insular resection were guided by the depth electrode reference. The patient was discharged 3 d after surgery with no neurological deficits and remains seizure free.  We demonstrate that depth electrode guided insular surgery is a safe and precise technique, leading to an optimal outcome.

scholarly journals Health outcomes of sexual and gender minorities after cancer: a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Mandi L. Pratt-Chapman ◽  
Ash B. Alpert ◽  
Daniel A. Castillo
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Cancer Survivors ◽  
Cochrane Central Register ◽  
Transgender Persons ◽  
Patient Reported ◽  
History Of ◽  
Reported Health ◽  
And Gender ◽  
After Cancer

Abstract Purpose Cancer research on sexual and gender minority (SGM) populations is gaining momentum. The purpose of this systematic review was to examine what is currently known in the research literature regarding patient-reported health outcomes after cancer treatment among SGM populations. Methods In March 2021, a medical librarian conducted a systematic keyword search on PubMed, Embase, Scopus, Web of Science, PsycINFO, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials. The primary inclusion criterion was assessment of at least one physical, psychosocial, emotional, or functional patient-reported health outcome related to the impacts of cancer diagnosis and/or treatment. Articles that met inclusion criteria were reviewed in their entirety, charted in a Word Table, and assessed for quality. Quality considerations included study design, sampling approach, diversity of sample, measures used, and analytic procedures. Studies were synthesized based on type of cancer study participants experienced. Results Sixty-four studies were included in the final analysis: most were quantitative, secondary analyses or cross-sectional studies with convenience samples, and focused on people with a history of breast or prostate cancer. Differences between sexual minority men and women in terms of coping and resilience were noted. Few studies reported on experiences of transgender persons and none reported on experiences of intersex persons. Conclusions A growing literature describes the patient-reported health outcomes of SGM people with a history of cancer. This study summarizes important between-group differences among SGM and heterosexual, cisgender counterparts that are critical for clinicians to consider when providing care. Implications for cancer survivors Sexual orientation and gender identity are relevant to cancer survivors’ health outcomes. Subgroups of SGM people have differential experiences and outcomes related to cancer and its impacts.

scholarly journals Sialendoscopy With Intraductal Steroid Irrigation in Patients With Sialadenitis Without Sialoliths

2019 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
Saudamini J. Lele ◽  
Mickie Hamiter ◽  
Torrey Louise Fourrier ◽  
Cherie-Ann Nathan
Keyword(s):  
Treatment Option ◽  
Case Series ◽  
Complete Response ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Effective Treatment Option ◽  
Patient Reported ◽  
History Of ◽  
The Mean

Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.

Sign in / Sign up

Export Citation Format

Share Document