scholarly journals Annular lichen planus, a rare variant of lichen planus

2020 ◽  
Vol 4 (10) ◽  
pp. 642-646
Author(s):  
I.I. Zakhur ◽  
◽  
S.V. Koshkin ◽  
V.A. Bobro ◽  
◽  
...  

The paper reviews current data on lichen ruber planus, a disease characterized by multifactorial pathogenesis, polymorphic clinical symptoms, severe long recurrent course, and a significant resistance to treatment. In the last decades, a substantial growth in the prevalence of this dermatosis is observed. Moreover, the rate of atypical cases also increases. The most common symptoms at disease onset are a generalized rash, severe itching, and malaise. Many patients present with acute clinical signs. Patients with the different forms of the disease (in particular, those with oral lichen planus) report on the significant reduction in the quality of life. The authors describe the specificity of clinical polymorphism, the variability of clinical manifestations and HLA system in annular lichen planus. The aim of this paper is to summarize currently available data considering the diversity of clinical variants which are required for the understanding of the pathogenesis to improve the diagnosis in difficult cases and to control its course. The authors also address a case study of annular lichen planus in a 63-year-old woman. KEYWORDS: lichen ruber planus, dermatosis, histopathology, HLA system. FOR CITATION: Zakhur I.I., Koshkin S.V., Bobro V.A. Annular lichen planus, a rare variant of lichen planus. Russian Medical Inquiry. 2020;4(10):642–646. DOI: 10.32364/2587-6821-2020-4-10-642-646.

2003 ◽  
Vol 11 (1) ◽  
pp. 21-24 ◽  
Author(s):  
Branko Dozic ◽  
Dubravka Cvetkovic ◽  
Marko Dozic ◽  
Ljiljana Bumbasirevic

A 51-year-old female patient was admitted to the Neurological clinic because of motor seizures with myoclonus of the right hand and right side of the face. The results of initial brain CT scan, chest X rays, EEG ultrasonography of the great blood vessels and laboratory tests made in another hospital were unremarkable. Because of repeated partial seizures transient aphasic disturbances, urinary sphincter disturbances and periodic low-grade fever the patient was transferred to our hospital four months after the disease onset. Laboratory tests and NMR suggested a nonspecific disseminated viral encephalitis. After administration of Endoxan she was ambulatory for several weeks and then became increasingly exhausted confused, febrile, dyspneic, tachypneic and developed a shock status with hepatorenal insufficiency. She died after 7 months of disease duration. Postmortem examination revealed intravascular collections of large atypical lymphoid cells of B cell line. Blood vessels changed in this way were common in the brain and rare in other organs including skin, lungs, heart, liver spleen and digestive system. They were not found in the lymph nodes and bone marrow. A biopsy was not done because of absence of symptomatic and swollen tissues. However, correlation of clinical feature and postmortem findings shows that absence of clinical manifestations in an organ does not mean lack of microscopic pathological changes and biopsy should be done regardless of absence of clinical signs. This case shows that intravascular lymphoma may mimic vasculitis or disseminated nonspecific viral encephalitis.


2020 ◽  
Author(s):  
Wenjun Du ◽  
Jinhong Yu ◽  
Hui Wang ◽  
Xiaoguo Zhang ◽  
Shouwei Zhang ◽  
...  

Abstract Aims & Background: The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.Methods: Retrospectively, two research centers’ case series of 67 consecutive hospitalized cases including 14 children cases with COVID-19 between 23 Jan 2020 to 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.Results: Most cases in children were mild(21.4%) and conventional cases(78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough(21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults(p=0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils counts did in children compared with adults(p=0.00).There was an elevated level of LDH(p=0.01) and a lower level of CRP(p=0.00)and IL-6(p=0.01) in children compared with adults. There were 8 (57.1%)asymptomatic cases and 6 (42.9%)symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients(p=0.03). Even among asymptomatic patients, 5(62.5%)cases had pneumonia including 3 (60%) cases with bilateral pneumonia, which was not different compared with that of asymptomatic cases(p=0.58, p=0.74).Conclusions: The clinical symptoms of children are mild, and the positive indicators of laboratory tests are rare, which may easily cause clinical misdiagnoses.


2020 ◽  
Vol 4 (10) ◽  
pp. 617-624
Author(s):  
O.V. Parygina ◽  
◽  
I.O. Smirnova ◽  
M.V. Oganesyan ◽  
Y.G. Petunova ◽  
...  

Lichenoid vulvar dermatoses are a heterogeneous group of diseases characterized by a number of overlapping signs and/or morphological features. Clinical similarity is accounted for by the appearance of small discrete papules with closely adjacent superficial squamae. The prototype of lichenoid dermatoses is lichen ruber planus. Histologically, lichenoid pattern is characterized by basal epithelial cell damage and a band-like infiltrate in the upper dermis. The International Society on Vulvovaginal Diseases categorizes lichen ruber planus and early lichen sclerosus as dermatoses with this histological pattern. Some authors also classify plasma cell (Zoon) vulvitis as lichenoid vulvar dermatoses. The cause of diagnostic errors lies in the similarity of the clinical and histological presentations of lichenoid vulvar dermatoses. Dermatoscopy should be considered as an additional diagnostic test. Only few studies address the key dermatoscopic signs of vulvar dermatoses. Histological study is important for the differential diagnosis. However, at some stages of disease evolution, vulvar dermatoses can have an overlapping histological pattern. This paper summarizes the data on the clinical, histological, and dermatoscopic presentation of the most common lichenoid vulvar dermatoses, i.e., lichen planus, lichen sclerosus, lichen simplex chronicus, and plasma cell vulvitis. KEYWORDS: lichenoid dermatoses, vulvar dermatoses, lichen sclerosus, lichen planus, lichen simplex chronicus, plasma cell vulvitis, Zoon vulvitis, dermoscopy. FOR CITATION: Parygina O.V., Smirnova I.O., Oganesyan M.V. et al. Lichenoid vulvar dermatoses: clinical presentation, morphology, and dermatoscopic signs. Russian Medical Inquiry. 2020;4(10):617–624. DOI: 10.32364/2587-6821-2020-4-10-617-624.


2021 ◽  
Vol 2 (6) ◽  
pp. 46-52
Author(s):  
Irina K. Lutskaya ◽  
◽  
Olga G. Zinovenko ◽  
Irina O. Beloivanenk ◽  
◽  
...  

The manifestation of skin diseases in the oral cavity can be detected by doctors of any profile during the interview and examination of the patient. Often, the diagnosis is carried out by a dentist. A thorough diagnostic search allows you to determine the main clinical manifestations and treatment tactics. The dentist independently prescribes local therapy. A complex general effect is recommended by a dermatologist. Severe cases require inpatient treatment. A correct diagnosis and adequate medical measures improve the general condition and the local clinical picture, as well as contribute to a stable remission of the disease.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243347
Author(s):  
Yujuan Han ◽  
Zujin Luo ◽  
Wenliang Zhai ◽  
Yue Zheng ◽  
Huan Liu ◽  
...  

The current study investigated the clinical manifestations and outcomes of different age groups of patients with overseas imported COVID-19. In total, 53 COVID-19 patients admitted to the designated Beijing Xiaotangshan Hospital between March 16 and April 15 of 2020 were included. Based on the percentage of disease aggravation during hospital stay according to CT, the patients were divided into two groups: ≤40 years (group A; n = 41) and >40 years (group B; n = 12). The demographic data, epidemiological history, disease courses, potential complications, clinical symptoms, lab indices, chest CT outcomes, treatment protocols and turnovers of the two groups were compared. According to clinical typing, compared with group A, group B had a significantly greater proportion of the common type of COVID-19 (P<0.05) and greater comorbidity of type 2 diabetes (P<0.001). The two groups presented significantly different lab indices. Group B showed significantly more frequent CT abnormalities, with greater proportions of multiple lesions and bilateral lung involvement (P<0.05). During hospitalization, group B had a greater proportion of disease aggravation according to CT (P<0.01). Compared with group A, group B received a significantly greater proportion of antiviral therapy and presented a significantly greater occurrence of adverse drug reactions (P<0.05). The two groups did not significantly differ in time from admission to clinical symptom improvement or from disease onset to negative outcomes according to nucleic acid testing, the appearance of IgG or the appearance of IgM. They also did not significantly differ in length of stay. Older imported COVID-19 patients, particularly those with type 2 diabetes, showed a broader pulmonary extent and faster development of the disease, more severe pathogenetic conditions and a greater risk of developing a critically severe type. Increased attention should be given to this population in clinical practice.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daryoosh Fahimi ◽  
Leila Khedmat ◽  
Azadeh Afshin ◽  
Zahra Noparast ◽  
Maryam Jafaripor ◽  
...  

Abstract Background Upper urinary tract infection (UTI) or pyelonephritis may increase the pathogenesis rate and risk of severe complications in children due to kidney atrophy. Objective A set of clinical symptoms, laboratory markers, and ultrasound findings were assessed to achieve the early diagnosis and prognosis of pyelonephritis in hospitalized pediatrics. Methods A cross-sectional study with 104 Iranian children (95 girls and 9 boys) aged 1 month to 12 years with acute pyelonephritis during 2012–2018 was conducted. The ultrasound examination of kidneys and urinary tract during hospitalization, the incidence of clinical symptoms, and laboratory markers in blood and urine were monitored to identify the best predictive factors of early diagnosis of this bacterial infection. Results Three-fourth of the patients had one of the four clinical symptoms of abdominal pain, constipation, dysuria, and vomiting, while others were asymptomatic. A much frequency of pyuria (88.46%), Escherichia coli in urine (92.31%), leukocytosis (81.73%), and high ESR (> 10 mm/h, 92.30%) and CRP (> 10 mg/L, 82.82%) was observed. The kidney and urinary tract ultrasonography only in 32.7% of children revealed findings in favor of pyelonephritis (cystitis, ureteral stones, and hydronephrosis). Conclusion There was a high frequency of clinical signs and laboratory markers associated with pyelonephritis. Ultrasound alone was not an efficient tool to track febrile UTI as most patients presented normal sonography.


2018 ◽  
Vol 9 ◽  
pp. 215265671877360 ◽  
Author(s):  
Urs C. Steiner ◽  
Lucas M. Bachmann ◽  
Micheal B. Soyka ◽  
Stephan Regenass ◽  
Lukas Steinegger ◽  
...  

Background Rhinitis is a very common disease with allergies being the most frequent causative factor. It can co-occur together with asthma and eczema in atopic as well as in nonatopic patients. Objectives To assess the prevalence of allergic sensitization within patient groups with rhinitis in consideration of the co-occurring disorders of asthma and eczema. Methods Students of the third year of medical school completed an anonymous questionnaire on age, gender, and clinical symptoms, such as seasonal rhinitis, perennial rhinitis, asthma, and eczema, and underwent an ImmunoCAP Rapid test. We calculated the prevalence of sensitization within subgroups of patients reporting allergic disorders, such as rhinitis, asthma, and eczema. Results Questionnaires and ImmunoCAP Rapid tests of 1513 medical students were analyzed. The participants’ self-reported presence of seasonal/perennial rhinitis, asthma, and eczema was compared to the presence of sensitization. Data of 1467 subjects could be analyzed. Seasonal rhinitis was the most common symptom, followed by eczema, asthma, and perennial rhinitis. The participants were differentiated into 16 subgroups according to the combined clinical manifestations of the different symptoms and association to sensitization within subgroups. The prevalence of sensitization ranged from 18% in subjects reporting only eczema without any other symptom to 100% in those reporting to have asthma, seasonal/perennial rhinitis, and eczema together. In subjects reporting no sign or symptom at all, the prevalence of sensitization was 19%. Seasonal rhinitis was the strongest single predictor for sensitization with the highest proportion of sensitized participants in all symptom combinations (67%–100%), followed by perennial rhinitis (31%–100%), asthma (30%–100%), and eczema (18%–100%). Conclusion Rhinitis most often is associated with allergen sensitization, and the probability of sensitization is substantially enhanced by co-occurrence of asthma. A careful assessment of clinical signs and symptoms is important and enables the selection of patients in whom targeted diagnostic analysis and therapy is appropriate. Trial registration: retrospectively registered by the Cantonal Ethics Committee Zurich on 22.01.2016; Nr: 08-2016.


2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Sakviseth Bin ◽  
Sethikar Im

Introduction. Syphilis is a tropical disease, caused by a spirochete Treponema pallidum, which can be transmitted transplacentally from untreated mothers to the fetus during any stages of pregnancy. Clinical manifestations of early congenital syphilis are variable and nonspecific. The diagnosis is based on the serology status of the mother, newborn clinical symptoms, and comparative serology titer between mother and newborn. Case Presentation. A late preterm female infant, appropriate for gestational age, was treated for severe early onset sepsis due to Enterobacter cloacae since day 2 of life. The coinfection with Treponema pallidum was suspected and confirmed at day 4 with clinical signs and a fourfold increase of rapid plasma reagin (RPR) compared to mother’s serology. Combined with meropenem and amikacin, Benzyl-Penicillin was used for 10 days, thereby resulting in a significant clinical and laboratory improvement. The girl was discharged at day 18 and brought for regular follow-ups for both growth milestone and syphilis serology. RPR decreased fourfold at the age of 1 month. Conclusion. Syphilis should not be overlooked. The vertical transmission is preventable by an on-time treatment of the infected mother, triggered by a proper antenatal screening at the right time. Congenital syphilis should be ruled out in any challenging neonatal sepsis. The diagnosis tools and treatments are easily accessible and inexpensive in our economical settings.


2021 ◽  
Vol 100 (1) ◽  
pp. 75-83
Author(s):  
E.A. Shevareva ◽  
◽  
D.O. Ivanov ◽  
O.V. Nevmerzhitskaia ◽  
L.A. Fedorova ◽  
...  

In recent decades, the problem of chorioamnionitis (CA) (or intra-amniotic infection) takes a leading place in modern obstetrics and perinatology. It is known that CA is one of the main risk factors for preterm birth and increases neonatal morbidity. Intraamniotic infection is a polyetiology condition. It is characterised by the variety of clinical manifestations absence of clearly association between the infection`s clinical signs in mother and infants injury. In present review we defined current data about chorioamnionitis, based on the last evidence of international scientific literature.


2019 ◽  
Vol 4 (3) ◽  

Introduction: Fascioliasis is a disease of the hepatobiliary system, caused by Fasciola spp that are increasing and threating of public health in the tropic areas, including of Central coastal of Vietnam. World Health Organisation estimates that at least 2.4 million people are infected in more than 70 countries worldwide, with several million at risk, and particularly, no continent is free from fascioliasis. This study carried out to evaluate several typical clinical and paracinical aspects in the pregnant women and children groups with fascioliasis. Methods: With the descriptive cross-sectional study design, and sample size in line with hospital based data. Results: the data post-analysis showed that total of 94 pregnant women and 212 child with gigantica fascioliasis were enrolled:- In the pregnant women group: the major clinical symptoms of epigastric and Chauffard Rivet triangle pain (95.74%), subshoulder muscle pain (97.87%), gastrointestinal disturbances as abdominal pain plus constipation (14.89%), loosed stool (22.34%), nausea and/or vomit (29.78%), mild fever (68%), allergic reaction with pruritis and urticaria (64.89%), mild anemia (4.26%), rare symptoms may be hepatomegaly (6.38%), chest pain, dyspnoea (43.62%), jaundice (2.13%); Laboratory parameters were positive ELISA test with Fasciola gigantica antigen (95.74%), hepatobiliary lesions by ultrasound (97.87%), majority in right liver (90.32%), eosinophilia is the predominant indicator (90.42%), In the children group: the clinical manifestations included of epigastric and Chauffard-Rivet area pain (94.34%), flatuence, nausea and intermittent vomiting (76.41%), digestive disoders (40.57%), allergy (30.66%), fatigue plus weight loss (12.74%); laboratory findings included of hepatobiliary lesions by US (100%), positive ELISA with Fasciola gigantica antigen (96.70%), eosinophil of 93.39% and 1.90% positive copro-examination with Fasciolae eggs. Conclusions: In pregnant women, symptoms are indistinguishable from hepatobiliary, digestive tract diseases or overlap with gestation terrains, and clinical signs of paediatric fascioliasis may mimic a wide spectrum of hepatobiliary disorders laboratory parameters and imaging diagnostics, especially in FasELISA, hypereosinophilia and liver lesions by ultrasound were very useful in positive diagnosis.


Sign in / Sign up

Export Citation Format

Share Document