scholarly journals Terapi necrobiotic xanthogranuloma dengan siklofosfamid-metilprednisolon

2016 ◽  
Vol 46 (2) ◽  
pp. 202
Author(s):  
Bayu Lesmono ◽  
Yussy Afriani Dewi ◽  
Sinta Sari Ratunanda ◽  
Nur Akbar Aroeman

Latar belakang: Necrobiotic xanthogranuloma (NXG) merupakan suatu penyakit yang langka, kronis, dan progresif. NXG ditandai dengan lesi kulit ulseratif pada daerah indurasi, dan berwarna kuning, atau berupa nodul yang mengenai sel histiosit non Langerhans. Daerah predileksi tersering ialah pada wajah, orbita, dan ekstremitas. Etiologi belum diketahui, tetapi sering dikaitkan dengan monoclonal gammopathy. Gambaran histopatologi NXG yaitu ditemukan makrofag dan terdapat sel busa pada dermis, jaringan subkutan, nekrobiosis luas, sel datia Touton, dan folikel limfoid. Penderita memiliki lesi yang bersifat asimtomatik, parestesi, rasa terbakar, dan terkadang timbul rasa nyeri. Tata laksana NXG sampai saat ini masih sangat bervariasi. Tujuan: Memaparkan hasil penatalaksanaan dua pasien NXG. Laporan kasus: Dilaporkan pasien pertama, laki-laki 44 tahun dengan lesi pada kedua pipi dan dahi sejak 5 bulan sebelumnya. Terapi diberikan metilprednisolon dengan dosis 0,8 mg/kgBB tappering off selama 1 bulan dengan hasil perbaikan. Pasien kedua, wanita 29 tahun dengan lesi pada kedua pipi dan telinga sejak 5 bulan sebelumnya. Terapi diberikan siklofosfamid 750 mg/m2 per 3 minggu dengan hasil membaik. Metode: Pencarian dilakukan melalui PubMed dan Dermatol. Setelah menyaring judul dan abstrak yang sesuai dengan kriteria inklusi dan eksklusi, didapatkan lima artikel utuh. Kemudian, tiga artikel terpilih untuk ditelaah secara konsensus, meliputi kesahihan (validity), kepentingan (importancy), dan aplikabilitas (applicability) pada pasien necrobiotic xanthogranuloma. Hasil: Telaah artikel-artikel tersebut menunjukkan bahwa semua artikel memiliki karakteristik yang serupa dalam hal kesahihan (validity), hasil atau kesimpulannya. Walau demikian, ada beberapa kekuatan dan kelemahan pada masing-masing artikel. Kesimpulan: Penatalaksanaan NXG masih diperlukan penelitian lebih lanjut dengan jumlah sampel yang banyak untuk mengetahui keefektifitasan penatalaksanaan NXG.Kata kunci: Siklofosfamid, metilprednisolon, necrobiotic xanthogranulomaABSTRACT Background: Necrobiotic Xanthogranuloma (NXG) is a rare, chronic, and progressive disease that provokes skin lesions, such as damage of the histiocytes of non-Langerhans cell, skin lesions (yellowish or noduled ulcerative lesions) in the induration skin. The most common predilection areas of this are on the face, orbital, and extremities. The etiology is still unknown, but sometimes associates with monoclonal gammopathy. NXG histopathologic contained macrophages and foam cells in the dermis, subcutaneous tissue, extensive necrobiosis, touton giant cells, and lymphoid follicles. Some patients who had lesions are asymptomatic, sometimes they will feel paresthesias, burning pain. Nowadays, this management is still vary widely. Objective: Sets forth the results of two patients NXG. Case: There were two patients. Patient number one, a 44-years-old man, with some lesions on both cheeks and forehead since 5 months ago. He was treated with methylprednisolon 0.8 mg/kg body weight, and tappered off for a month with improved results. Patient number two, a 29-years-old woman, with some lesions on both cheeks and ears since 5 months ago. She was treated with Cyclosphosphamide 750 mg/m2 with improved results within three weeks. Method: Searching for literature was conducted in PubMed and Dermatol. After screening titles and abstracts with inclusion and exclusion criteria, five articles were available as full texts. Three articles were selected to be reviewed for their validity, importancy and applicability in patient with necrobiotic xanthogranuloma. Results: The review showed that all those articles had a similar characteristic in validity, result, and conclusion. Nevertheless, each articles had its own strong points and weaknesses. Conclusion: NXG treatment still required further research by the number of samples that much to find out the efficiency management NXG.Keywords: Cyclophosphamide, methylprednisolon, necrobiotic xanthogranuloma

2016 ◽  
Vol 36 (5) ◽  
pp. 383-388 ◽  
Author(s):  
Rayane C. Pupin ◽  
Gleice K.A. Melo ◽  
Rubiane F. Heckler ◽  
Tatiane C. Faccin ◽  
Camila C.B.F. Ítavo ◽  
...  

Abstract: This study was designed to assess the influence of genetic resistance against brachiaria poisoning in sheep. Two groups of sheep, one identified as susceptible (formed by two ewes and one ram) and the other as resistant against brachiaria poisoning (formed by three ewes and one ram) were selected. Sheep considered susceptible were those that presented clinical signs of brachiaria poisoning at any time of their life; resistant sheep were those that even raised on Brachiaria spp. pastures, did not developed any sign of the poisoning during their life. The offspring of the two flocks (15 lambs from the sensitive flock and 9 lambs from the resistant flock) were placed into brachiaria pasture (initially Brachiaria decumbens and B. brizantha,and only B. decumbens after weaning) and followed up during two years (2013-2014). The determination of protodioscin levels in B. decumbens pasture was performed only in 2014 and revealed significant amounts of the toxic principle. Eleven lambs of the susceptible group were affected to some degree of brachiaria poisoning and six died; no lamb of the resistant group was affected. Clinical signs consisted of varying degrees of subcutaneous edema of the face and, erythema and loss of hair of the ears, crusts on the skin of ears, around the eyes and on planum nasale, scar deformation of the ears, and bilateral ocular discharge; affected lambs also sought for shadowy shelters and they were poor doers. Several sheep recovered from the condition and then relapsed. Necropsy findings in six lambs included pale mucous membranes, emaciation, dermatitis, scar deformation of the ears, large yellow livers with marked lobular pattern, and moderate infestation by Haemonchus contortus. Histologically the liver lesions were similar in all necropsied lambs but with varying degrees of severity; they were consistent with brachiaria poisoning and included architectural disruption of hepatocellular trabecula, clusters of foamy macrophages occasionally forming multinucleated giant cells, swollen and vacuolated hepatocytes, crystals or negative images of crystals in the biliary system, bilestasis, bile duct proliferation and lymphoplasmacytic infiltrate in portal triads. The skin lesions were those of photodermatitis and included epidermal necrosis, hyperkeratosis and dermal neutrophilic infiltrate. The results of this study allow to conclude that there is a genetic related resistance to brachiaria poisoning in sheep since the progeny of resistant sheep did not manifest the poisoning. The use of resistant flocks in brachiaria pastures is suggested as a valuable option for the prevention of brachiaria poisoning in sheep.


2021 ◽  
Vol 55 (5) ◽  
Author(s):  
Blythe N. Ke ◽  
Erika Belinda T. Chen ◽  
Kevin Jer V. David ◽  
Sarah Faye V. Obbus ◽  
Val Constantine S. Cua ◽  
...  

Introduction. Non-Langerhans cell histiocytoses (non-LCH) are a group of rare diseases with varied clinical manifestations and overlapping features seen among the subtypes. Here, we present a case of Rosai-Dorfman disease with features of necrobiotic xanthogranuloma. Case. A 45-year-old female presented with a 10-year history of an enlarging neck mass with normal overlying skin accompanied by dysphagia and multiple asymptomatic pink to yellowish-brown papules, nodules, and plaques on the face, trunk and extremities. Biopsies of a skin nodule and plaque revealed granulomatous dermal infiltrates (lymphocytes, foamy histiocytes, and Touton giant cells), emperipolesis and areas of necrosis. CD1A and Fite-Faraco staining showed negative results while CD68 and S100 positively stained the tissues of interest. Histopathology of the neck mass paralleled these findings in addition to being negative for lymphoid markers. Patient had monoclonal gammopathy and thyromegaly with enlarged cervical lymph nodes on further tests and imaging. Intralesional and systemic steroids were given which led to flattening of skin lesions and improvement in dysphagia, respectively. Conclusion. Diagnosis and classification of a particular type of non-LCH may be difficult due to similarities across its subtypes. Hence, it is our belief that these diseases may occur on a spectrum. Treatment involves a multidisciplinary approach for the best possible care.


The article presents experimental studies on the use of cell technology in experimental ulcerative pyoderma. The results of the study showed that the introduction of embryonic cultured allofibroblasts in the treatment of experimental ulcerative pyoderma is associated with the activation of fibroblasts in the dermis and promotes significant epithelization of ulcerative lesions on the skin in experimental animals. Lately, in dermatological practice, there has been an increase in the frequency of chronic, long-term non-healing ulcerative foci of the skin and subcutaneous tissue, which make up a pressing issue in terms of choosing the appropriate therapy. Etiological factors in the development of ulcerative foci of skin lesions are endocrinopathy (primarily diabetes mellitus, obesity), disorders of the vascular system, as well as the nervous system.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Juan Pablo Sáenz ◽  
Mónica Paola Novoa ◽  
Darío Correal ◽  
Bell Raj Eapen

Background. The use of mobile applications in dermatology to support remote diagnosis is gaining acceptance, particularly in rural areas, where dermatology services are commonly managed by healthcare personnel with no specialty training. Moreover, ontologies—sets of concepts that represent knowledge in a given domain—are increasingly being used to support medical diagnosis. A specific case is ONTODerm: an ontology to aid dermatological diagnosis. However, there is little information on the combined use of mobile applications and ontologies as support solutions in dermatology. Objective. Assessing the reliability of ONTODerm as a tool to support remote dermatological diagnosis when used together with a mobile dermatological application in underprivileged areas. Methods. A mobile application that allows characterization of skin lesions was developed, and the information about the lesions was sent to ONTODerm. An exploratory study was conducted in a remote area without access to a dermatologist. A total of 64 dermatological queries were recorded in the application and consulted with ONTODerm. Later, an experienced dermatologist evaluated the characterization and diagnosis of each query to determine the accuracy of the system. Results. The results showed that the probability of obtaining a correct diagnosis was between 64.4% and 85.6% with a confidence interval of 95%. A higher accuracy rate was obtained when the skin lesion occurred on the face or when its border was categorized as poorly demarcated. Conclusions. This study demonstrates the implementation of a teledermatology strategy based on mobile applications and domain ontology-driven knowledge base to provide timely assistance to healthcare professionals. This approach was found to be pertinent in the Colombian rural context, particularly in forest regions, where dermatology specialists are not available. The results of this article do not represent a final validation of the proposed approach; they suggest how the ontology can be improved to effectively support medical staff in marginalized regions.


Author(s):  
Lauren E. Miller ◽  
David A. Shaye

AbstractNecrotizing fasciitis (NF) is part of the class of necrotizing soft tissue infections characterized by rapid fascial spread and necrosis of the skin, subcutaneous tissue, and superficial fascia. If left untreated, NF can rapidly deteriorate into multiorgan shock and systemic failure. NF most commonly infects the trunk and lower extremities, although it can sometimes present in the head and neck region. This review provides an overview of NF as it relates specifically to the head and neck region, including its associated clinical features and options for treatment. Noma, a related but relatively unknown disease, is then described along with its relationship with severe poverty.


PEDIATRICS ◽  
1957 ◽  
Vol 20 (4) ◽  
pp. 688-697
Author(s):  
Haddow M. Keith ◽  
Lyle A. Weed ◽  
Gerald M. Needham

THE TUBERCLE bacillus is the most common cause of lymphadenitis with caseous necrosis. Such a condition in the cervical region, while less frequent than in previous decades, still occurs occasionally. While other agents, for example, Coccidioides, Histoplasma, Brucella, Pasteurella and Miyagawanella, are known to produce a similar histopathologic reaction, they are not commonly associated with lesions in the cervical lymph nodes, especially in children. Therefore the finding of acid-fast bacilli in such lesions has generally been considered bona fide evidence of tuberculosis, although previous reports from this clinic indicate that such is not necessarily true. It is recognized that there are other acid-fast bacilli, such as the lepra and smegma bacilli, which may or may not cause disease. In 1944 Gellerstedt reported seven cases of tuberculoid skin lesions due to atypical acid-fast bacilli. He considered these to be due to exogenous infection with acid-fast bacilli differing from the organisms found in tuberculosis, and he considered them as possibly saprophytic organisms. In 1948 MacCallum and co-workers reported six cases of skin lesions due to acid-fast organisms that were not Mycobacterium tuberculosis. The lesions did not contain tubercle follicles, giant cells or caseous material. The name "Mycobacterium ulcerans" was applied to these organisms by Australian workers. In 1954 Linnell and Nordén described skin lesions that occurred in 80 boys and girls who used a certain swimming pool in a Swedish town. The etiologic organisms were acid fast, differed from those described by MacCallum and associates and were not lepra bacilli. Guinea pigs injected with these organisms presented no evidence of lesions after 7 weeks.


2020 ◽  
Vol 16 (3) ◽  
pp. 320-324
Author(s):  
Lesya Besh ◽  
◽  
Oksana Matsyura ◽  
Olesya Besh ◽  
Olga Troyanovska ◽  
...  

Eczema herpeticum is a chronic dermatosis with erosive and ulcerative lesions of the skin in children of a predominantly young age. The clinical case presented in this article shows the severe course of herpesvirus infection combined with atopic dermatitis in a 5-month infant. A rash in the form of vesicles and pustules throughout the body with a predominant localisation on the skin of the face, the scalp, neck, and chest was found in the course of the examination of the child. Influence of infections on the course of allergic processes is an ambiguous and complicated issue. It has been proved that an infection can contribute to the development of allergies and exacerbate the course of already existing allergic inflammation. In recent years, an increasing number of studies have shown the preventive effect of infection on the development of allergic pathology in children, especially during the first years of life.


2013 ◽  
Vol 2 (1) ◽  
Author(s):  
Poppy M. Lintong ◽  
Inneke V. Sumolang

Abstract: Diagnosis of sporotrichosis associated with lymphocutaneous nodules was made based on the histopathological examination of skin lesions and the cytology of fine needle aspiration biopsy (FNAB). A case of sporotrichosis in a 63-year-old man was reported with papules and nodules spread along the back of the left hand, forearm, and arm. The histopatho-logical examination showed infiltration of PMNs, granulomas, and giant cells in the dermis and epidermis, along with hyperplasia and microabscesses. Sporothrix schenckii was not found in the skin lesion tissues. However, in the FNAB cytology examination of lymphocutaneus nodules we found spores of Sporothrix schenckii in the cytoplasma of histiocytes besides granuloma and infiltration of PMNs. Key words: sporothrix schenckii, histopathology, FNAB cytology.  Abstrak: Diagnosis sporotrikosis kulit dengan nodul limfokutan ditegakkan melalui pemerik-saan histopatologi pada lesi kulit dan sitologi biopsi aspirasi jarum halus pada nodul limfo-kutan. Kami melaporkan kasus sporotrikosis pada laki-laki berusia 63 tahun dengan papul-papul dan nodul-nodul eritematosa pada dorsum manus, antebrakium, dan brakium sinistra. Pemeriksaan histopatologi jaringan biopsi dari lesi kulit menunjukkan reaksi radang, gambaran granuloma, dan sel datia dalam dermis dan epidermis, dengan mikroabses disertai hiperplasia. Tidak ditemukan jamur Sporothrix schenckii dalam potongan jaringan histopatologi. Hasil pemeriksaan sitologi biopsi aspirasi jarum halus pada nodul limfokutan memperlihatkan adanya spora-spora jamur Sporothrix schenckii dalam sitoplasma sel-sel histiosit disamping  terdapatnya bentuk granuloma dalam infiltrat radang. Kata kunci: sporothrix schenckii, histopatologi, sitologi biopsi aspirasi jarum halus.


2022 ◽  
Vol 12 (1) ◽  
pp. 39
Author(s):  
Jesús Acevedo-Borrega ◽  
Jesús Valverde-Berrocoso ◽  
María del Carmen Garrido-Arroyo

Interest in computational thinking (CT) in the scientific community has increased significantly in the last 4 years, as evidenced by the numerous systematic reviews carried out. However, there is a lack of reviews that update the emerging conceptualization of CT and which also examine the roles of the school curriculum and teachers in the face of CT. A systematic literature review (SLR) consists of a collection of research conducted according to previous criteria with the aim of answering research questions with validity and quality. For this reason, the PRISMA-ScR statement was followed. Articles published in scientific journals, from Scopus and WoS, between January 2018 and August 2021 were included, in the English or Spanish language. The initial search resulted in 492 articles, to which the inclusion-exclusion criteria were applied. The final sample of texts for the present systematic review was n = 145. The texts were analyzed from three perspectives: conceptual, documentary and pedagogical. Thus, a renewal of previous literature reviews was carried out, updating the situation with research from recent years and new data, obtained to contribute to the collective intelligence on methodological strategies (80% of the sample was divided into “plugged” and “unplugged”); educational (more than 50% studied CT evaluation); and resources, including a collection of more than 119 educational resources.


2006 ◽  
Vol 7 (3) ◽  
pp. 135-140 ◽  
Author(s):  
Shirley S. Earle

This article discusses the background, characteristics, caregiver benefits, and facilitator rewards of Alzheimer’s Caregiver Support Groups conducted over a 12-year period. The objective being to motivate more professionals to start similar groups to increase supports for family members in the face of this devastating progressive disease and/or to encourage clients to consult their local Alzheimer’s Association to find caregiver groups already formed in or around their community. Providing or locating this service is strongly advocated by both the caregivers interviewed and the facilitator.


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