TYPE 1 LEPRA REACTION MIMICKING BULLOUS FIXED DRUG ERUPTION

2021 ◽  
pp. 32-33
Author(s):  
P. Pravallika ◽  
K. Penchalaiah
Keyword(s):  
Histopathological Examination ◽  
Common Peroneal Nerve ◽  
Skin Lesions ◽  
Acute Onset ◽  
Fixed Drug Eruption ◽  
Erythematous Plaque ◽  
Bullous Eruption ◽  
Tuberculoid Leprosy ◽  
Single Well

Leprosy is a chronic infectious disease with varied clinical presentations. Leprosy reactions generally manifest as erythematous edematous tender plaques or evanescent erythematous nodules with or without neuritis. Bullous type of reactions are rare in leprosy. We hereby report a case of borderline tuberculoid leprosy with bullous eruption. A 24 year old male, known case of borderline tuberculoid leprosy who has completed MB MDT after which he continued Dapsone and Rifampicin for another 6 months, now presented with acute onset of fever, malaise, swelling of both feet and painful raised reddish lesions followed by uid lled lesions over the pre existing lesions of leprosy i.e.,on right ear and right sole since 10 days. There is no history of similar episodes. On examination patient looks toxic with bilateral pitting type of pedal edema. Cutaneous examination revealed a single well dened erythematous plaque with vesicles and crusting over pinna and helix of right ear. A single well dened erythematous plaque with central vesicle surrounded by edematous ring noted over medial aspect of right sole. No other skin lesions & mucosal lesions were present. Nikolsky and bulla spread sign was negative. Nerve examination revealed ulnar & common peroneal nerve thickening and tenderness over right side. Routine investigations revealed raised ESR & bilirubin levels. Tzanck smear and slit skin smear was negative. Histopathological examination showed dermal edema with few ill dened granulomas. Based on the above ndings a diagnosis of BT leprosy in Type 1 reaction with bullous eruption was made which is rare after completing MB MDT. However it needs to be differentiated from other causes of bullous eruption

scholarly journals A Case of Giant Posterior Mediastinal Mass: Gastrointestinal Stromal Tumor Developed in Neurofibromatosis Type 1 Patient.

2021 ◽  
Author(s):  
Volkan ASLAN ◽  
Fatih Gürler ◽  
ozan yazıcı ◽  
özlem erdem ◽  
ali çelik ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Genetic Disorders ◽  
Neurofibromatosis Type ◽  
Skin Lesions ◽  
Posterior Mediastinum ◽  
Pathological Examination ◽  
Imatinib Treatment ◽  
First Case ◽  
Posterior Mediastinal

Abstract Introduction: Gastrointestinal Stromal Tumors mostly located in the stomach and esophageal GIST is extremely rare. Various genetic disorders increase the risk of developing GIST, among these, NF-1 is the most common. A case of posterior mediastial GIST developing in the neurofibromatosis patient has not been reported yet.Case: A 48-year-old male patient is being evaluated with complaints of dyspnea and progressive dysphagia. Computed tomography detected a cystic, lobulated contour mass that was located at the posterior mediastinum and measuring 11 x 14x12 cm. The giant semisolid mass has been dissected from adjacent the vertebra, the esophagus, pericardium and inferior pulmonary vein and Histopathological examination revealed GİST. Pathological examination of skin lesions confirmed NF-1. Finally, NF-1-associated posterior mediastinal GIST was diagnosed and adjuvant imatinib treatment was initiated. Conclusion: To the best our knowledge, this patient was the first case, who diagnosed with posterior mediastinal GIST developing on the basis of NF-1.

scholarly journals Hansen's Neuritis Revisited – A Clinicopathological Study

2018 ◽  
Vol 09 (01) ◽  
pp. 042-055
Author(s):  
Navya Jaiswal ◽  
Shrijeet Chakraborti ◽  
Kashinath Nayak ◽  
Shivananda Pai ◽  
B. P. Shelley ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Nerve Biopsy ◽  
Skin Lesions ◽  
Common Finding ◽  
Diagnostic Challenge ◽  
Female Ratio ◽  
Tuberculoid Leprosy ◽  
Male Female Ratio ◽  
Uncommon Condition ◽  
Age Range

ABSTRACT Introduction: Leprosy affecting the nerve solely or with concomitant skin lesions is not an uncommon condition in clinical practice. It is responsible for extensive morbidity and often poses a diagnostic challenge. This study aims to highlight the clinicopathological features of Hansen's neuritis (HN). Materials and Methods: In this retrospective study, cases of histologically diagnosed HN, from January 2010 to July 2017, were reviewed in the light of clinical features, treatment history, and outcome. Results: There were 18 cases of HN which accounted for 3.97% of total nerve biopsy samples (n = 453) and 0.02% of total histopathology samples (n = 81,013). The male: female ratio was 5:1 in the cases of HN. Age range was 20–79 years with a mean age of 42.4 years (standard deviation: ±14.03). Among the HN cases, there were 13 cases of pure neuritic leprosy (61.1%). Mononeuritis multiplex was the most common finding in the nerve conduction study. Six (33.3%) cases exhibited histological features of borderline tuberculoid leprosy, followed by five (27.8%) cases of mid-borderline features, three (16.7%) cases each of borderline lepromatous and burnt-out HN, and one (5.6%) case of polar tuberculoid leprosy. Lepra bacilli were detected on Fite-Faraco stain in 44.4% cases. Conclusion: Diagnosis of HN depends on astute search for skin lesions, nerve thickening or tenderness, sensory or motor symptoms, histopathological examination, and demonstration of lepra bacilli.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

scholarly journals AB0463 ETIOLOGY OF PALPABLE PURPURA; A SINGLE CENTER EXPERIENCE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1530.1-1530
Author(s):  
G. Kaynar ◽  
O. C. İçaçan ◽  
S. Çelik ◽  
M. Yalçin Mutlu ◽  
C. Bes
Keyword(s):  
Drug Use ◽  
Histopathological Examination ◽  
Leukocytoclastic Vasculitis ◽  
Systemic Vasculitis ◽  
Skin Lesions ◽  
Serological Tests ◽  
Recent Infection ◽  
Important Place ◽  
Palpable Purpura ◽  
Underlying Diseases

Background:Purpura are lesions that occur after bleeding on the skin, mucous or serosal surfaces. Purpura can be classified into 2 subgroups; which are linked to thrombocytopenia and non-trombocytopenic purpura. While thrombocytopenic purpura often occurs due to a hematological disease; in non-trombocytopenic purpura etiological causes are very variable, and systemic vasculitis has an important place among them.Objectives:The demographic features of the patients applying with purpura and the underlying causes and diseases were aimed to be revealed.Methods:44 consecutive patients (22 women, 22 men) who were admitted to the hospital in the last 6 months, due to purpura were evaluated. Average age of patients was 49.6 ± 19.6 years. Patients were questioned about a recent infection, drug use, concomitant or underlying diseases. The serological tests and other laboratory tests for etiology were performed and biopsy was taken from the skin lesions which are appropriate.Results:While 4 (9%) patients had widespread purpura on the trunk-upper-lower extremities, in 22 (50%) patients purpuric lesions were limited only to the lower limb. The period between the onset of the first symptom and the admission to the hospital was longer than 4 weeks in 35 (79.5%) patients, and shorter than 1 week in 9 (20.5%) patients. 24 (54%) patients had an anamnesis of infection 2-3 weeks before purpura, and 20 (45%) patients had an anamnesis of drug use. The most common accompanying symptom was abdominal pain and was present in 15 (34%) patients. Biopsy was performed from the skin lesion in 37 patients. Histopathological examination of all was compatible with leukocytoclastic vasculitis. In indirect immunofluorescence staining, 17 were found to be IgA positive. 2 (4.5%) patients were diagnosed PR3-ANCA positive granulomatosis with polyangiitis. 1 patient had Hepatitis B virus infection was detected in 1 patient (2.2%), HIV infection was detected in 1 patient (2.2%) and malignancy was detected in 1 patient (2.2%).Conclusion:In our study, the most common reason was found as IgA vasculitis in patients presenting with palpable purpura. Although vasculitic involvement was limited to the skin in most patients, organ-threatening systemic vasculitis was detected in a few patients. Patients applying with Purpura should be questioned for infection and drug use, should be examined for underlying diseases including systemic vasculitis, and closely monitored for organ involvement.Disclosure of Interests:None declared

Effects of Analgesics on Delayed Postherpetic Pain in Mice

2002 ◽  
Vol 96 (5) ◽  
pp. 1168-1174 ◽  
Author(s):  
Ichiro Takasaki ◽  
Atsushi Sasaki ◽  
Tsugunobu Andoh ◽  
Hiroshi Nojima ◽  
Kimiyasu Shiraki ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Postherpetic Neuralgia ◽  
Herpes Simplex Virus Infection ◽  
Skin Lesions ◽  
Cutaneous Lesions ◽  
Acyclovir Treatment ◽  
Simplex Virus ◽  
Von Frey Filaments

Background Postherpetic neuralgia is pain that persists long after the disappearance of the cutaneous lesions of herpes zoster. However, the mechanisms of this delayed pain are unclear. Herpes simplex virus infection induces cutaneous lesions and pain-related responses in mice. The authors examined whether such responses would persist after the disappearance of the cutaneous lesions and whether some analgesics would be effective against them. Methods Female BALB/c mice were inoculated with herpes simplex virus type 1 on the unilateral hind paw. Pain-related responses of hind paw were determined using von Frey filaments. Beginning 5 days after inoculation, mice were given perorally the antiherpes agent acyclovir five times a day for 7 days. Effects of morphine (3-5 mg/kg subcutaneously), gabapentin (30-100 mg/kg perorally), mexiletine (10-30 mg/kg intraperitoneally), and diclofenac (30 mg/kg intraperitoneally) on pain-related responses were examined on days 25-35 after inoculation. Results Viral inoculation induced cutaneous lesions and pain-related responses beginning on day 5 after inoculation. Acyclovir treatment healed all skin lesions by day 15 after inoculation. Approximately half of the mice given acyclovir showed pain-related responses at least until day 40 after inoculation. Morphine, gabapentin, and mexiletine dose-dependently inhibited pain-related responses, but diclofenac had no effects. Conclusions The authors show a mouse model of delayed postherpetic pain. This may be useful for manifesting the mechanisms of postherpetic neuralgia and the factors contributing to the transition from acute herpetic pain to delayed postherpetic pain. This may also be useful for the development of new analgesics against postherpetic neuralgia.

scholarly journals Methotrexate-Associated Lymphoproliferative Disorder: Dermoscopic Features

2018 ◽  
Vol 10 (2) ◽  
pp. 149-153 ◽  
Author(s):  
Takeshi Namiki ◽  
Yumiko Sone ◽  
Keiko Miura ◽  
Masaru Tanaka ◽  
Hiroo Yokozeki
Keyword(s):  
Lymphoproliferative Disorder ◽  
Histopathological Examination ◽  
Subcutaneous Tissue ◽  
Lymphoid Cells ◽  
Erythematous Plaque ◽  
Rheumatic Arthritis ◽  
Barr Virus ◽  
Perivascular Infiltrate ◽  
Epstein Barr ◽  
Enhanced Computed Tomography

Methotrexate-related lymphoproliferative disorder (MTX-LPD) is a rare disorder caused by long-term MTX therapy for autoimmune diseases. There has been no report of the dermoscopic features of MTX-LPD to date. A 64-year-old female presented with a slightly elevated indurated erythematous plaque with scales on her right thigh. The patient had been treated for rheumatic arthritis with MTX and prednisolone for more than 15 years, and 18 mg/week MTX without prednisolone had been administered in the last year. Dermoscopy revealed dotted vessels and glomerular vessels on pink homogeneous areas and multiple surface scales. Enhanced computed tomography showed multiple nodules and lymphadenopathies at the mediastinum and axillae. Histopathological examination revealed telangiectasia in the superficial dermis. Atypical lymphoid cells were scattered in the whole dermis and subcutaneous tissue. A perivascular infiltrate of atypical lymphocytes and histiocytoid cells partially destroyed the vessel walls. Epstein-Barr virus in situ hybridization showed a positive result. The cessation of MTX reduced the erythematous plaque, and lymphadenopathies at the neck, mediastinum, and axillae were not palpable. We discuss the relevance of these dermoscopic and histopathological features. The accumulation of such cases will reveal the dermoscopic features of MTX-LPD and the utility of dermoscopy for the diagnosis of MTX-LPD.

scholarly journals Prevalence and risk of appearence of skin lesions considered to be cutaneous markers of diabetes in a population group in bihor county

2012 ◽  
Vol 19 (3) ◽  
pp. 285-290
Author(s):  
Denisa Kovacs ◽  
Luiza Demian ◽  
Aurel Babeş
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Skin Lesion ◽  
Skin Diseases ◽  
Population Group ◽  
Skin Lesions ◽  
Diabetic Patients ◽  
Cutaneous Lesions

Abstract Objectives: The aim of the study was to calculate the prevalence rates and risk ofappearance of cutaneous lesions in diabetic patients with both type-1 and type-2diabetes. Material and Method: 384 patients were analysed, of which 47 had type-1diabetes (T1DM), 140 had type-2 diabetes (T2DM) and 197 were non-diabeticcontrols. Results: The prevalence of the skin lesions considered markers of diabeteswas 57.75% in diabetics, in comparison to 8.12% in non-diabetics (p<0.01). The riskof skin lesion appearance is over 7 times higher in diabetic patients than in nondiabetics.In type-1 diabetes the prevalence of skin lesions was significantly higherthan in type-2 diabetes, and the risk of skin lesion appearance is almost 1.5 timeshigher in type-1 diabetes than type-2 diabetes compared to non-diabetic controls.Conclusions: The diabetic patients are more susceptible than non-diabetics todevelop specific skin diseases. Patients with type-1 diabetes are more affected.

scholarly journals Coexistence of Ankylosing Spondylitis and Löfgren’s Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Senol Kobak ◽  
Fidan Sever ◽  
Oya Sivrikoz ◽  
Ahmet Karaarslan
Keyword(s):  
Ankylosing Spondylitis ◽  
Low Dose ◽  
Histopathological Examination ◽  
Skin Lesions ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Löfgren’S Syndrome ◽  
Significant Regression ◽  
Dose Corticosteroid ◽  
Thorax Ct

A 46-year-old male patient diagnosed with ankylosing spondylitis presented to our polyclinic with complaints of pain, swelling, and limitation in joint mobility in both ankles and erythema nodosum skin lesions in both pretibial sites. The sacroiliac joint graphy and the MRI taken revealed active and chronic sacroiliitis. On the thorax CT, multiple mediastinal and hilar lymphadenopathies were reported. Mediastinoscopic excisional lymph node biopsy was taken and noncalcified granulomatous structures, lymphocytes, and histiocytes were determined on histopathological examination. The patients were diagnosed with ankylosing spondylitis, sarcoidosis, and Löfgren’s syndrome. NSAIDs, sulfasalazine, and low dose corticosteroid were started. Significant regression was seen in the patient’s subjective and laboratory assessments.

scholarly journals SURPRISING GENOTYPE EXPRESSED AS A COMMON LIMB-GIRDLE MUSCULAR DYSTROPHY

2017 ◽  
Vol 16 (2) ◽  
pp. 71-73
Author(s):  
Liviu Cozma ◽  
◽  
Maria Barsevschi ◽  
Cristina Mitu ◽  
Alexandra Bastian ◽  
...  
Keyword(s):  
Muscular Dystrophy ◽  
Clinical Picture ◽  
Histopathological Examination ◽  
Muscular Dystrophies ◽  
Myofibrillar Myopathy ◽  
Homozygous Variant ◽  
Heterozygous Variant ◽  
High Degree

Limb-girdle muscular dystrophies (LGMDs) comprise a phenotypical spectrum of muscular dystrophies with a high degree of genotypical variability. We describe the case of a 56-year-old male with a history and clinical picture sugestive for LGMD with skeletal and cardiologic involvement. Histopathological examination shows a severe dystrophic picture and geneting testing revealed a unique never reported genotype association: a homozygous variant in the DES gene, associated with myofibrillar myopathy type 1 and LGMD2R, as well as a heterozygous variant in the CRYAB gene, associated with myofibrillar myopathy type 2, both of which could be responsible for the clinical picture.

scholarly journals SPOROTRIKOSIS LIMFOKUTAN DIAGNOSIS HISTOPATOLOGI DAN SITOLOGI

2013 ◽  
Vol 2 (1) ◽  
Author(s):  
Poppy M. Lintong ◽  
Inneke V. Sumolang
Keyword(s):  
Skin Lesion ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Histopathological Examination ◽  
Sporothrix Schenckii ◽  
Giant Cells ◽  
Skin Lesions ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Left Hand

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.

Sign in / Sign up

Export Citation Format

Share Document