Een perioculaire vorm van necrobiosis lipoidica

2021 ◽  
Author(s):  
A. DE VOS ◽  
L. TEMMERMAN ◽  
L. DE SMET
Keyword(s):  
Diabetes Mellitus ◽  
Skin Disease ◽  
Correct Diagnosis ◽  
Unknown Origin ◽  
Skin Lesions ◽  
Blood Analysis ◽  
Necrobiosis Lipoidica ◽  
Autoimmune Thyroid ◽  
Topical Tacrolimus ◽  
The Face

A periocular form of necrobiosis lipoidica Necrobiosis lipoidica (NL) is an uncommon granulomatous skin disease of unknown origin. It is more often seen in patients with diabetes mellitus. Other cases describe an association with conditions like autoimmune thyroid disease, inflammatory bowel disease, sarcoidosis and rheumatoid arthritis. The skin lesions usually appear on the legs of the patient. Rarely, the disease presents in the face and/or scalp, in this case it is called “facial necrobiosis lipoidica” (FNL). When one or multiple annular, non-scaly plaques are observed in the face and/or scalp, it is important to think about FNL. The lesions are usually yellowish in the centre with areas of depigmentation and/or atrophy of the skin. In the periphery, the colour might be brown-red and sometimes an elevated border can be observed. FNL may look like another skin disease called “necrobiotic xanthogranuloma”. For this reason, histology is crucial for a correct diagnosis. It is important to exclude underlying diabetes mellitus. Necrobiotic xanthogranuloma is frequently associated with paraproteinemia. Therefore, this condition has to be ruled out by means of a blood analysis. There are no guidelines available for the treatment of FNL, but topical tacrolimus 0,1% might be an effective therapy for these patients.

scholarly journals On Using a Mobile Application to Support Teledermatology: A Case Study in an Underprivileged Area in Colombia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Juan Pablo Sáenz ◽  
Mónica Paola Novoa ◽  
Darío Correal ◽  
Bell Raj Eapen
Keyword(s):  
Rural Areas ◽  
Mobile Applications ◽  
Mobile Application ◽  
Correct Diagnosis ◽  
Skin Lesions ◽  
Healthcare Personnel ◽  
Combined Use ◽  
Forest Regions ◽  
The Face

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.

scholarly journals PROFIL DERMATITIS SEBOROIK DI POLIKLINIK KULIT DAN KELAMIN RSUP PROF. DR. R. D. KANDOU MANADO PERIODE JANUARI-DESEMBER 2012

e-CliniC ◽  
2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Ranita O. Terroe ◽  
Marlyn G. Kapantow ◽  
Renate T. Kandou
Keyword(s):  
Skin Disease ◽  
Antifungal Agent ◽  
Seborrheic Dermatitis ◽  
Descriptive Study ◽  
Skin Lesions ◽  
Age Group ◽  
Sebaceous Glands ◽  
The Face ◽  
Combined Medication

Abstract: Seborrheic dermatitis (SD) is a chronic, recurrent skin disease in areas which are abundant in sebaceous glands, with a prevalence of 3-5% worldwide. Though its pathogenesis is still unknown, SD is related to sebum overproduction and the fungus Malassezia. SD can be suffered by all kinds of ages, most commonly found in men. The skin lesions found are erythematous, yellowish, oily squamas with uncircumscribed border. Pitiriasis sika, also known as dandruff, is a mild type of SD often suffered by people.This research is a retrospective descriptive study based on the number of cases, gender, age, location of lesion, and type of medication. Results shown that out of 134 seborrheic dermatitis cases (3,3%), this disease is often suffered by the age group 45-65 years old (55,2%) and male (67,2%), with most lesions located on the face (53,7%) and with combined medication of corticosteroid + antifungal agent (62,7%).Keywords: seborrheic dermatitisAbstrak: Dermatitis seboroik (DS) adalah penyakit kulit kronis berulang pada area yang memiliki banyak kelenjar sebasea, dengan prevalensi 3-5% di dunia. Patogenesis DS belum diketahui, namun DS memiliki hubungan terhadap produksi sebum yang berlebih dan adanya jamur Malassezia.DS dapat diderita oleh semua golongan umur, biasanya lebih sering diderita laki-laki.Kelainan kulit DS berwujud ritema dan skuama berminyak dan agak kekuningan dengan batas kurang tegas.Pitiriasis sika, atau ketombe, adalah jenis ringan DS yang paling sering diderita.Penelitian ini merupakan penelitian deskriptif retrospektif berdasarkan jumlah kasus, jenis kelamin, umur, lokasi lesi, dan jenis pengobatan.Hasil penelitian ini menunjukkan bahwa dari 134 kasus dermatitis seboroik (3,3%), penyakit ini sering terjadi pada kelompok umur 45-65 tahun (55,2%), jenis kelamin laki-laki (67,2%), lokasi lesi wajah (53,7%), dan pengobatan kombinasi topikal antara kortikosteroid + antijamur (62,7%).Kata kunci: dermatitis seboroik

Granuloma anulare, Necrobiosis lipoidica und deren Assoziation zu Adipositas, Diabetes mellitus und hämatologischen Malignomen

2021 ◽  
Vol 47 (04) ◽  
pp. 159-161
Author(s):  
C. S. L. Müller ◽  
M. Shabani ◽  
G. Wagenpfeil ◽  
T. Vogt
Keyword(s):  
Diabetes Mellitus ◽  
Necrobiosis Lipoidica ◽  
Granuloma Anulare

ZusammenfassungDas Granuloma anulare und die Necrobiosis lipoidica sind zwei selten auftretende Dermatosen mit Gynäkotropie und granulomatöser feingeweblicher Komponente und meist therapierefraktärem hoch-chronischen Verlauf. Assoziationen mit einem Diabetes mellitus, Schilddrüsenerkrankungen und Dyslipidämie wurden schon länger vermutet, konnten jedoch bisher nicht sicher statistisch nachgewiesen werden.

scholarly journals Face, Content, and Construct Validity of a Virtual Reality Otoscopy Simulator and Applicability to Medical Training

2021 ◽  
pp. 019459982110328
Author(s):  
Tobias Albrecht ◽  
Christoph Nikendei ◽  
Mark Praetorius
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Construct Validity ◽  
Content Validity ◽  
Medical Training ◽  
Controlled Trial ◽  
Correct Diagnosis ◽  
Age Groups ◽  
Tertiary Referral Center ◽  
The Face

Objective Otologic diseases are common in all age groups and can significantly impair the function of this important sensory organ. To make a correct diagnosis, the correct handling of the otoscope and a correctly performed examination are essential. A virtual reality simulator could make it easier to teach this difficult-to-teach skill. The aim of this study was to assess the face, content, and construct validity of the novel virtual reality otoscopy simulator and the applicability to otologic training. Study Design Face and content validity was assessed with a questionnaire. Construct validity was assessed in a prospectively designed controlled trial. Setting Training for medical students at a tertiary referral center. Method The questionnaire used a 6-point Likert scale. The otoscopy was rated with a modified Objective Structured Assessment of Technical Skills. Time to complete the task and the percentage of the assessed eardrum surface were recorded. Results The realism of the simulator and the applicability to medical training were assessed across several items. The ratings suggested good face and content validity as well as usefulness and functionality of the simulator. The otolaryngologists significantly outperformed the student group in all categories measured (P < .0001), suggesting construct validity of the simulator. Conclusion In this study, we could demonstrate face, content, and construct validity for a novel high-fidelity virtual reality otoscopy simulator. The results encourage the use of the otoscopy simulator as a complementary tool to traditional teaching methods in a curriculum for medical students.

The protean phenotype of MSH6 pathogenic variants (PV) in Lynch syndrome (LS) patients (pts).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10537-10537
Author(s):  
Michelle J McSweeny ◽  
Susan Montgomery ◽  
Kristen Danielle Whitaker ◽  
Mary Beryl Daly ◽  
Michael J. Hall
Keyword(s):  
Skin Disease ◽  
Early Onset ◽  
Skin Lesions ◽  
Published Data ◽  
Pedigree Data ◽  
Skin Manifestations ◽  
Pathogenic Variants ◽  
Ca 50 ◽  
Uncertain Variant ◽  
Histologic Types

10537 Background: LS is among the most common hereditary cancer (CA) syndromes. PVs in MSH6 are 2-4 fold more common in the population (1/758) than those in MLH1 (1/1946) or MSH2 (1/2841), and are increasingly regarded as lower penetrance for CRC due to published data supporting later mean age of CRC onset and lower CRC risk. Unlike for MLH1/MSH2, NCCN 2020 CA risk estimates recognize only endometrial CA (EC) and CRC risks in MSH6+ carriers as clearly above SEER population estimates. Further, risks of other LS manifestations such as skin disease/Muir-Torre, ovarian CA (OC), and possible rare tumors in LS like sarcoma, have been minimally characterized in MSH6+ carriers. Methods: Pedigree data for 44 MSH6+ index (first-evaluated family member by our program) pts consecutively ascertained since 2009 at Fox Chase (FCCC) were reviewed. 1 pt w/a rare MSH6 uncertain variant w/personal history (PHx) of MSH6-expression deficient EC (age 50) and MSH6-deficient sebaceous skin CA (age 50) and a strong family history (FHx) c/w LS is also included here. 34% (15/44) index pts were referred to FCCC for cascade testing due to a known MSH6 PV in the family. Of the remaining 29 index pts, ascertainment included: 14% w/positive universal LS tumor screening, 21% w/early-onset or synchronous LS CA, 14% w/multi-gene panel for PHx of OC, 10% w/incidental MSH6+ result (2 had testing for PHx breast CA, 1 tumor genomic profiling), and 28% w/PHx and/or FHx of LS CA warranting genetic testing. Age of CA onset and path data were verified in > 90% index pts. Results: Index pts had a mean age of 55.5 yrs, and 77% were female. Overall, 11% (5/44) of MSH6+ index pts were found to have LS at diagnosis of synchronous primary CAs (3 EC/OC, 1 CRC/CRC, 1 CRC/EC), and 4/5 of these occurred <50 yrs. An additional 20% (9/44) index pts reported PHx of >2 metachronous LS CAs. OC was the presenting CA in 14% (6/44) female index pts; 2 additional index pts had rarer OC variants (Mullerian duct @ 41, primary peritoneal CA @ 50). Skin manifestations of LS were documented in 9.1% (4/44) index pts (3 sebaceous, 1 SCC in-situ/Bowen’s disease); 1 other family had documented sebaceous CAs in an FDR (father) but the 2 daughters seen @FCCC (both 30s) had yet to develop skin lesions. 2 index pts were found to have LS after developing early-onset breast CA (age 39) and contralateral breast CA (ages 50 and 54). Finally, 7% (3/44) index pts had a PHx of sarcoma: 2 were liposarcomas (ages 57 and 67), and 1 was a dermatofibrosarcoma. 2 other index pts had siblings w/childhood sarcomas. Conclusions: Our data, encompassing 44 MSH6+ pts evaluated in our clinic and consecutively ascertained, suggest MSH6 PV carriers develop synchronous primaries (11%), common and rare OC histologic types (18%), sarcomas (7%) and skin disease/Muir-Torre (9%). While common in the population and lower penetrance for CRC, MSH6 PV can behave in uncommon ways and may have significant extra-colonic CA risks such as OC, sarcoma and skin manifestations.

Rosai-Dorfman Disease of the Parotid Gland

2001 ◽  
Vol 125 (10) ◽  
pp. 1348-1350
Author(s):  
Ridas Juskevicius ◽  
James L. Finley
Keyword(s):  
Salivary Gland ◽  
Lupus Erythematosus ◽  
Plasma Cells ◽  
Correct Diagnosis ◽  
Unknown Origin ◽  
Needle Aspiration ◽  
Major Salivary Gland ◽  
Massive Lymphadenopathy ◽  
Rosai Dorfman Disease ◽  
Mixed Inflammatory Infiltrate

Abstract Rosai-Dorfman disease is a rare histiocytic proliferative disorder of unknown origin and a distinct clinicopathologic entity also known as sinus histiocytosis with massive lymphadenopathy. The disease can involve extranodal tissues and rarely can present as salivary gland enlargement without significant lymphadenopathy. Involvement of the extranodal head and neck sites appears to be more common in patients with immunologic abnormalities. The disease was first described in 4 patients in 1969, and with later descriptions of more patients, the disease was established as a well-defined clinicopathologic entity. The characteristic pathologic feature of this disease is proliferation of distinctive histiocytic cells that demonstrate emperipolesis in the background of a mixed inflammatory infiltrate, consisting of moderately abundant plasma cells and lymphocytes. Fine-needle aspiration biopsy can be helpful in establishing the correct diagnosis, since surgical treatment is not necessary other than obtaining tissue for definitive diagnosis. We describe cytologic, histopathologic, and immunohistochemical features of a case of Rosai-Dorfman disease that involved a major salivary gland without significant lymphadenopathy in a 48-year-old patient with systemic lupus erythematosus. We also briefly discuss possible causes and pathogenesis and review the literature.

Skin lesions in diabetes mellitus: prevalence and clinical correlations

1998 ◽  
Vol 39 (2) ◽  
pp. 101-106 ◽  
Author(s):  
G Romano ◽  
G Moretti ◽  
A Di Benedetto ◽  
C Giofrè ◽  
E Di Cesare ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Skin Lesions ◽  
Clinical Correlations

scholarly journals Frequency and types of skin disorders and associated diabetes mellitus in elderly Jordanians

2021 ◽  
Vol 8 (4-5) ◽  
pp. 574-578
Author(s):  
F. Najdawi ◽  
M. Fa'ouri
Keyword(s):  
Diabetes Mellitus ◽  
Bacterial Infection ◽  
Fungal Infection ◽  
Skin Disorder ◽  
Skin Diseases ◽  
The Elderly ◽  
Skin Lesions ◽  
Skin Disorders ◽  
Patients With Diabetes ◽  
Considerable Morbidity

A retrospective study of 232 elderly patients seen between August 1998 and April 2000 at the skin clinic in Princess Haya hospital, Aqaba, was undertaken to determine the prevalence of skin disorders, and those most commonly associated with diabetes mellitus, in the elderly. Eczema/dermatitis was the commonest skin disorder seen [25.9% of cases], followed by pruritus without skin lesions [15.1%], viral infection [14.7%, most commonly herpes zoster], fungal infection [13.8%], and bacterial infection [10.3%]. Bacterial infection was the commonest skin disorder in patients with diabetes mellitus [62.5%], followed by fungal infection [50.0%]. Skin diseases cause considerable morbidity in elderly people; health promotion and education can do much to reduce the risks of these disorders in the elderly, especially those with diabetes

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