scholarly journals Accentuated Skin Markings: A Clinical Clue for Idiopathic Eruptive Macular Pigmentation

Author(s):  
Stuti Khare ◽  
Bhushan Madke ◽  
Adarshlata Singh

AbstractIdiopathic eruptive macular pigmentation (IEMP) is a distinct clinicopathologic entity of which less cases have been reported in the literature. We report here a case of a 16-year-old boy who had completely asymptomatic brownish-colored lesions distributed over the trunk, back, and upper limbs since 4 months, and histopathologic findings showed features consistent with diagnosis of IEMP with one additional finding having papillomatosis with moderate acanthosis. We are reporting this case with additional clinical finding that is accentuated skin markings similar to acanthosis on dermoscopy, which aid in clinical diagnosis of this less reported entity. This helps avoidance of unnecessary treatment for this self-resolving state.

Author(s):  
Haidy Elshebawy ◽  
Mohamed Y. Ezzeldin ◽  
Eman Hassan Elzamarany

Abstract Background The aim of this study is to describe the different forms of polyneuropathy associated with coronavirus disease 2019 (COVID-19) as a secondary neurological complication for (COVID-19) and the outcome from different therapeutic regimens in adults and pediatrics in first and second waves of the pandemic. Case presentation This study was conducted on 42 patients, they were divided into two groups, group (A) and group (B) in first and second waves respectively. Twenty-five patients presented by ascending weakness preceded by fever, dry cough and respiratory distress, electromyography (EMG) and nerve conduction (NC) studies done and confirmed the clinical diagnosis of demyelinating polyneuropathy. Eight patients presented by acute flaccid quadriparesis, more severe in upper limbs preceded by fever and diarrhea diagnosed as acute axonal polyneuropathy. Five patients presented by severe fatigue and progressive weakness of both lower and upper limbs, they developed fever and cough 10 days after the neurological symptoms. EMG and NC done and confirmed clinical diagnosis of polyneuropathy of demyelinating with secondary axonal picture. Four patients presented 30 to 40 days after their recovery form corona virus infection with gradual progressive weakness of both upper and lower limbs over 2 to 3 months duration, mainly the proximal muscles of lower limbs were affected with areflexia. EMG and NC done and confirmed the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). Conclusion We should gain a better understanding of the underlying pathophysiology and therapeutic options of polyneuropathies related to COVID-19, which will have an impact on the treatment of the COVID related respiratory failure presenting with neuropathy.


2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Francisco Bezerra De Almeida Neto ◽  
Raul Aureliano Neto ◽  
Lucas Machado Carvalho Cardoso

We describe the case of a young man, 22 years old, a household contact of leprosy, presenting paresthesia in the right leg and great thickening in the anterior femoral nerve and in the ipsilateral sural nerve. There were no typical dermatological lesions of leprosy. Ultrasonography confirmed the clinical finding. The clinical diagnosis of the disease was established and the patient started multibacillary-multidrug therapy, obtaining improvement of the initial symptomatology.


Author(s):  
Maria Leonor Enei ◽  
Francisco Paschoal ◽  
Rodrigo Valdes

Targetoid hemosiderotic hemangioma (THH) or hobnail hemangioma (HH) is a benign vascular lesion that presents with the classical clinical presentation of a ring-shaped tumor having a targetoid appearance, with a central purple-brown papule surrounded by a thin pale area and an ecchymotic ring on the outside. Dermoscopic features and patterns of HH have been documented and have proven to be sufficient to establish a clinical diagnosis in many cases. We present a facial lesion in which both the clinical presentation and dermoscopy were atypical. The presence of arborizing vessels in the dermoscopic pattern, never before described for this lesion, led us to the diagnosis of basocellular carcinoma (BCC). We also report the changes in this pattern experienced over 12 months of progression and their correlation with the histopathologic findings.


Author(s):  
Ashok S. Hogade ◽  
N. Sri Hari Reddy

<p class="abstract"><strong>Background:</strong> The objective of the study was to study the various etiologies and ascertain different clinicalpresentations of post-inflammatory hypopigmented lesions. Age and sex distribution, socio economic status, seasonal incidence, most common to rare variants amongst all conditions and to correlate them histopathologically.</p><p class="abstract"><strong>Methods:</strong> 100 patients presenting with Post-inflammatory hypopigmented lesions were selected and detailed history and examination was done. Lab investigations and histopathology was done in those cases.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among the various causes of post-inflammatory hypopigmentation, commonly observed conditions were Pityriasis versicolor, mechanical injuries, Pityriasis alba, burns, leprosy, allergic contact dermatitis, morphoea, discoid lupus erythematosus, psoriasis and Steven’s Johnson syndrome. Most common age group affected was in 21-30 years of age. Males (60%) were more than females (40%). People of lower socioeconomic status (55%) presented with post-inflammatory hypo pigmented lesions commonly. History of hypopigmentation ranged from 0-6 months in majority of cases. Upper limbs, trunk and face and neck regions were the most common sites involved. Commonest etiology amongst all cases was pityriasisversicolor, followed by mechanical injuries, PityriasisAlba and burns. Clinical diagnosis correlated with histopathology in these cases.</p><p class="abstract"><strong>Conclusions:</strong> The study concluded that post-inflammatory hypopigmented lesions presented with various manifestations, more common in young, male adults, common in people of lower socioeconomic group. Upper limbs, trunk and face and neck are the common sites involved and histopathology correlated with clinical diagnosis in many cases.</p><p> </p>


Author(s):  
Tong Wensheng ◽  
Lu Lianhuang ◽  
Zhang Zhijun

This is a combined study of two diffirent branches, photogrammetry and morphology of blood cells. The three dimensional quantitative analysis of erythrocytes using SEMP technique, electron computation technique and photogrammetry theory has made it possible to push the study of mophology of blood cells from LM, TEM, SEM to a higher stage, that of SEM P. A new path has been broken for deeply study of morphology of blood cells.In medical view, the abnormality of the quality and quantity of erythrocytes is one of the important changes of blood disease. It shows the abnormal blood—making function of the human body. Therefore, the study of the change of shape on erythrocytes is the indispensable and important basis of reference in the clinical diagnosis and research of blood disease.The erythrocytes of one normal person, three PNH Patients and one AA patient were used in this experiment. This research determines the following items: Height;Length of two axes (long and short), ratio; Crevice in depth and width of cell membrane; Circumference of erythrocytes; Isoline map of erythrocytes; Section map of erythrocytes.


VASA ◽  
2004 ◽  
Vol 33 (4) ◽  
pp. 247-251 ◽  
Author(s):  
Zeller ◽  
Koch ◽  
Frank ◽  
Bürgelin ◽  
Schwarzwälder ◽  
...  

Diagnosis of non-specific aorto-arteritis (NSAA, Takaysu's arteritis) is typically based on clinical and investigational parameters. We report here about two patients with clinically suspected diagnosis of a Takayasu's arteritis already under anti-inflammatory therapy in whom percutaneous transluminal atherectomy of subclavian and axillary artery stenoses was performed to relief the patients from symptoms – intermittent dyspraxia of the arms – and to verify the clinical diagnosis by histology. In the first case aorto-arteritis could be histologically confirmed through the analysis of plaque material including media structures excised from the subclavian and axillary arteries using a new device for atherectomy. The biopsy showed diffuse inflammation and granulomatous lesions with giant cells typically for Takayasu's disease. In the second patient, biopsy showed no acute or chronic inflammatory signs but only atherosclerotic lesions. Percutaneous transluminal atherectomy is therefore not only an interventional but also a diagnostic tool and should be used in every case of interventional therapy of suspected aorto-arteritis to make the clinical diagnosis and as a major consequence the initiation of an aggressive anti-inflammatory medical therapy more reliable.


VASA ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Mandy Becker ◽  
Tom Schilling ◽  
Olga von Beckerath ◽  
Knut Kröger

Background: To clarify the clinical use of sonography for differentiation of edema we tried to answer the question whether a group of doctors can differentiate lymphedema from cardiac, hepatic or venous edema just by analysing sonographic images of the edema. Patients and methods: 38 (70 ± 12 years, 22 (58 %) females) patients with lower limb edema were recruited according the clinical diagnosis: 10 (26 %) lymphedema, 16 (42 %) heart insufficiency, 6 (16 %) venous disorders, 6 (16 %) chronic hepatic disease. Edema was depicted sonographically at the most affected leg in a standardised way at distal and proximal calf. 38 sets of images were anonymised and send to 5 experienced doctors. They were asked whether they can see criteria for lymphedema: 1. anechoic gaps, 2. horizontal gaps and 3. echoic rims. Results: Accepting an edema as lymphedema if only one doctor sees at least one of the three criteria for lymphatic edema on each single image all edema would be classified as lymphatic. Accepting lymphedema only if all doctors see at least one of the three criteria on the distal image of the same patient 80 % of the patients supposed to have lymphedema are classified as such, but also the majority of cardiac, venous and hepatic edema. Accepting lymphedema only if all doctors see all three criteria on the distal image of the same patients no edema would be classified as lymphatic. In addition we separated patients by Stemmers’ sign in those with positive and negative sign. The interpretation of the images was not different between both groups. Conclusions: Our analysis shows that it is not possible to differentiate lymphedema from other lower limb edema sonographically.


2019 ◽  
Vol 30 (3) ◽  
pp. 157-168
Author(s):  
Helmut Hildebrandt ◽  
Jana Schill ◽  
Jana Bördgen ◽  
Andreas Kastrup ◽  
Paul Eling

Abstract. This article explores the possibility of differentiating between patients suffering from Alzheimer’s disease (AD) and patients with other kinds of dementia by focusing on false alarms (FAs) on a picture recognition task (PRT). In Study 1, we compared AD and non-AD patients on the PRT and found that FAs discriminate well between these groups. Study 2 served to improve the discriminatory power of the FA score on the picture recognition task by adding associated pairs. Here, too, the FA score differentiated well between AD and non-AD patients, though the discriminatory power did not improve. The findings suggest that AD patients show a liberal response bias. Taken together, these studies suggest that FAs in picture recognition are of major importance for the clinical diagnosis of AD.


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