scholarly journals Lichen aureus induced by an insect bite

2022 ◽  
Vol 13 (1) ◽  
pp. 70-72
Author(s):  
Emad Bahashwan
Keyword(s):  
Risk Factors ◽  
Skin Lesion ◽  
Lower Limbs ◽  
Histopathological Feature ◽  
Histopathological Findings ◽  
History Of ◽  
The Right ◽  
Benign Course ◽  
Over Time

Lichen aureus is an uncommon variant of pigmented purpura and presents itself with a chronic and benign course. Clinically, lichen aureus cases are asymptomatic and are found in the lower limbs, presenting themselves as erythematous, brownish or golden macules and/or papules. Its diagnosis is based on clinical and histopathological findings. The prognosis of lichen aureus is generally good. A 34-year-old Filipino male presented himself with a single itchy skin lesion on the right leg present for three months. The lesion started as a small, round, reddish to brownish area and then increased in size over time. A history of an insect bite on the same site was reported. An examination revealed a single annular, golden to brownish macule on the right leg. Based on this clinical and histopathological feature, the skin lesion was diagnosed as lichen aureus. The comprehension of the pathogenesis of lichen aureus is essential for knowing its risk factors.

Odontogenic choristoma embedded in the cheek of an old patient

2021 ◽  
Vol 14 (10) ◽  
pp. e245733
Author(s):  
Guido Gabriele ◽  
Simone Benedetti ◽  
Fabiola Rossi ◽  
Paolo Gennaro
Keyword(s):  
Skin Lesion ◽  
Histological Study ◽  
Neck Region ◽  
Early Age ◽  
Histopathological Diagnosis ◽  
Unique Case ◽  
Head And Neck Region ◽  
Dental Procedures ◽  
History Of ◽  
The Right

Odontogenic choristomas are a rare and recently classified entity, defined as neoplasms containing tissues of odontogenic derivation, found in abnormal locations and usually diagnosed in the early age. The authors report a unique case of a 79-year-old patient who presented to our attention for a skin lesion in the right cheek with no history of trauma or recent dental procedures, that underneath presented an indolent tooth-like structure inside the soft tissue of the right cheek, which at the histological study resulted to be an odontogenic choristoma. This rare histopathological diagnosis should be considered when a hard lesion is present in the head and neck region.

Adult Victimization over Time

2018 ◽  
pp. 171-174
Author(s):  
Mary C. Zanarini
Keyword(s):  
Risk Factors ◽  
Sexually Abused ◽  
Female Gender ◽  
Physical Assault ◽  
Clinical Implications ◽  
Axis Ii ◽  
Borderline Patients ◽  
History Of ◽  
Over Time

At baseline, borderline patients reported higher rates of adult rape and physical assault by a partner than Axis II comparison subjects. Four risk factors were found to significantly predict whether borderline patients had an adult history of being a victim of physical and/or sexual violence before their index admission: female gender, a substance use disorder that began before the age of 18, childhood sexual abuse, and emotional withdrawal by a caretaker (a form of neglect). At six-year and 10-year follow-up, borderline patients reported higher rates of being verbally, emotionally, physically, and sexually abused or assaulted than did Axis II comparison subjects. However, each of these forms of abuse declined significantly over time. The clinical implications of these prevalence and predictive findings are discussed.

scholarly journals Hemichorea-hemiballismus in a patient with hyperglycaemic hyperosmolar state

2020 ◽  
Vol 8 (10) ◽  
pp. 3710
Author(s):  
Rifkatu S. Reng ◽  
Odumodu Kenechukwu ◽  
Shuaibu Ramatu ◽  
Oyakhire Shyngle ◽  
Omonua Special ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Involuntary Movement ◽  
Rare Complication ◽  
Cerebral Atrophy ◽  
Lower Limbs ◽  
High Grade Fever ◽  
Rare Manifestation ◽  
History Of ◽  
Hypertensive Woman ◽  
The Right

Hemichorea-hemiballismus (HCHB) is a rare manifestation of hyperglycaemic hyperosmolar state caused by contralateral lesion in basal ganglia. A 74-year-old, known diabetic and hypertensive woman presented with one-week history of high-grade fever and loss of consciousness associated with involuntary movement of the right upper and lower limbs for 10 hours prior to presentation. Physical examination revealed pyrexia, tachycardia and altered sensorium. Blood glucose was 53.8 mmol/l, hemoglobin A1c (Hb A1c) 9.9% and brain computed tomography (CT) scan showed cerebral atrophy with bilateral basal ganglia hyperdensities. Escherichia coli was cultured from the urine. She did well on treatment with soluble insulin, rehydration and intravenous ceftriaxone. HCHB is a rare complication seen in patients with poorly controlled diabetes mellitus. This report highlights the reversibility of the disease with prompt diagnosis and appropriate insulin treatment. HCHB should be distinguished from other intracranial pathologies.

scholarly journals Foot Arch and Plantar Pressure in the Age of 17-21 Years

2021 ◽  
Vol 21 (2) ◽  
pp. 124-129
Author(s):  
Arif Wicaksono ◽  
Sasanthy Kusumaningtyas ◽  
Angela BM Tulaar
Keyword(s):  
Plantar Pressure ◽  
Pressure Difference ◽  
Lower Limbs ◽  
P Value ◽  
Research Subjects ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
Foot Arch ◽  
History Of ◽  
The Right

Research on the plantar segment has not been widely carried out in Indonesia’s population, even though the plantar segment data will be essential in further research and therapy of plantar-related problems. Therefore, this research intends to describe the plantar profile: the foot arch and the plantar pressure difference between the right and left foot. This research applied a cross-sectional study. Subjects were recruited from the Faculty of Medicine students, Universitas Indonesia, class 2012, with inclusion criteria aged 17-21 years and normal gait. Meanwhile, the exclusion criteria consisted of having postural abnormalities, a history of neuromusculoskeletal disorders in the lower limbs, a history of fractures in the spine and legs, a history of surgery on the spine and legs, and refusing to participate in the study. Research subjects stood on a plantar scanner, conducted at the Anatomy Laboratory, the Faculty of Medicine, Universitas Indonesia. The Mann-Whitney test was then used to analyze the difference in plantar pressure between the right and left foot. The results revealed that a hundred research subjects had a proportion of a low foot arch of 4%, a normal foot arch of 89%, and a high foot arch of 7%. The median right plantar pressure was 273.5 KPa, while the median left plantar pressure was 253.5 KPa. The Mann-Whitney test showed a p-value of 0.954 for the pressure difference between right and left foot. There was no plantar pressure difference between the right and left foot.

scholarly journals SPINDLE CELL CARCINOMA OF LARYNX- A DISTINCT CLINICOPATHOLOGICAL AND HISTOLOGICAL ENTITY

2017 ◽  
Vol 3 (3) ◽  
Author(s):  
Muhammad Faisal ◽  
Arif Jamshed ◽  
Raza Hussain
Keyword(s):  
Risk Factors ◽  
Cell Carcinoma ◽  
Vocal Cord ◽  
Distant Metastasis ◽  
Spindle Cell ◽  
Spindle Cell Carcinoma ◽  
Treatment Result ◽  
Left Vocal Cord ◽  
History Of ◽  
The Right

Spindle cell carcinoma (SpCC) is a variant of squamous cell carcinoma with biphasic components and more aggressive behaviour. Its rarity and histopathological pattern pose a diagnostic challenge. Early diagnosis and treatment result in a decrease in local and distant metastasis. Case 1 is a 71-year-old female presented with hoarseness of voice and dyspnoea for 2 years without any risk factors. Fibre-optic laryngoscopy (FOL) revealed smooth polyp hanging from anterior two-third of the left vocal cord. Microlaryngoscopic excision revealed SpCC followed by post-operative radiotherapy and is currentlyalive. Case 2 is a 72-year-old male presented with worsening stridor for 2 years post-excision of laryngeal nodule and history of smoking and hookah use for >20 years. He developed dysphonia after a few months with fixed hard level 3 nodes at the right side. FOL showed a polypoid mass extending from the left vocal cord into the supraglottis. Fine-needle aspiration cytology of the neck swelling confirmed the diagnosis of SpCC. Computerised tomography (CT) chest/abdomen showed distant metastasis. Palliative radiotherapy was given, but the patient died after 3 months due to locoregional failure. Case 3 is a 35-year-old male presented with a history of hoarseness for 3 years with no risk factors. FOL showed a 1.2-cm polypoid growth on the right vocal cord. Total laryngectomy was performed and histopathology showed SpCC. Radiotherapy was given and the patient is alive without disease with regular follow-ups. Smoking and alcohol are thought to be the contributing factors causing this disease. Biphasic nature of the tumour requires pathological sampling for diagnostic confirmation. Surgery combined with radiotherapy has a better survival outcome. SpCC is a rare tumour with a tendency for locoregionalrecurrence. Surgery should remain the mainstay of treatment followed by post-operative radiotherapy for a better control.Key words: Larynx, radiotherapy, spindle cell carcinoma

scholarly journals Sacral Tuberculosis: An Atypical Manifestation

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Faisal Amir Si Mirah ◽  
Ahmad Faizal Roslan ◽  
Ed Simor Khan Mor Japar Khan ◽  
Rajandra Kumar Karupiah ◽  
Zamzuri Zakaria @ Mohamad
Keyword(s):  
Correct Diagnosis ◽  
Lower Limbs ◽  
Mantoux Test ◽  
Ct Guided ◽  
Walking Aids ◽  
Grade 5 ◽  
History Of ◽  
Prolapsed Intervertebral Disc ◽  
The Right ◽  
High Index Of Suspicion

Sacral tuberculosis (TB) is extremely rare and its unusual entity might delay the diagnosis and treatment of this treatable disease. A 38-year-old lady presented with a 1 year history of lower back pain with radiculopathy more to right lower limb. The patient was initially treated as Prolapsed Intervertebral Disc (PID), but showed no improvement despite regular physiotherapy and medication. Subsequently, the pain was confined to the right gluteal area and became more severe. Quality of life was impaired in which patient started using walking aids and stopped working. There was a weight loss of 20kg. No other symptom of TB infection or history of contact with TB patient. Bowel and urinary functions were normal. Examination showed localized tenderness at the right gluteal area. Neurological assessment of both lower limbs were MRC grade 5. Blood investigations were normal including the ESR level (17mm/hour). Mantoux test was positive with 18mm induration. MRI revealed a large rim enhancing paravertebral collection at pre-sacral space which extended into bilateral piriformis and gluteal muscles. The patient underwent CT-guided drainage of both gluteals and specimens taken to confirm the diagnosis of TB. Patient showed significant improvement clinically within 1 week after the drainage procedure and initiation of antituberculous chemotherapy. The initial presentation of this patient mimics PID due to irritation of sciatic nerve at piriformis level. However a change in the presentation and failure of conservative treatment should raise a high index of suspicion and necessitates further investigation to establish correct diagnosis hence proper treatment can be initiated.

scholarly journals Internal Carotid Dissection as the Cause of Stroke in Childhood

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Giulia Cinelli ◽  
Vitaliana Loizzo ◽  
Lisa Montanari ◽  
Ilaria Filareto ◽  
Elisa Caramaschi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Magnetic Resonance ◽  
Internal Carotid ◽  
Clinical Signs ◽  
Cervical Pain ◽  
Resonance Imaging ◽  
Cervical Trauma ◽  
History Of ◽  
Associated Risk Factors ◽  
The Right

Internal carotid artery (ICA) dissection is a cause of stroke, but it is often underdiagnosed in children. ICAs’ risk factors and pathogenic mechanisms are poorly understood, and the treatment is still empirical. We report the case of a previously healthy 9-year-old girl who presented with involuntary hypertonic closure of the right hand associated with transient difficulty for both fine movements of the right arm and speech. She had a history of minor cervical trauma occurring 20 days prior to our observation without other associated risk factors. Magnetic resonance imaging and magnetic resonance angiography showed ischemic lesions due to the left ICA dissection. Treatment with both acetylsalicylic acid and levetiracetam allowed recanalization of the ICA associated with the resolution of clinical signs. Our clinical case suggests that the ICA dissection must be suspected early whenever a child manifests mild neurologic deficits after a cervical trauma, especially if they are associated with headache and/or cervical pain. Moreover, the management of ICA dissection must be improved.

scholarly journals A case of recurring Amaurosis Fugax

2019 ◽  
pp. 85-87
Author(s):  
Y. Suthahar ◽  
J. Blackwell ◽  
G. Zachariah ◽  
V. Umachandran
Keyword(s):  
Risk Factors ◽  
Visual Loss ◽  
Sudden Onset ◽  
Vascular Risk ◽  
Amaurosis Fugax ◽  
Anti Platelet Therapy ◽  
History Of ◽  
Ct Head ◽  
The Right ◽  
Hospital Manager

WW a 43 year old Caucasian Hospital Manager, first presented in July 08 complaining of transient mono-ocular visual loss in the right eye.  She described sudden onset loss of vision – ‘like a curtain coming across the vision’.  She then proceeded to have similar symptoms in the left eye.  There was no history of a subsequent headache. The episode would between 30 seconds and 10 minutes and could occur up to 10 times a day. At times, the attack was also associated with some left arm numbness.  She was initially reviewed by Dr Vu [ Stroke Consultant] who diagnosed Amaurosis Fugax and started her on standard anti-platelet therapy  [combination of Aspirin and Dypyridamole].  She had very little in terms of vascular risk factors [nil hypertensive, minimal alcohol and a life-long non-smoker with a fasting cholesterol 3.12]. Her PMH history consisted of Gilberts’ Syndrome and endometriosis. She also suffered a DVT following a hysterectomy. Her initial investigations of a CT head and carotid duplex were normal.

scholarly journals A Case of Unilateral Coccidioidal Chorioretinitis in a Patient with HIV-Associated Meningoencephalitis

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher B. Toomey ◽  
Andrew Gross ◽  
Jeffrey Lee ◽  
Doran B. Spencer
Keyword(s):  
Risk Factors ◽  
Vision Loss ◽  
Complement Fixation ◽  
Rare Condition ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Blurry Vision ◽  
Systemic Symptoms ◽  
The Right

Intraocular coccidioidomycosis is a rare condition, with the most commonly reported presentation being an idiopathic iritis in patients who live in or have traveled thorough endemic areas. A paucity of reports exists describing the chorioretinal manifestations of coccidioidomycosis. Here we report a case of unilateral coccidioidal chorioretinitis and meningoencephalitis in an AIDS patient that led to near complete unilateral loss of vision. A 48-year-old Hispanic female with poorly controlled HIV/AIDS in southern California presented with a three-week history of headache, nausea, vomiting, right eye blurry vision, and a one-day history of subjective fever. Examination of the right eye revealed vitritis and several large chorioretinal lesions scattered throughout the periphery and macula with optic disc pallor. Serum coccidioidomycoses complement fixation (CF) was positive (titers of 1 : 256). Neuroimaging revealed a new area of enhancement in the left anterior frontal lobe consistent with meningoencephalitis. The patient was treated with intravenous fluconazole and intravitreal voriconazole with resolution of systemic symptoms and vitritis but persistence of unilateral, severe chorioretinal scarring and vision loss. In conclusion, in spite of the rarity of intraocular coccidioidomycosis, one must carry a degree of suspicion for this vision- and life-threatening condition as a potential etiology of chorioretinitis in individuals with pertinent risk factors.

scholarly journals Transformation of Seborrheic Keratosis into Bowenoid Actinic Keratosis via Three Steps of Histological Change in a Patient with Rheumatoid Arthritis Treated with Multiple Immunosuppressants

2020 ◽  
Vol 12 (1) ◽  
pp. 19-24
Author(s):  
Masahiro Oka ◽  
Yuki Yamamoto ◽  
Miki Fujii
Keyword(s):  
Rheumatoid Arthritis ◽  
Skin Lesion ◽  
Malignant Transformation ◽  
Actinic Keratosis ◽  
Histological Change ◽  
The Other ◽  
Lateral Side ◽  
Seborrheic Keratosis ◽  
History Of ◽  
The Right

We report a case of seborrheic keratosis (SK) that transformed into bowenoid actinic keratosis (AK) via three steps of histological change in a 77-year-old woman. The patient presented with a multiple-year history of a brownish lesion on the right cheek. She reported that some months earlier she had noted a pinkish lesion developing within the brownish lesion. She had also been treated with several immunosuppressants for rheumatoid arthritis for many years. Physical examination revealed a nodule measuring 13 × 12 mm on the lateral side of the right upper cheek. The lesion comprised three regions: a brownish hyperkeratotic region in the upper portion; a pinkish region in the lower portion; and a slightly dented, band-like region between the other two regions. Histopathologically, the specimen consisted of four zones: SK comprising basaloid cells; SK composed of squamoid cells; atrophic AK; and bowenoid AK. The zones of SK with basaloid cells and squamoid cells clinically corresponded to the brownish hyperkeratotic region. Atrophic and bowenoid AK zones corresponded to the dented, band-like region and pinkish region, respectively. Collectively, the nodular skin lesion was diagnosed as SK associated with atrophic and bowenoid AK within the SK lesion. The present case suggests that bowenoid AK developed from SK by malignant transformation via three steps of histological change. The facts that our patient had received treatment with several immunosuppressants and that no other AK lesions were evident around the AK support the notion that in this case, bowenoid AK developed from SK by malignant transformation.

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