Perniosis

2016 ◽  
Vol 106 (2) ◽  
pp. 138-140 ◽  
Author(s):  
Joseph S. Baker ◽  
Sarnarendra Miranpuri

Perniosis, or chilblain, is an uncommon condition of the acral skin. Presented herein is a case report of a 65-year-old otherwise healthy construction worker with perniosis. He had a 3-year history of lesions on the fingers and toes brought on by cold, damp weather. On initial presentation, a biopsy sample was taken of a hallux lesion, and the patient was given a trial course of nifedipine therapy. Follow-up at 3 weeks showed complete relief of symptoms with nifedipine use, and the biopsy results confirmed the diagnosis. The etiology and pathogenesis of perniosis are reviewed. Differential diagnoses and treatment options are reviewed and discussed. Nifedipine therapy has been shown to be effective and should be considered the standard of care in the treatment of perniosis along with avoidance of cold, damp environments, with protection using gloves and warm socks.

2021 ◽  
pp. 107815522110026
Author(s):  
Nicolle A Trudeau ◽  
Jessica M Lawton ◽  
Nirav D Patel

Introduction Pemigatinib is an FGFR inhibitor that is one of few second-line treatment options for cholangiocarcinoma. Nail toxicities were common in the phase 2 study evaluating the safety and efficacy of pemigatinib. Case report We describe a 54-year-old female with a history of stage IV cholangiocarcinoma presenting for a follow-up visit after completing Cycle 4 of pemigatinib. The patient had been having significant nail changes to her fingernails and toenails, which has led to her great toenails falling off. Management and outcome: The patient was prescribed betamethasone dipropionate 0.05% cream to help with her nail changes and instructed to continue vinegar and hot water soaks that she had already been doing. It was discussed that if this did not help with her nail changes, treatment may have to be held for 2 weeks to allow her nails to heal. Discussion Nail changes are a common side effect with pemigatinib and should be monitored closely for the need for temporary disruption in therapy.


2021 ◽  
Vol 10 (4) ◽  
pp. e24110413699
Author(s):  
Ana Paula Farnezi Bassi ◽  
Karen Rawen Tonini ◽  
Daniela Ponzoni

Impaction of permanent first and second molars is an uncommon condition, with a prevalence rate of 0.01% to 0.08% and few cases are described in the literature. Many etiological factors are reported for failure in the eruption of these teeth. However, the mechanisms responsible for this occurrence are still unknown. This article describes the treatment of a 12-year-old patient with a permanent lower molar impacted with twelve-year follow-up. The presence of the impacted tooth was diagnosed from an asymptomatic extra-oral volumetric increase at the base of the patient's jaw. The first impacted molar was surgically removed by intraoral access under local anesthesia. The patient was not able to follow orthodontic follow-up. In 12-year follow-up, it was observed that the removal of the impacted tooth was the best option for the case. This article also offers a discussion to broaden the understanding of the causes and treatment options in cases of permanent molar impacted.


2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Su Li ◽  
Xin Li ◽  
Fu-lun Li ◽  
Bin Li

<p>Acquired digital fibrokeratoma (ADFK) has typical characteristics and occurs most frequently on the fingers. The size of the tumor is usually less than 1 cm in diameter. We report a case of a typical ADFK, along with a review of the literature. A 76-year-old man presented with a two-year history of a slow-growing keratotic tumor on the edge aspect of his right hand ring finger. A literature search was conducted to identify published case reports of ADFK. Data on patient demographics, size and location of the lump, treatment, and follow-up were collected from each case report. This case is of interest because of the rarity of ADFK. Additionally, we have emphasized the importance of ruling out other causes of abnormal growths and considering fibrokeratoma during differential diagnoses.</p>


2020 ◽  
Vol 13 (12) ◽  
pp. e233179
Author(s):  
Eric Garrels ◽  
Fawziya Huq ◽  
Gavin McKay

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara L Weidmayer ◽  
Hakan Demirci

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.


2021 ◽  
pp. 29-32
Author(s):  
Elsiddig E. Mahmoud

Congenital bilateral humeroradial synostosis (HRS) is a rare condition. It is generally divided into 2 categories. In the first group, which is mainly sporadic, additional upper limb hypoplasia typically coexists. In the second group, which is classically familial, HRS is commonly an isolated upper extremity anomaly. HRS can lead to variable degrees of functional disability. The clinical case reported here illustrates a possibly avoidable presentation of this uncommon condition. In this case report, we present a 6-week-old male who presented with bilateral radius fractures. Radiography revealed congenital HRS at both elbows. No other associated congenital abnormalities were detected, and there was no family history of similar conditions in any first-degree relatives. In cases of congenital HRS, movement at the elbow joint is not possible. Parents who are unaware of this information might try to straighten their infant’s elbows, which in turn may result in fractures of the proximal radius. Hence, early diagnosis and proper parental education could prevent fractures as a sequela of HRS.


2017 ◽  
Vol 8 (1) ◽  
pp. 120-123
Author(s):  
Akinori Baba ◽  
Hiromichi Matsuda ◽  
Takuya Shiba ◽  
Yasuhiro Takahashi ◽  
Hiroshi Tsuneoka

An 84-year-old woman presented with a 3-month history of conjunctival chemosis in the left eye. At the first examination, the chemosis neighbored the lacrimal caruncle and was localized in the inferomedial region of the conjunctiva. During eyelid closure, only the left lacrimal caruncle was exposed. One month later, the chemosis further extended to the inferolateral region. We debulked the lacrimal caruncle to prevent the exposure of the caruncle. One month after the surgery, conjunctival chemosis had resolved completely. At the postoperative 6-month follow-up, the patient showed no recurrence of chemosis.


2021 ◽  
Vol 14 (11) ◽  
pp. e247189
Author(s):  
Jacob Moneim

A 70-year-old asthmatic man presented with a history of chronic intermittent left-sided chest pains and a bulge-like deformity of his chest which became more prominent with expiration. He sustained a traumatic fall 2 years prior whereby he fractured his right humerus at the surgical neck, requiring total arthroplasty. Examination and CT imaging of the thorax revealed a left costal arch fracture with hemidiaphragm rupture and associated transperitoneal fat herniation. He underwent left thoracolaparotomy with costal arch and diaphragmatic hernia repair. He was discharged 48 hours postoperatively and is satisfied with good outcomes under initial follow-up. This case report highlights the surgical management of a condition that usually presents late after significant trauma and may progress to visceral strangulation if untreated.


Case reports ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 77-83
Author(s):  
William Fernando Bautista-Vargas

Introduction: Recurrent falls are a usual problema in older patients. It is therefore important to learn how to differentiate a pathological or syncopal episode from a simple stumbling fall, especially in patients who have limitations for communicating clearly and are poorly understood, in general terms, during the medical consultation. Implantable loop recorders (ILR) have been used as an investigation tool in selected cases of recurrent falls in older patients. Consequently, this case report aims to describe its usefulness in this type of patients.Case presentation: An 87-year-old female patient, hypertensive, with a history of recent stroke and frequent falls —referred to as stumbling—, received an implantable loop recorder due to atrial fibrillation. During one follow-up appointment, a 36-second pause related to a fall was documented, so a bicameral pacemaker was implanted.Conclusions: Evaluating repeated falls in older patients is complex; it must be done in detail to rule out syncopal episodes. Implantable devices to diagnose arrhythmic causes are useful and allow achieving accurate diagnoses and establish specific behaviors aimed at improving the quality of life of patients.


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