Malignant melanoma. A clinical and surgical review. Part II: Diagnosis and treatment

1989 ◽  
Vol 79 (9) ◽  
pp. 421-431 ◽  
Author(s):  
ML Zivot ◽  
IO Kanat
Keyword(s):  
Risk Factors ◽  
Malignant Melanoma ◽  
Lower Extremity ◽  
Cause Of Death ◽  
Clinical Features ◽  
Delayed Diagnosis ◽  
Growth Patterns ◽  
Diagnosis And Treatment ◽  
Clinical Staging ◽  
Disease Entity

Malignant melanoma, the leading cause of death from disease of the skin, often is found on the lower extremity. A thorough understanding of the disease entity is essential, because misdiagnosis or delayed diagnosis can be fatal. In Part I of this two-part clinical and surgical review of malignant melanoma, the authors discussed etiology, risk factors, signs, symptoms, clinical features, and growth patterns. Part II places special emphasis on diagnosing malignant melanoma and differentiating it from other lesions of the lower extremity. Clinical staging of the tumor and the corresponding surgical criteria are presented from a podiatric medical standpoint.

Malignant melanoma. A clinical and surgical review. Part I: Introduction and general discussion

1989 ◽  
Vol 79 (8) ◽  
pp. 367-374 ◽  
Author(s):  
ML Zivot ◽  
IO Kanat
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Malignant Melanoma ◽  
Lower Extremity ◽  
Cause Of Death ◽  
Clinical Features ◽  
Delayed Diagnosis ◽  
Growth Patterns ◽  
Disease Entity

Malignant melanoma, the leading cause of death from diseases of the skin, often is found on the lower extremity. When encountered by the podiatric physician, a thorough understanding of the disease entity is essential, as misdiagnosis or delayed diagnosis can have fatal consequences. The authors present the first of a two-part comprehensive clinical and surgical review of malignant melanoma. Part I reviews etiology, risk factors, signs, symptoms, clinical features, and growth patterns. In Part II, a pictorial lower extremity differential diagnosis will be provided, along with diagnostic and surgical criteria for the podiatric surgeon.

Risk factors for the delayed diagnosis of extrapulmonary TB

2021 ◽  
Vol 25 (3) ◽  
pp. 191-198
Author(s):  
M. K. Lee ◽  
C. Moon ◽  
M. J. Lee ◽  
Y. G. Kwak ◽  
E. Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Outpatient Clinic ◽  
Diagnostic Testing ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Diagnosis And Treatment ◽  
Delay In Diagnosis ◽  
Microbiological Characteristics ◽  
Significant Difference ◽  
Basic Characteristics

BACKGROUND: Extrapulmonary TB (EPTB) is more difficult to diagnose than pulmonary TB. The delayed management of EPTB can lead to complications and increase the socio-economic burden.METHODS: Patients newly diagnosed with EPTB were retrospectively enrolled from 11 general hospitals in South Korea from January 2017 to December 2018. The basic characteristics of patients were described. Univariable and multivariable analyses were performed between early and delayed diagnosis groups to identify risk factors for delayed diagnosis and treatment in EPTB.RESULTS: In total, 594 patients were enrolled. Lymph node TB (28.3%) was the predominant form, followed by abdominal (18.4%) and disseminated TB (14.5%). Concurrent lung involvement was 17.8%. The positivity of diagnostic tests showed no significant difference between the two groups. Acute clinical manifestations in disseminated, pericardial and meningeal TB, and immunosuppression were associated with early diagnosis. Delayed diagnosis was associated with outpatient clinic visits, delayed sample acquisition and diagnostic departments other than infection or pulmonology.CONCLUSION: The delay in diagnosis and treatment of EPTB was not related to differences in microbiological characteristics of Mycobacterium tuberculosis itself; rather, it was due to the indolent clinical manifestations that cause referral to non-TB-specialised departments in the outpatient clinic and delay the suspicion of TB and diagnostic testing.

Lower Extremity Glomus Tumors: Comprehensive Review for Surgeons

Vascular ◽  
2008 ◽  
Vol 16 (6) ◽  
pp. 326-332 ◽  
Author(s):  
Leon R. Luis ◽  
Goshima R. Kaoru ◽  
Psalms B. Shemuel ◽  
Joseph L. Mills
Keyword(s):  
Lower Extremity ◽  
Glomus Tumor ◽  
Symptomatic Relief ◽  
Delayed Diagnosis ◽  
Surgical Excision ◽  
Disease Entity ◽  
Review Of The Literature ◽  
Comprehensive Review ◽  
Glomus Tumors ◽  
Diagnosis And Management

The diagnosis of a lower extremity glomus tumor (GT) is often delayed owing to the lack of awareness and low level of suspicion by the treating physician. GT is thought to arise from cutaneous arteriovenous connections, often involving the nail beds. The unusual location of the lower extremity often leads to missed or delayed diagnosis and management. Surgical excision of GT is often curative and provides significant symptomatic relief. There is a paucity of information in regard to GT in general, especially among vascular surgeons. The aim of this report is to make the surgical community more aware of this disease entity based on the analysis of our own experience and review of the literature.

scholarly journals Bone and joint tuberculosis in patients undergoing dialysis: clinical features, risk factors, and outcomes in 17 patients

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094550
Author(s):  
Xuehua Wu ◽  
Jing Liu ◽  
Guorong Wang ◽  
Fengfeng Wu
Keyword(s):  
Risk Factors ◽  
Cell Count ◽  
Clinical Features ◽  
Medical Records ◽  
Delayed Diagnosis ◽  
Cd4 Cell Count ◽  
Spine Tuberculosis ◽  
The Mean ◽  
Anti Tubercular Therapy ◽  
Cd4 Cell

Objective This study was performed to investigate the clinical features, risk factors, and outcomes of bone and joint tuberculosis in patients undergoing dialysis. Methods We systematically reviewed the medical records of 17 patients with bone and joint tuberculosis undergoing dialysis who were admitted to our hospital from January 2009 to January 2019. Results Seventeen patients with bone and joint tuberculosis undergoing dialysis were identified in this retrospective study, and 13 patients were undergoing hemodialysis. The mean age of the 17 patients was 61.3 years (range, 32–82 years), and 10 (58.9%) patients were male. Most of the patients had a low CD4+ cell count and low hemoglobin and albumin levels. Surgery was performed in 6 patients (35.3%), and 13 of the 17 patients (76.4%) were cured. Three patients had bone or spine sequelae, mainly because of a delayed diagnosis, and one patient died of heart failure. Conclusion These findings indicate that older age, a low CD4+ cell count, and low hemoglobin and albumin levels are possible risk factors for bone and spine tuberculosis in patients undergoing dialysis. If diagnosed early, most patients should have a good outcome after anti-tubercular therapy with or without surgery.

Valproic acid-induced encephalopathy: A review of clinical features, risk factors, diagnosis, and treatment

2021 ◽  
Vol 120 ◽  
pp. 107967
Author(s):  
Junhong Wu ◽  
Jiyuan Li ◽  
Wei Jing ◽  
Xin Tian ◽  
Xuefeng Wang
Keyword(s):  
Risk Factors ◽  
Valproic Acid ◽  
Clinical Features ◽  
Diagnosis And Treatment

scholarly journals Delayed diagnosis of myelitis in a patient with Vogt-Koyanagi-Harada disease: a case report

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110016
Author(s):  
Dongwoo Yu ◽  
Tae Uk Kim ◽  
Min Cheol Chang
Keyword(s):  
Lower Extremity ◽  
Vision Loss ◽  
Delayed Diagnosis ◽  
University Hospital ◽  
Diagnosis And Treatment ◽  
Motor Weakness ◽  
Left Lower Extremity ◽  
Cell Counts ◽  
Good Treatment Outcome ◽  
Vkh Disease

A case of myelitis following Vogt-Koyanagi-Harada (VKH) disease is reported, in which diagnosis and treatment were delayed. A 43-year-old male patient diagnosed with VKH disease presented at the Spine Centre of Yeungnam University Hospital, Daegu, Republic of Korea, with motor weakness, sensory deficit in both lower extremities, and dysuria for the previous 3 months. VKH disease had been diagnosed 15 months previously, based on vision loss in both eyes and the presence of bilateral nontraumatic granulomatous iridocyclitis, exudates, and retinal oedema. The patient exhibited severe motor weakness (right lower extremity, Medical Research Council (MRC) muscle scale, grade 2–0; left lower extremity, MRC grade 0). On cervical magnetic resonance imaging, a high-intensity T2 signal was observed in the spinal cord C4–C7 segments. Cerebrospinal fluid analysis revealed slightly elevated white blood cell counts. The patient was diagnosed with myelitis complicating VKH disease. Intravenous and oral corticosteroid therapy was administered. After steroid treatment, the patient’s motor function in the right lower extremity was significantly improved (MRC grade 4–3). However, the left lower extremity did not show any improvement (MRC grade 0). To achieve a good treatment outcome, the diagnosis and treatment of myelitis in VKH disease should not be delayed.

Alzheimer’s disease

2020 ◽  
pp. 443-478
Author(s):  
John-Paul Taylor ◽  
Benjamin R Underwood
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cause Of Death ◽  
Clinical Features ◽  
Therapeutic Approaches ◽  
Common Cause ◽  
Disease Modifying Drugs ◽  
Future Potential ◽  
Disease Modifying

Dementia is the fifth leading cause of death worldwide. The most common cause of dementia is Alzheimer’s disease (AD). This fully updated and revised chapter comprehensively reviews the latest evidence on diagnosis, assessment, investigations, clinical features, management, risk factors, prognosis, and future potential treatments for AD. Importantly, the chapter explores newer evidence that has changed the way AD is viewed as regards methods of assessment using various scales to determine diagnosis, as well as current and investigative methods of treating AD. Finally, it looks at the states of disease progression, potential disease-modifying drugs for Alzheimer’s disease, and possible therapeutic approaches to treatment and management.

scholarly journals Pyogenic granuloma-like lesion in children: Should we wait?

2017 ◽  
Vol 50 (01) ◽  
pp. 104-106
Author(s):  
Lai Kuan Chooi ◽  
Arman Zaharil Mat Saad ◽  
Shamala Durairajanayagam
Keyword(s):  
Malignant Melanoma ◽  
Skin Lesion ◽  
Delayed Diagnosis ◽  
Pyogenic Granuloma ◽  
Clinicopathological Characteristics ◽  
Diagnosis And Treatment ◽  
Suspicious Lesion ◽  
Cutaneous Malignancy ◽  
High Index Of Suspicion ◽  
Slow Growing

ABSTRACTMalignant melanoma is a potentially lethal cutaneous malignancy. Melanoma in paediatrics is rare as compared to adult melanoma. The clinicopathological characteristics of paediatric melanoma are different from adult melanoma, and the presence of melanoma mimics which occurs frequently in children (Spitz naevi) resulted in diagnosis uncertainty. We reported a 9-year-old girl who presented with a slow-growing, pyogenic granuloma-like lesion which was diagnosed with melanoma. It is important to have a high index of suspicion in paediatric skin lesion that would usually be deemed benign. Early tissue biopsy in a suspicious lesion prevents delayed diagnosis and treatment.

LONGITUDINAL MELANONYCHIA: DETECTION AND MANAGEMENT OF NAIL MELANOMA

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 133-139 ◽  
Author(s):  
Kathleen A. Mannava ◽  
Sandeep Mannava ◽  
L. Andrew Koman ◽  
Leslie Robinson-Bostom ◽  
Nathaniel Jellinek
Keyword(s):  
Risk Factors ◽  
Malignant Melanoma ◽  
Mortality Rate ◽  
Delayed Diagnosis ◽  
Nail Plate ◽  
Clinical Approach ◽  
Biopsy Technique ◽  
Longitudinal Melanonychia

Malignant melanoma of the nail confers a higher mortality rate compared to other cutaneous melanomas, which is often attributable to delayed diagnosis. Two-thirds of nail melanomas present as longitudinal melanonychia (LM), longitudinally-oriented brown-black bands of pigment in the nail plate. This article delineates the appropriate clinical approach toward evaluation and management of a patient with longitudinal melanonychia, which includes determining risk factors for melanoma, recognizing scenarios in which biopsy is indicated, selecting the appropriate biopsy technique, and managing a patient in whom the diagnosis of nail melanoma has been made.

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