Symmetrical Drug-related Intertriginous and Flexural Exanthema (Baboon Syndrome)

Baboon syndrome, also called symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), is an erythematous maculopapular rash that presents in skin folds in a symmetrical pattern. This condition may develop after the patient starts a particular agent. Treatment consists of stopping the associated trigger and medicating with topical or systemic corticosteroids. A 30-year-old man with odynophagia, otalgia and fever was prescribed amoxicillin. He developed erythematous and pruriginous lesions in the cubital fossa and inguinal regions. He attended the emergency department (ED) where he was prescribed penicillin. Lesions continued to progressively worsen with a bilateral symmetrical pattern in the axillary region and later in the nape folds, popliteal regions, and on the perineum and buttocks. The patient presented to the ED for a second time, where he was diagnosed with baboon syndrome and prescribed topical steroids with clear improvement.

ADULT-ONSET CYSTIC HYGROMA IN AXILLA: A RARE CASE REPORT FROM INDIA AND LITERATURE REVIEW

Background. Cystic hygroma (CH), occurs in 1/6000 live births and in 90% of cases develops in age less than 2 years old. They are mainly located in cervicofacial region. Adult-onset CH is very rare. Objective. The aim of this study is to review literature to discuss the clinical presentation, diagnosis, and treatment of CH in adults through a case report of unilocular CH in the axillary region in an adult male from India. Methods. A first case report of unilocular CH in axillary region in an adult male from India is being investigated. Results. Here we report a case of unilocular CH in the axillary region in a 49-year-old male with a 14x16x8 cm cystic swelling in left axilla with a history of aspiration failure. Contrast-enhanced MRI (CEMRI) showed well-defined thin walled, unilocular cystic lesion which appeared hyperintense on T2 & STIR and hypointense on T1W1 and showed thin peripheral rim of enhancement on post contrast images. The patient underwent surgical excision and the diagnosis of a pathological CH was established. His postoperative recovery was uneventful and had no evidence of recurrence. Conclusion. Due to rarity of adult-onset unilocular CH in axilla, its evaluation for prompt diagnosis and definitive treatment to prevent recurrence and complications is urgent. Furthermore, this is the first reported case from India which has been successfully managed at a peripheral hospital in Northeast-India and our report of this case contributes to the evidences supporting the role of CH in a differential diagnosis for masses in the adult axilla, especially in acute phase with no predisposing factors.

Thoracodorsal Artery Perforator Flap for Chronic Radiation-Induced Ulcer of the Axilla in Vietnam

Breast cancer is the leading cause of death in females worldwide. Radiotherapy plays an important role for locoregional control in the comprehensive management of breast cancer. Chronic radiation-induced ulcer of the axilla can occur, and it is complicated to treat for these lesions. The application of a thoracodorsal artery perforator flap offers many advantages to be one of the most efficient treatments for radiation-induced ulcers of the axillary region. We introduce a series of 5 patients with radiation-induced ulcers of the axilla treated by using a thoracodorsal artery perforator flap. The mean operative time was 190 minutes. During at least a two-year follow-up, no complication has been found, and the patient has achieved good cosmetic result without movement limitation of the upper limb.

Reticular Erythematous Mucinosis: Exclusive Involvement of the Axillary Region

Reticular erythematous mucinosis is a primary cutaneous mucinosis characterized by the presence of erythematous macules, papules, or plaques coalescing into a reticular pattern that typically involves the midline of the chest or back in middle-aged women. Because of this peculiar location, it is also called midline mucinosis. Although atypical disease localizations have been described in the literature, these have always been accompanied by midline involvement. We report a case of reticular erythematous mucinosis with exclusive involvement of the axillary region.

A New Case of Hybrid Epidermoid and Apocrine Cyst

We described a new case of a hybrid epidermoid and apocrine cyst, known to be a rare histopathological entity. The cyst was located in the axillary region and completely excised, without complication. The diagnosis was made at the histological analysis, where we found a cystic lesion in the dermis, lined with both epidermoid and apocrine epithelium.

‘Unique does not mean impossible: infant presenting with complicated course of ulceroglandular tularemia.’

ABSTRACT Tularemia is a disease caused by Francisella tularensis—gram-negative coccobacillus. The ulceroglandular type characterized by skin ulcers and painful regional adenopathy is recognized as the most common. A 1-year-old patient was admitted with severe normocytic anemia, high fever and hepatosplenomegaly. A nonspecific lesion in the axillary region with a homogenous nodal reaction was found, combined with a history of a tick-bite in the pectoral muscle. Primary differentiation included leukemia, lymphoma, mononucleosis, borrelial lymphoma and simple abscess. All of the above were excluded. A further search for diagnosis focused on tick-borne diseases: TIBOLa or anaplasmosis. The ulceroglandular tularemia was eventually confirmed serologically. Besides the fact that tularemia is a rare diagnosis nowadays, it is still necessary to include this disease in the differentiation of a nonresolving tick-bite abscess with lymphadenopathy. Diagnostic vigilance is the key to effective treatment because other obvious symptoms such as severe anemia might delay the diagnosis.

Pectoral-fin glands and delivery apparatus in the catfish genus Brachyrhamdia Myers, 1927 (Siluriformes: Heptapteridae)

The Siluriformes, popularly known as catfishes, are probably the vertebrate group with the highest diversity of venomous animals, even though only approximately a hundred venomous catfishes are reported to date. Venomous catfishes might present a delivery system apparatus, formed by an unbranched ray at the leading edge of pectoral and dorsal fins (spine), which can be stiffened and pungent, while venom glands can be present at the surface of such spines and/or the axillary region. This work investigated the presence, morphology and distribution of glands and pectoral-fin delivery apparatus in the heptapterid Brachyrhamdia genus. Pectoral-fin spine external morphology was compared across all valid species in the genus, histological sections of the pectoral-fin spine and axillary regions of B. heteropleura and B. marthae were produced, and dissections of the pectoral girdle region of the mentioned species were analyzed. The histological sections confirmed the presence of pectoral-fin glands at the surface of the pectoral-fin spine of Brachyrhamdia species, and cellular morphology indicates these glands are probably venomous. Also, we found a piriform gland at the axillary region, whose cell morphology is like the reported for other catfishes. However, we cannot currently confirm or deny axillary gland participation in the venom delivery apparatus. This work constitutes the first report of venom glands in Brachyrhamdia, and the first description of Heptapteridae axillary glands.

Equine attachment site preferences and seasonality of common North American ticks: Amblyomma americanum, Dermacentor albipictus, and Ixodes scapularis

Background Ticks are common on horses, but recent publications characterizing equine tick infestations in North America are lacking. Methods To further understand attachment site preferences of common ticks of horses, and to document the seasonality of equine tick infestation in northeastern Oklahoma, horses from eight farms were evaluated twice a month over a 1-year period. Each horse was systematically inspected beginning at the head and moving caudally to the tail. Attachment sites of ticks were recorded and all ticks collected were identified to species and stage. Results Horses (26 males and 62 females) enrolled in the study ranged in age from 1 to 23 years (mean = 12, 95% CI 11–13). A total of 2731 ticks were collected; 84.1% (74/88) of the horses were infested (median = 3 ticks) at one or more examinations. Five tick species were identified, including Amblyomma americanum (78.2%; 2136/2731), Ixodes scapularis (18.2%; 497/2731), Dermacentor albipictus brown variant (2.6%; 71/2731), Dermacentor variabilis (0.7%; 20/2731), and Amblyomma maculatum (0.3%; 7/231). Most ticks were adults (83.6%; 2282/2731), but immature A. americanum (436/2136; 20.4%), D. albipictus (12/71; 16.9%), and A. maculatum (n = 1) were occasionally recovered. Amblyomma americanum were most often attached to the inguinal area, and I. scapularis and D. albipictus were most commonly found on the chest and axillary region (P < 0.0001). Ticks were found on horses in every month of the year. The largest number of ticks (638/2731; 23.4%) were collected in May (P < 0.0001). Amblyomma americanum, primarily immature, was the only tick recovered in September, I. scapularis and D. albipictus predominated October through February, and both A. americanum and I. scapularis were common in March. In the warmer months, April through August, A. americanum was the most common tick, followed by D. variabilis and A. maculatum. Conclusions This research confirms that ticks common on horses in North America have attachment site preferences and that ticks infest horses in Oklahoma throughout the year, including during the winter. Additional research is warranted to fully understand the risk these infestations pose to equine health. Graphical abstract

PHARMACOLOGICAL ACTIVITY OF AN AMINOCHROMENE DERIVATIVE IN THE TREATMENT OF BREAST CANCER (EXPERIMENTAL STUDY)

We studied an antitumor effect of a compound of 4-aminochromene derivatives (AX-554) in the tumor system of breast cancer Ca-755. We used C57Bl / 6 mice, which were subcutaneously injected with a suspension of Ca-755 tumor cells into the right axillary region in the amount of 1×106 cells in 199 solution. AX-554 was administered intragastrically through a tube once on the 48 hours after tumor transplantation, in comparison with reference antitumor drugs with proven antitumor activity, which were used as doxorubicin, paclitaxel. The antitumor activity was judged by the survival rate of animals, the size and morphology of the tumor node. It was shown that the 4-aminochromene derivative AX-554 increases the survival rate of animals with breast cancer by 30% compared with the control group and by 10% with the group receiving doxorubicin. with control. In the study of tumor sections stained with hemotoxylin and eosin in animals treated with AX-554, there were single tumor cells in a state of severe dystrophy, the necrosis zone was 90%, which indicates drug pathomorphosis of the 3rd degree. In animals treated with doxorubicin, atypical cells in the center of the tumor node retained their structure, in the periphery - cells in a state of dystrophy, foci of necrosis accounted for 60%. The morphological picture of the tumor in animals treated with paclitaxel was a drug pathomorphosis of the 2nd degree.