scholarly journals Blue Rubber Bleb Nevus Syndrome Showing Vascular Skin Lesions Predominantly on the Face

2015 ◽  
Vol 7 (2) ◽  
pp. 194-198 ◽  
Author(s):  
Ayumi Korekawa ◽  
Koji Nakajima ◽  
Takayuki Aizu ◽  
Hajime Nakano ◽  
Daisuke Sawamura
Keyword(s):  
Gastrointestinal Tract ◽  
Histopathological Examination ◽  
Past History ◽  
Subcutaneous Fat ◽  
Skin Lesions ◽  
Upper Limbs ◽  
Normal Epithelium ◽  
X Ray ◽  
The Face ◽  
Dark Blue

An 81-year-old Japanese man presented with dark blue papules and nodules on his face. There were multiple soft papules and nodules, dark blue in color, compressive, and ranging in size from 2 to 10 mm. A few similar lesions were seen on the patient's right dorsal second toe and right buccal mucosa. There were no skin lesions on his trunk and upper limbs. The patient's past history did not include gastrointestinal bleeding or anemia. Histopathological examination showed dilated vascular spaces lined by the normal epithelium extending beneath the dermis and into the subcutaneous fat. Endoscopy of the gastrointestinal tract to check for colon involvement was not performed. X-ray images of the limbs revealed no abnormalities in the bones or joints. Laboratory investigations did not show anemia. Although we failed to confirm a diagnosis by endoscopy, the skin lesions, histopathological findings, lack of abnormal X-ray findings, and the presence of oral lesions as a part of gastrointestinal tract guided the diagnosis of blue rubber bleb nevus syndrome (BRBNS). Skin lesions of BRBNS occur predominantly on the trunk and upper limbs. However, the present case showed multiple skin lesions predominantly on the face. Therefore, it is important for clinicians to know about a possible atypical distribution of skin lesions in BRBNS.

scholarly journals A rare case of Sweet syndrome secondary to melioidosis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sahathevan Vithoosan ◽  
Balendran Thanushah ◽  
Paramarajan Piranavan ◽  
Dayal Gamlaksha ◽  
Harindra Karunatilake ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Burkholderia Pseudomallei ◽  
Skin Lesions ◽  
Upper Limbs ◽  
Cutaneous Manifestations ◽  
Sweet Syndrome ◽  
Emerging Infection ◽  
Oral Ulcers ◽  
First Case ◽  
The Face

Abstract Background Melioidosis is an emerging infection in South Asia caused by Burkholderia pseudomallei with various clinical presentations that include pneumonia, bacteraemia, arthritis, and deep-seated abscesses. Various cutaneous manifestations have been described in association with melioidosis. However Sweet Syndrome secondary to melioidosis has not been reported in the literature. Herein we describe the first case of Sweet syndrome secondary to melioidosis. Case presentation A 53-year-old previously healthy Sri Lankan female presented with high-grade fever, painful oral ulcers, odynophagia and multiple bilateral cervical lymphadenopathies for 1 month. She also had a loss of appetite and weight. She had oral ulcers and bilateral blepharitis. Dermatological examination revealed multiple tender papules with a mamillated appearance and targetoid lesions with a yellowish centre over the face, upper trunk and upper limbs. She also had multiple tender subcutaneous nodules over the extensor aspect of upper limbs. Her inflammatory markers were significantly elevated. Aspirate from a submental lymph node abscess revealed the growth of Burkholderia pseudomallei. Melioidosis antibody titer was > 10,240. The histology of the skin lesions of the face and left forearm showed a prominent neutrophilic infiltrate in the dermis and the morphological features were in favour of Sweet syndrome with panniculitis. She was started on intravenous meropenem 2 g daily and showed rapid clinical improvement with the disappearance of skin lesions as well as a reduction in inflammatory markers. Conclusion Sweet syndrome is an uncommon inflammatory disorder known to be associated with upper respiratory tract and gastrointestinal infections, malignancies and the use of certain drugs. Melioidosis is an emerging infection with various cutaneous manifestations. This is the first case of melioidosis causing the secondary sweet syndrome. It emphasizes the importance of considering melioidosis as a potential aetiology in patients with Sweet syndrome.

Pilomatricoma: Experience of the Hospital for Sick Children

2007 ◽  
Vol 15 (3) ◽  
pp. 159-161 ◽  
Author(s):  
Tatiana Karine Simon Cypel ◽  
Vijith Vijayasekaran ◽  
Gino R Somers ◽  
Ronald Melvin Zuker
Keyword(s):  
Recurrence Rate ◽  
Histopathological Examination ◽  
Pediatric Population ◽  
Surgical Excision ◽  
Upper Limbs ◽  
Common Skin ◽  
The Face ◽  
Clinical Differential Diagnosis ◽  
Skin Conditions ◽  
Sick Children

Background Pilomatricoma (calcifying epithelioma of Malherbe) is a common skin neoplasm in the pediatric population that is often misdiagnosed as other skin conditions or tumours. Objectives The objective of the present retrospective study was to review the clinical and histopathological presentation of this neoplasm in children. Methods The records of the pathology department at The Hospital for Sick Children, Toronto, Ontario, were searched for all cases of pilomatricoma between 2001 and 2006. The records of these patients were reviewed to determine sex, age, location and size of the tumour, pathological features and recurrence rate. All patients underwent surgical excision of the lesions. Results A total of 93 lesions in 85 patients were identified. The median age was 8.7 years. Of the 85 patients diagnosed with pilomatricoma, 44 (52%) were female. In all cases, the initial presentation was an asymptomatic, slow growing, superficial hard mass with bluish discolouration. The most common sites of occurrence were the face (48%), neck (21%) and upper limbs (18%). The size of the surgical specimens collected ranged from 0.1 cm to 2.6 cm. The diagnosis was confirmed by histopathological examination in all cases. Ghost cells and basaloid cells were described in most of the cases (83%). There were no recurrences in this series. Conclusions This entity should be considered with other benign or malignant conditions in the clinical differential diagnosis of solitary firm skin nodules, especially those on the face, neck and upper limbs. The diagnosis can generally be made by clinical examination. The treatment of choice is surgical excision, and the recurrence rate is very low.

TUTANKHAMUN'S GOLDEN MASK INVESTIGATED WITH XRDF

2007 ◽  
Vol 17 (01n02) ◽  
pp. 65-76 ◽  
Author(s):  
M. UDA ◽  
S. YOSHIMURA ◽  
A. ISHIZAKI ◽  
D. YAMASHITA ◽  
Y. SAKURABA
Keyword(s):  
Thin Layer ◽  
X Ray ◽  
Joint Investigation ◽  
Similar Chemical ◽  
The Face ◽  
Main Components ◽  
Glass Paste ◽  
Fluorescence Spectrometer ◽  
K Matrix ◽  
Dark Blue

This is a preliminary report for “the joint investigation between Japan and Egypt on Tutankhamun's golden mask”. This experiment was performed in the Egyptian Museum in Cairo using an XRDF (X-Ray Diffractometer equipped with x-ray Fluorescence spectrometer) setup invented by one of the authors (M. U.) and improved here. A diffraction pattern and a fluorescence spectrum can be obtained by the XRDF setup in the air from one and the same small area (1–2 mm in diameter) on a specimen. The face and neck, and the other parts of the Tutankhamun's golden mask were composed of 23.2–23.5 K matrix covered with an 18 K Au - Ag - Cu thin layer, whitish gold in color, and with a 22.5 K Au - Ag - Cu thin layer, gold in color, respectively. A dark blue material used for the nemes (headdress) was characterized with a new kind of glass paste which includ main components of Amarna blue and Egyptian blue, and is named here as Tutankhamun blue. A grayish blue material used for a false beard had a similar chemical composition to the dark blue one. Pectoral red and green beads were made of carnelian and amazonite, respectively.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

scholarly journals AB0463 ETIOLOGY OF PALPABLE PURPURA; A SINGLE CENTER EXPERIENCE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1530.1-1530
Author(s):  
G. Kaynar ◽  
O. C. İçaçan ◽  
S. Çelik ◽  
M. Yalçin Mutlu ◽  
C. Bes
Keyword(s):  
Drug Use ◽  
Histopathological Examination ◽  
Leukocytoclastic Vasculitis ◽  
Systemic Vasculitis ◽  
Skin Lesions ◽  
Serological Tests ◽  
Recent Infection ◽  
Important Place ◽  
Palpable Purpura ◽  
Underlying Diseases

Background:Purpura are lesions that occur after bleeding on the skin, mucous or serosal surfaces. Purpura can be classified into 2 subgroups; which are linked to thrombocytopenia and non-trombocytopenic purpura. While thrombocytopenic purpura often occurs due to a hematological disease; in non-trombocytopenic purpura etiological causes are very variable, and systemic vasculitis has an important place among them.Objectives:The demographic features of the patients applying with purpura and the underlying causes and diseases were aimed to be revealed.Methods:44 consecutive patients (22 women, 22 men) who were admitted to the hospital in the last 6 months, due to purpura were evaluated. Average age of patients was 49.6 ± 19.6 years. Patients were questioned about a recent infection, drug use, concomitant or underlying diseases. The serological tests and other laboratory tests for etiology were performed and biopsy was taken from the skin lesions which are appropriate.Results:While 4 (9%) patients had widespread purpura on the trunk-upper-lower extremities, in 22 (50%) patients purpuric lesions were limited only to the lower limb. The period between the onset of the first symptom and the admission to the hospital was longer than 4 weeks in 35 (79.5%) patients, and shorter than 1 week in 9 (20.5%) patients. 24 (54%) patients had an anamnesis of infection 2-3 weeks before purpura, and 20 (45%) patients had an anamnesis of drug use. The most common accompanying symptom was abdominal pain and was present in 15 (34%) patients. Biopsy was performed from the skin lesion in 37 patients. Histopathological examination of all was compatible with leukocytoclastic vasculitis. In indirect immunofluorescence staining, 17 were found to be IgA positive. 2 (4.5%) patients were diagnosed PR3-ANCA positive granulomatosis with polyangiitis. 1 patient had Hepatitis B virus infection was detected in 1 patient (2.2%), HIV infection was detected in 1 patient (2.2%) and malignancy was detected in 1 patient (2.2%).Conclusion:In our study, the most common reason was found as IgA vasculitis in patients presenting with palpable purpura. Although vasculitic involvement was limited to the skin in most patients, organ-threatening systemic vasculitis was detected in a few patients. Patients applying with Purpura should be questioned for infection and drug use, should be examined for underlying diseases including systemic vasculitis, and closely monitored for organ involvement.Disclosure of Interests:None declared

scholarly journals Tapering body stiffness shortens upper gastrointestinal examination via transoral insertion with ultrathin endoscope

2020 ◽  
Vol 08 (12) ◽  
pp. E1748-E1753
Author(s):  
Satoshi Ono ◽  
Shun Ito ◽  
Kyohei Maejima ◽  
Shosuke Hosaka ◽  
Kiyotaka Umeki ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Past History ◽  
Insertion Time ◽  
Trade Off ◽  
Examination Time ◽  
Total Examination Time ◽  
History Of ◽  
Food Residues ◽  
Gastrointestinal Examination ◽  
Upper Gastrointestinal

Abstract Background and study aims Ultrathin endoscopes are commonly used for surveillance esophagogastroduodenoscopy (EGD) to reduce discomfort associated with scope insertion. However, the flexibility of an ultrathin endoscope is a trade-off between reducing discomfort and lengthening examination time. Patients and methods The EG17-J10 (EG17) is a novel ultrathin endoscope characterized by its tapering body stiffness; however, the flexibility of its tip is comparable to that of the traditional ultrathin endoscope EG16-K10 (EG16). We compared EGD examination time between EG17 and EG16. A total of 319 examinees who underwent EGD from November 2019 to January 2020 at the Chiba-Nishi General Hospital were enrolled. Six examinees were excluded due to past history of surgical resection of the upper gastrointestinal tract or too much food residues; 313 examinees (EG17, 209; EG16,104) were retrospectively analyzed. The examination time was divided into three periods: esophageal insertion time (ET), gastroduodenal insertion time (GDT), and surveillance time of the stomach (ST). The total amount of ET, GDT, and ST was defined as total examination time (TT). Results TT of EGD using EG17 was significantly shorter compared to EGD using EG16 (222.7 ± 68.9 vs. 245.7 ± 78.5 seconds) (P = 0.004). Among the three periods of examination time, ET (66.7 ± 24.1 vs. 76.0 ± 24.1 seconds) (P = 0.001) and GDT (47.9 ± 17.4 vs. 55.2 ± 35.2 seconds) (P = 0.007) of EGD using EG17 were significantly shorter compared to EGD using EG16, except for ST (108.1 ± 51.5.1 vs. 114.5 ± 50.1 seconds) (P = 0.148). Conclusion An ultrathin endoscope with tapering body stiffness can shorten EGD examination time, mainly due to the shortening of insertion time.

scholarly journals Lesion with blue bone-a case report

2018 ◽  
Vol 8 (1) ◽  
pp. 1323-1325
Author(s):  
Laila Mohamed Ilias ◽  
Babitha Alingal Mohammed ◽  
Roshini PS ◽  
Anupama Ponniah ◽  
Poornima Vijayan
Keyword(s):  
Histopathological Examination ◽  
Fibrous Tissue ◽  
Bone Lesion ◽  
Metacarpal Bone ◽  
Cortical Surface ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
X Ray ◽  
Spindle Cells ◽  
Small Bones ◽  
Hands And Feet

Bizzare parosteal osteochondromatous proliferation, or Nora‘s lesion is a unique bone lesion that most often arises in the small bones of hands and feet.  It is characterised by proliferation of chondroid, bony and fibrous tissue, and is occasionally misdiagnosed as a malignant process.  Our case was a 31 yr old lady, who presented with a painless swelling near the 5th metacarpal bone of right hand.  X-ray showed well marginated mineralised mass arising from the cortical surface of the metacarpal bone.  Histopathological examination revealed bizarre parosteal osteochondromatous proliferation composed of varying amounts of cartilage, bone and spindle cells. Cartilage was hypercellular and chondrocytes were enlarged. Ossification was irregular and had a peculiar blue tinctorial quality. 

scholarly journals Polypoidal lesions of the gastrointestinal tract

2020 ◽  
Vol 10 (1) ◽  
pp. 1625-1629
Author(s):  
Palzum Sherpa ◽  
Abhimanyu Jha ◽  
Sudhamshu Koirala ◽  
Rojan Ghimire
Keyword(s):  
Gastrointestinal Tract ◽  
Large Intestine ◽  
Hyperplastic Polyp ◽  
Histopathological Examination ◽  
Biological Behavior ◽  
Research Centre ◽  
Chi Square ◽  
Neoplastic Lesions ◽  
Chi Square Test ◽  
Conventional Adenoma

Background: With increasing usage of endoscopic procedures, gastrointestinal polypoidal lesions are commonly encountered specimens. Histopathological examination is crucial as biological behavior is dependent on its pathological nature. Materials and Methods: A retrospective descriptive study performed in Pathology department, Om Hospital and Research Centre from January 2017 to June 2019. The study included lesions received as polyp or polypoidal lesions of gastrointestinal tract for histopathological examination. Data was analysed using SPSS version 17.0. Gender, number and site were analysed using Chi square test to evaluate its association with neoplastic nature. Correlation with age and size was tested with Pearson’s correlation coefficient. Results: Among 150 cases of gastrointestinal tract polypoidal lesions, 58% were seen in male and 42% in female. Hyperplastic polyp and conventional adenoma were the commonest non-neoplastic and neoplastic lesions respectively. The age of patients ranged from 7 to 84 years with a mean age of 50 years. Rectosigmoid region was the commonest site. 134 patients had single and 16 had multiple polypoidal lesions. Most polypoidal lesion had size <1 cm. Gender, age, number and size showed no correlation with neoplastic nature. A significant association was found with site with notably higher number of neoplastic lesions in large intestine. Conclusion: A spectrum of histological types of polypoidal lesions were found in Gastrointestinal tract, most frequently in colorectal region. Hyperplastic polyp and adenomatous polyp were the commonest non-neoplastic and neoplastic lesions respectively. A notably higher number of polypoidal lesions in the large intestine were found to be neoplastic in nature.

scholarly journals On Using a Mobile Application to Support Teledermatology: A Case Study in an Underprivileged Area in Colombia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Juan Pablo Sáenz ◽  
Mónica Paola Novoa ◽  
Darío Correal ◽  
Bell Raj Eapen
Keyword(s):  
Rural Areas ◽  
Mobile Applications ◽  
Mobile Application ◽  
Correct Diagnosis ◽  
Skin Lesions ◽  
Healthcare Personnel ◽  
Combined Use ◽  
Forest Regions ◽  
The Face

Background. The use of mobile applications in dermatology to support remote diagnosis is gaining acceptance, particularly in rural areas, where dermatology services are commonly managed by healthcare personnel with no specialty training. Moreover, ontologies—sets of concepts that represent knowledge in a given domain—are increasingly being used to support medical diagnosis. A specific case is ONTODerm: an ontology to aid dermatological diagnosis. However, there is little information on the combined use of mobile applications and ontologies as support solutions in dermatology. Objective. Assessing the reliability of ONTODerm as a tool to support remote dermatological diagnosis when used together with a mobile dermatological application in underprivileged areas. Methods. A mobile application that allows characterization of skin lesions was developed, and the information about the lesions was sent to ONTODerm. An exploratory study was conducted in a remote area without access to a dermatologist. A total of 64 dermatological queries were recorded in the application and consulted with ONTODerm. Later, an experienced dermatologist evaluated the characterization and diagnosis of each query to determine the accuracy of the system. Results. The results showed that the probability of obtaining a correct diagnosis was between 64.4% and 85.6% with a confidence interval of 95%. A higher accuracy rate was obtained when the skin lesion occurred on the face or when its border was categorized as poorly demarcated. Conclusions. This study demonstrates the implementation of a teledermatology strategy based on mobile applications and domain ontology-driven knowledge base to provide timely assistance to healthcare professionals. This approach was found to be pertinent in the Colombian rural context, particularly in forest regions, where dermatology specialists are not available. The results of this article do not represent a final validation of the proposed approach; they suggest how the ontology can be improved to effectively support medical staff in marginalized regions.

Primary Peritonitis Due to Group G Streptococcus: A Case Report

PEDIATRICS ◽  
1975 ◽  
Vol 56 (6) ◽  
pp. 1078-1079
Author(s):  
Abdul J. Khan ◽  
Hugh E. Evans ◽  
Marylu R. Macabuhay ◽  
Yu-En Lee ◽  
Robert Werner
Keyword(s):  
Case Report ◽  
Burn Injury ◽  
Past History ◽  
Abdominal Distension ◽  
Streptococcus Group ◽  
Primary Peritonitis ◽  
The Face ◽  
Life Threatening ◽  
Average Size ◽  
Streptococcus A

Beta-hemolytic Streptococcus group G, a rare human pathogen, has long been implicated in human disease as causing pharyngitis, puerperal sepsis, empyema, and even septicemia. We are reporting a rare, life-threatening, acute illness, primary peritonitis, due to this organism, whose etiological source probably was a family dog. Case Report R.K., a 2-year-old girl, was admitted with the complaints of anorexia, vomiting of three days' duration, and severe abdominal distension of one day's duration. The symptoms started following a burn injury over the face and lips three days prior to admission. Past history was noncontributory. Physical examination revealed an ill child of average size, fully conscious.

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