Pterygium Complicating Nail Psoriasis and Trachyonychia: Is It Rare?

2021 ◽  
pp. 1-8
Author(s):  
Chander Grover ◽  
Archana Singal ◽  
Sambit Nath Bhattacharya
Keyword(s):  
Inflammatory Diseases ◽  
Early Recognition ◽  
Nail Plate ◽  
Cicatricial Pemphigoid ◽  
Adequate Treatment ◽  
Graft Versus Host ◽  
Nail Matrix ◽  
Aggressive Management ◽  
Fibrotic Process ◽  
Post Traumatic

Pterygium is an irreversible scarring of the nail matrix resulting in a split nail. The deformity is most often post-traumatic, though it can be the end result of aggressive inflammatory diseases involving the nail matrix like nail lichen planus, graft versus host disease, or autoimmune bullous disorders like cicatricial pemphigoid. It is thought to be a result of lymphocytic inflammation-mediated damage to the nail matrix, initiating a fibrotic process which slowly fuses the nail fold with the nail matrix and bed, destroying the nail plate. We report an interesting observation in a series of patients of various ages with nail and/or skin psoriasis, and trachyonychia associated with pterygium formation in multiple nails. Insidious progression to anonychia was also observed despite initiating adequate treatment. This report highlights the potential of irreversible nail damage occurring in reportedly benign nail conditions like psoriasis and trachyonychia, emphasizing the need for early recognition and aggressive management in such cases.

Superior Orbital Fissure Syndrome due to Sinusitis: Report of Two Cases

2005 ◽  
Vol 19 (4) ◽  
pp. 417-420 ◽  
Author(s):  
Fabio de Rezende Pinna ◽  
Daniel L. Dutra ◽  
Maura C. Neves ◽  
Fabrizio Ricci Romano ◽  
Richard L. Voegels ◽  
...  
Keyword(s):  
Early Recognition ◽  
Complete Recovery ◽  
Ocular Motility ◽  
Intravenous Antibiotic ◽  
Superior Orbital Fissure ◽  
Adequate Treatment ◽  
Superior Orbital Fissure Syndrome ◽  
Brain Involvement ◽  
The Brain ◽  
Anatomic Region

Background The potential morbidity and mortality of sphenoid sinus infectious processes are related to their proximity to vital structures within the orbit, such as the cavernous sinus and the brain. Involvement of the posterior orbit can result in superior orbital fissure syndrome, a rare entity affecting structures that cross this anatomic region. Early recognition of this syndrome is mandatory. Delays in adequate treatment may compromise the patient's prognosis. Methods We present two cases of incomplete superior orbital fissure syndrome due to infectious processes of the posterior ethmoid and sphenoid sinuses. Conclusions In our experience, endoscopic decompression of the lamina papyracea shows complete recovery of extrinsic ocular motility in these patients and should be combined with intravenous antibiotic therapy.

scholarly journals Congenital intestinal lymphangiectasia

2011 ◽  
Vol 68 (3) ◽  
pp. 270-273
Author(s):  
Dusan Popovic ◽  
Milan Spuran ◽  
Tamara Alempijevic ◽  
Miodrag Krstic ◽  
Srdjan Djuranovic ◽  
...  
Keyword(s):  
Early Recognition ◽  
Clinical Manifestations ◽  
Lymphatic Vessels ◽  
High Protein Diet ◽  
Intestinal Wall ◽  
Intestinal Biopsy ◽  
Intestinal Lymphangiectasia ◽  
Laboratory Assessment ◽  
Protein Losing Enteropathy ◽  
Adequate Treatment

Background. Congenital intestinal lymphangiectasia is a disease which leads to protein losing enteropathy. Tortous, dilated lymphatic vessels in the intestinal wall and mesenterium are typical features of the disease. Clinical manifestations include malabsorption, diarrhea, steatorrhea, edema and effusions. Specific diet and medication are required for disease control. Case report. A 19-year old male patient was hospitalized due to diarrhea, abdominal swelling, weariness and fatigue. Physical examination revealed growth impairment, ascites, and lymphedema of the right hand and forearm. Laboratory assessment indicated iron deficiency anaemia, lymphopenia, malabsorption, inflammatory syndrome, and urinary infection. Enteroscopy and video capsule endoscopy demonstrated dilated lymphatic vessels in the small intestine. The diagnosis was confirmed by intestinal biopsy. The patient was put on high-protein diet containing medium-chain fatty acids, somatotropin and suportive therapy. Conclusion. Congenital intestinal lymphangiectasia is a rare disease, usually diagnosed in childhood. Early recognition of the disease and adequate treatment can prevent development of various complications.

scholarly journals Therapeutic Potential of Kappa Opioid Agonists

2019 ◽  
Vol 12 (2) ◽  
pp. 95 ◽  
Author(s):  
Tyler C. Beck ◽  
Matthew A. Hapstack ◽  
Kyle R. Beck ◽  
Thomas A. Dix
Keyword(s):  
Therapeutic Potential ◽  
Inflammatory Diseases ◽  
Cartilage Degeneration ◽  
Review Article ◽  
Research Articles ◽  
Original Research ◽  
Kappa Opioid ◽  
Opioid Agonists ◽  
Novel Drugs ◽  
Post Traumatic

Many original research articles have been published that describe findings and outline areas for the development of kappa-opioid agonists (KOAs) as novel drugs; however, a single review article that summarizes the broad potential for KOAs in drug development does not exist. It is well-established that KOAs demonstrate efficacy in pain attenuation; however, KOAs also have proven to be beneficial in treating a variety of novel but often overlapping conditions including cardiovascular disease, pruritus, nausea, inflammatory diseases, spinal anesthesia, stroke, hypoxic pulmonary hypertension, multiple sclerosis, addiction, and post-traumatic cartilage degeneration. This article summarizes key findings of KOAs and discusses the untapped therapeutic potential of KOAs in the treatment of many human diseases.

scholarly journals The Role of Intestinal Microbiota in Acute Graft-versus-Host Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Yuanyuan Chen ◽  
Ye Zhao ◽  
Qiao Cheng ◽  
Depei Wu ◽  
Haiyan Liu
Keyword(s):  
Immune Responses ◽  
Intestinal Microbiota ◽  
Graft Versus Host Disease ◽  
Inflammatory Diseases ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host ◽  
Host Immune Responses ◽  
Acute Graft

The mammalian intestinal microbiota is a complex ecosystem that plays an important role in host immune responses. Recent studies have demonstrated that alterations in intestinal microbiota composition are linked to multiple inflammatory diseases in humans, including acute graft-versus-host disease (aGVHD). aGVHD is one of the major obstacles in allogeneic hematopoietic stem cell transplantation (allo-HSCT), characterized by tissue damage in the gastrointestinal (GI) tract, liver, lung, and skin. Here, we review the current understanding of the role of intestinal microbiota in the control of immune responses during aGVHD. Additionally, the possibility of using probiotic strains for potential treatment or prevention of aGVHD will be discussed.

scholarly journals Pulmonary Mucormycosis: An Emerging Infection

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Mohammed Muqeetadnan ◽  
Ambreen Rahman ◽  
Syed Amer ◽  
Salman Nusrat ◽  
Syed Hassan ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Fungal Infection ◽  
Diabetic Patient ◽  
Patient Survival ◽  
Early Recognition ◽  
Immunocompromised Patients ◽  
Delay In Diagnosis ◽  
Pulmonary Mucormycosis ◽  
Aggressive Management ◽  
Life Threatening

Mucormycosis is a rare, but emerging, life-threatening, rapidly progressive, angioinvasive fungal infection that usually occurs in immunocompromised patients. We present a case of pulmonary mucormycosis in a diabetic patient who was on chronic steroid therapy for ulcerative colitis. Early recognition of this diagnosis, along with aggressive management, is critical to effective therapy and patient survival. The delay in diagnosis of this rapidly progressive infection can result in mortality.

scholarly journals (P1-15) Russian Mobile Hospital Response to the Earthquake in Sumatra, Indonesia, October 2009

2011 ◽  
Vol 26 (S1) ◽  
pp. s103-s103 ◽  
Author(s):  
V.I. Petlakh ◽  
N.V. Bojko ◽  
V.V. Demenko ◽  
A.S. Popov
Keyword(s):  
Bone Fractures ◽  
Inflammatory Diseases ◽  
Medical Personnel ◽  
Post Traumatic Stress ◽  
Public Health Services ◽  
Upper Airways ◽  
Local Public Health ◽  
Delivery Of Care ◽  
Number Of Children ◽  
Post Traumatic

IntroductionA destructive 7.9 magnitude earthquake struck the Sumatra Island of Indonesia on 30 September 2009. A Russian mobile hospital was implemented on 04 October in the village of Lupu-Alu, 20 km from the city of Padang.MethodThe mobile hospital consisted of 20 pneumo modules equipped with technical systems. Personnel included 9 engineers and 25 medical specialists comprised of surgeons, therapists, traumatologists, children's surgeons, a pediatrician, and anesthesiologists. An air-mobile hospital was equipped with modern medical equipment (X-ray, ultrasonic diagnostics, etc.). Work at the hospital was complicated by almost daily tropical rains. The language barrier was addressed by using local translators who spoke Russian or English languages.ResultsMedical aid was rendered to 479 patients. The intensive care department experienced the heaviest patient load (n = 11). Trauma (n = 54, 2%) and proinflammatory complications prevailed among surgical patients (n = 131). Treatment of bone fractures represented significant difficulties due to the late delivery of care. Of the 479 patients, 207 (43.2%) were children; among them, 49 (7%) had diseases of the upper airways, and 30 (4%) experienced trauma. Psychologists consulted with 52 children with post-traumatic stress syndrome. Telemedical consultations were conducted by the following specialists: (1) orthopedist (n = 2); (2) dermatologist (n = 2); (3) neurosurgeon (n = 1); and (4) plastic surgeon (n = 1).ConclusionsFollowing the earthquake, medical personnel at the Russian mobile hospital in Indonesia experienced: (1) a large number of outpatients with various diseases who lacked medical care as a result of the non-functioning network of local public health services; (2) the admission of the patients with complications of trauma; (3) a significant number of children with inflammatory diseases of the upper airways; and (4) an opportunity of use telemedical consultations.

scholarly journals Improving the standard of care for patients with spondyloarthritis-related immune inflammatory conditions: results of a Delphi study and proposal for early detection

2020 ◽  
Vol 11 ◽  
pp. 204062232090429 ◽  
Author(s):  
Pablo Coto ◽  
Sabino Riestra ◽  
Paloma Rozas ◽  
Ana Señaris ◽  
Rubén Queiro
Keyword(s):  
Delphi Study ◽  
Multidisciplinary Approach ◽  
Inflammatory Diseases ◽  
Early Recognition ◽  
Standard Of Care ◽  
Point Of View ◽  
Ordinal Scale ◽  
Multidisciplinary Management ◽  
Simple Tool ◽  
Strongly Agree

Background: Our objective was to provide consensus recommendations on the optimal management of the immune-mediated inflammatory diseases (IMIDs) seen in patients with spondyloarthritis (SpA) using a multidisciplinary approach, and to develop a simple tool to help earlier recognition and referral of coexisting IMIDs in patients who already have one type of IMID. Methods: A total of 28 experts in the multidisciplinary management of the SpA-associated IMIDs assessed two questionnaires: one with statements focused on the multidisciplinary management of IMIDs, and a second questionnaire focused on questions useful for early recognition and referral. Panelists assessed the statements with a 9-point ordinal scale (1 = strongly disagree, 9 = strongly agree) using a modified Delphi methodology. Results: Consensus was reached on 72 out of the 82 statements (87.8%). Panelists agreed that the multidisciplinary approach to IMIDs is not sufficiently developed. The creation of multidisciplinary IMID units might be necessary. These units might focus primarily on patients with two or more coexisting IMIDs, or on IMIDs that are especially complex from a diagnostic or therapeutic point of view. Specialists who attend to patients with IMIDs should perform a screening for other coexisting IMIDs. A simple tool to help earlier recognition and referral of coexisting IMIDs is proposed. Conclusions: There is a need to improve care for patients with SpA-associated IMIDs. We provide expert recommendations to guide the adoption of a multidisciplinary approach for these cases, and a simple tool that may be useful for earlier recognition of coexisting IMIDs.

Thoracic duct injury during anterior cervical discectomy: a rare complication

1998 ◽  
Vol 88 (1) ◽  
pp. 151-154 ◽  
Author(s):  
Anna Kristina E. Hart ◽  
John H. Greinwald ◽  
Christopher I. Shaffrey ◽  
Gregory N. Postma
Keyword(s):  
Thoracic Duct ◽  
Early Recognition ◽  
Rare Complication ◽  
Content Type ◽  
Cervical Discectomy ◽  
Aggressive Management ◽  
Thoracic Duct Injury ◽  
First Case ◽  
Chyle Leakage ◽  
Chylous Fistula

✓ Chylous fistula resulting from intraoperative injury to the cervical thoracic duct is well described as a complication of neck dissection. However, injury to the thoracic duct during spinal surgery is rarely reported. The authors present the first case of thoracic duct injury occurring during cervical discectomy and fusion via an anterior approach. The anomalous location of the terminal arch of the thoracic duct in this patient contributed to the complication. The morbidity of chyle leakage is minimized by its early recognition, a thorough understanding of lymphatic system anatomy, and aggressive management of the thoracic duct injury.

scholarly journals Acquired Haemophilia A in the Elderly: Case Reports

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Antonella Tufano ◽  
Antonio Coppola ◽  
Anna Guida ◽  
Ernesto Cimino ◽  
Angela Maria De Gregorio ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Early Recognition ◽  
Case Reports ◽  
Age Distribution ◽  
The Elderly ◽  
Favourable Outcome ◽  
Factor Vii ◽  
Coagulation Disorder ◽  
Recombinant Activated Factor Vii ◽  
Adequate Treatment

Acquired hemophilia A (AHA) is a very rare disease, caused by the development of autoantibodies, directed against circulating factor VIII of coagulation. Age distribution is bimodal, with a first peak occurring among young women in the postpartum period, and a second major peak of incidence among elderly patients in whom it is frequently associated with malignancy and drugs. This disease often represents a life-threatening bleeding condition, especially in the elderly, thus requiring a prompt therapeutic intervention, including control of acute bleeding and eradication of the inhibitor by immunosuppressive therapy. The diagnosis of AHA should be considered in any elderly patient who presents with bleeding and prolonged activated Partial Thromboplastin Time. Moreover, the coexistence of a series of underlying diseases associated with AHA should be always searched for. An early recognition and an adequate treatment of this coagulation disorder and of the possible associated diseases play a significant role for a favourable outcome, but concomitant morbidities in the elderly may limit aggressive therapy and may complicate the clinical scenario. We report 3 consecutive elderly patients successfully treated with recombinant activated factor VII and standard immunosuppressive regimens, with remission of the disease.

scholarly journals Congenital thrombocytopenia with nephritis: The first case of MYH9 related disorder in Serbia

2014 ◽  
Vol 71 (4) ◽  
pp. 395-398 ◽  
Author(s):  
Milos Kuzmanovic ◽  
Shinji Kunishima ◽  
Jovana Putnik ◽  
Natasa Stajic ◽  
Aleksandra Paripovic ◽  
...  
Keyword(s):  
Case Report ◽  
Immune Thrombocytopenia ◽  
Early Recognition ◽  
Giant Platelets ◽  
Adequate Treatment ◽  
Related Disorder ◽  
First Case ◽  
Gene Coding ◽  
Function Impairment ◽  
End Stage

Introduction. The group of autosomal dominant disorders - Epstein syndrome, Sebastian syndrome, Fechthner syndrome and May-Hegglin anomaly - are characterised by thrombocytopenia with giant platelets, inclusion bodies in granulocytes and variable levels of deafness, disturbances of vision and renal function impairment. A common genetic background of these disorders are mutations in MYH9 gene, coding for the nonmuscle myosin heavy chain IIA. Differential diagnosis is important for the adequate treatment strategy. The aim of this case report was to present a patient with MYH9 disorder in Serbia. Case report. A 16-year-old boy was referred to our hospital with the diagnosis of resistant immune thrombocytopenia for splenectomy. Thrombocytopenia was incidentally discovered at the age of five. The treatment with corticosteroids on several occasions was unsuccessful. Although the platelet count was below 10 ? 109/L, there were no bleeding symptoms. Besides thrombocytopenia with giant platelets, on admission the patient also suffered sensorineuronal hearing loss and proteinuria. The diagnosis was confirmed with immunofluorescence and genetic analyses. Conclusion. Early recognition of MYH9-related diseases is essential to avoid unnecessary and potentially harmful treatments for misdiagnosed immune thrombocytopenia, and also for timely and proper therapy in attempt to delay end-stage renal failure and improve quality of life.

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