Dermatological examination

2006 ◽  
pp. 225-226
2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Satoshi Katagiri ◽  
Yuya Negishi ◽  
Kei Mizobuchi ◽  
Mitsuyoshi Urashima ◽  
Tadashi Nakano ◽  
...  

Purpose. To report the spectrum of ABCC6 variants in Japanese patients with angioid streaks (AS). Patients and Methods. This was a single-center cohort study. The medical records of 20 patients with AS from 18 unrelated Japanese families were retrospectively reviewed. Screening of the ABCC6 gene (exons 1 to 31) was performed using PCR-based Sanger sequencing. Results. Eight ABCC6 variants were identified as candidate disease-causing variants. These eight variants included five known variants (p.Q378X, p.R419Q, p.V848CfsX83, p.R1114C, and p.R1357W), one previously reported variant (p.N428S) of unknown significance, and two novel variants (c.1939C>T [p.H647Y] and c.3374C>T [p.S1125F]); the three latter variants were determined to be variants of significance. The following four variants were frequently identified: p.V848CfsX83 (14/40 alleles, 35.0%), p.Q378X (7/40 alleles, 17.5%), p.R1357W (6/40 alleles, 15.0%), and p.R419Q (4/40 alleles, 10.0%). The ABCC6 variants were identified in compound heterozygous or homozygous states in 13 of 18 probands. Two families showed a pseudodominant inheritance pattern. Pseudoxanthoma elasticum was seen in 15 of 17 patients (88.2%) who underwent dermatological examination. Conclusions. We identified disease-causing ABCC6 variants that were in homozygous or compound heterozygous states in 13 of 18 families (72.2%). Our results indicated that ABCC6 variants play a significant role in patients with AS in the Japanese population.


2014 ◽  
Vol 17 (1) ◽  
pp. 91-104 ◽  
Author(s):  
Lorena Dias Monteiro ◽  
Carlos Henrique Alencar ◽  
Jaqueline Caracas Barbosa ◽  
Candice Cristiane Barros Santana Novaes ◽  
Rita de Cássia Pereira da Silva ◽  
...  

INTRODUCTION: Neural damages are among the main factors that contribute to physical disability in leprosy. Systematic monitoring using a broad physical, psychological and social approach is necessary. OBJECTIVE: The objective of this study was to characterize the limitation of activity and social participation and its correlation with disabilities and/or impairment in individuals after being discharged from a multidrug leprosy therapy. METHOD: A cross-sectional study conducted in Araguaína, state of Tocantins, which is a leprosy hyperendemic municipality. We included cases of patients who were discharged from treatment considered as cured from January 2004 to December 2009. We performed dermatological examination and applied the Screening Activity Limitation and Safety Awareness (SALSA) and social participation scales. RESULTS: We included 282 individuals (mean age: 45.8 years old). The paucibacillary operational classification was more common (170; 60.3%). The eye-hand-foot score ranged from 0 to 12 (mean: 0.7). A total of 84 (29.8%) individuals presented limited activity. A slight restriction in social participation occurred in 18 (6.3%) cases. There was a statistically significant correlation between activity limitation, age (r = 0.40; p < 0.0001) and degree of functional limitation (r = 0.54; p < 0.0001), as well as of restricted social participation, activity limitation (r = 0.56, p < 0.0001) and functional limitations (r = 0.54, p < 0.0001). CONCLUSION: Functional limitation due to leprosy had an impact on the conduct of activities and social participation after the discharge from a leprosy treatment. The association between Screening of Activity Limitation and Safety Awareness and participation scales will assist in designing evidence-based assistance measures.


2021 ◽  
Vol 12 (1) ◽  
pp. 30-32
Author(s):  
Selma El Kadiri ◽  
Hanane Baybay

A 27-year-old female, a radiotherapy technician, was referred to our consultation with a localized gray pigmentation of the perinasal area. The condition had been asymptomatic for its entire duration of 2 years. A dermatological examination found a localized bluish-gray pigmentation in the perinasal area. Dermoscopy revealed an annular bluish-gray patch. Her occupation involved the manufacture and micromanipulation of machines, which required handling pure iron, nickel, copper, and silver with bare hands. She also reported a tic of flaring the nose. A skin biopsy was performed and histology revealed deposits of fine granules in the basal cell layer of eccrine sweat glands and along the elastic fibers of the superficial dermis, conforming with the diagnosis of argyria. The patient was given laser Q-switching treatment and showed a measurable improvement. This case studies a currently rare dermatological curiosity. Argyria is a disease caused by chronic absorption of silver-rich materials. This is the first description of argyria following the manipulation of radiopaque caches with a tic of flaring the nose.


2022 ◽  
Vol 13 (1) ◽  
pp. 107-108
Author(s):  
Siham Belmourida ◽  
Meriame Meziane ◽  
Nadia Ismaili ◽  
Laila Benzekri ◽  
Badreddine Hassam ◽  
...  

Sir, Pemphigus herpetiformis (PH) was originally described by Jablonska et al. in 1975. Clinically, PH presents itself as a herpetiform dermatitis with immunopathological characteristics of pemphigus [1,2]. We report an exceptional case of typical pemphigus vulgaris (PV) relapsing after 36 years in PH. A 65-year-old patient, followed for PV for 36 years and treated with corticosteroid therapy with a remission for more than thirty years, consulted for pruriginous lesions evolving for the previous eight months. A dermatological examination revealed urticariform pruriginous ring lesions surmounted by small peripheral vesicles spread throughout the body (Fig. 1), sparing the mucous membranes, and without Nikolsky’s sign. After two non-specific skin biopsies, the histological examination revealed an intraepidermal bubble with acantholytic cells and eosinophilic spongiosis (Figs. 2a and 2b). Direct immunofluorescence confirmed the diagnosis of pemphigus and indirect immunofluorescence was at the upper limit. The diagnosis of a PV relapse in PH was retained and a dapsone-based treatment was initiated at a dose of 150 mg/day and stopped seven days later when met with hemolytic anemia. Oral corticosteroid therapy involving prednisone at a dose of 1 mg/kg/day was initiated but, given the persistence of the pruritus, the decision was to combine methotrexate at a dose of 12.5 mg/week. A good evolution and a decline within eight months were observed. An improved pruritus and the disappearance of the skin lesions were achieved after one month of treatment. PV and PH are two different anatomical and clinical entities of the autoimmune disease pemphigus, with distinct clinical, histopathological, and immunopathological characteristics [1,2]. Our observation documents a complete phenotypic “switch” of pemphigus with a transition from PV to PH both clinically, histologically, and immunologically. Several rare cases of PV switching to superficial pemphigus (SP) (“phenotypic switch”) have, since 1991, been reported, with a higher frequency this direction than otherwise; the transition period varies from six months to twenty years [3]. To the best of our knowledge, no case has been described of a progression from PV to PH. Having observed one firsthand, we are first to describe the case of a complete phenotypic switch from PV to PH. The mechanism of such a transition remains poorly understood and is often observed during a relapse. Some authors suggest that the effect of immunosuppressants on the desmoglein DSG3 more marked than on DSG1 could explain the relapse of PS in PH [3,4]. Future studies on the immunological factors and predictors of PV relapses after the discontinuation of treatment would be useful to better understand the mechanisms of a relapse in pemphigus, with or without a phenotypic transition.


Author(s):  
Pradeep Vittal Bhagwat ◽  
R. Rajagopal ◽  
P. S. Murthy ◽  
R. S. V. Kumar

<p class="abstract"><strong>Background:</strong> Chronic renal failure is becoming common entity with increased incidence of diabetes mellitus and resulting diabetic nephropathy. With the availability of renal transplantation services in many centers, increased availability of donors, improved surgical technique and availability of better drugs, the survival of renal transplant recipients has increased. The objective of the study was to study the cutaneous manifestations in renal transplant recipients.</p><p class="abstract"><strong>Methods:</strong> Fifty consenting, consecutive renal transplant recipients attending the OPD and in-patients at Command Hospital Air Force, Bangalore during July 2001 to March 2003 were included in the study. Detailed history was taken and clinical examination was carried out with special emphasis on the Dermatological examination. Relevant investigations were carried out.<strong></strong></p><p class="abstract"><strong>Results:</strong> A total of 50 renal transplant recipients were studied of which 42 (84%) were males and 8 (16%) were females. The age of patients ranged from 16 years to 60 years. Infections were the most common finding, encountered in 38 (76%) patients, followed by drug induced manifestations in 24 (48%) patients. Cellulitis was noted in 1 (2%) patient, viral infections were seen in 18 (36%) patients, fungal infection was the commonest in this study, encountered in 38 (76%) patients. Monomorphic acne was seen in 13 (26%) patients. Hypertrichosis/hirsutism were the commonest drug induced manifestation in this study, seen in 16 (32%) patients.</p><p class="abstract"><strong>Conclusions:</strong> In patients with renal transplantation, superficial fungal infections and viral infections of the skin are seen more commonly. Monomorphic acne and hypertrichosis due to immunosuppressive are also seen frequently. These changes are moderately influenced by the immunosuppressive regimen used.</p>


Author(s):  
Isswariya Anandan ◽  
Nitya Selvaraj ◽  
Suganya Ganesan ◽  
Meher Ali Rajamohammad ◽  
Nalinidevi Jayabalan

Fixed drug eruption (FDE) is an adverse drug reaction seen with various groups of drugs are antibiotics such as trimethoprim -sulphamethoxazle, pencillin, tetracyclines, non steroidal anti- inflammatory drugs like ibuprofen, aspirin etc. Doxycycline belongs to tetracycline groups of antibiotics. We herein present the case of Doxycycline induced fixed drug eruption. A 35-year - old man presented to our hospital, with a 2-day history of itching and hyperpigmentation over the chest. Patient developed skin lesion 2 days after and he started taking Doxycycline 100 mg twice a day for skin infections. Dermatological examination revealed multiple well defined hyperpigmented patches seen over the anterior aspect of the chest. Doxycycline was discontinued immediately, and the skin lesions resolved spontaneously within 2 weeks. Causality assessment by using Naranjo adverse drug reaction probability scale and WHO Uppsala monitoring scale categorize the reaction as Doxycycline was the probable cause for the adverse drug reaction. Severity assessment by using modified Hartwig and Siegel ADR severity assessment scale labelled the reaction as mild-level 2. The causative drug or drugs and cross reactants should be avoided in future to prevent recurrence of similar skin reactions.


2021 ◽  
Vol 49 (03) ◽  
pp. 210-214
Author(s):  
Teresa M. S. A. Boehm ◽  
Christoph J. Klinger ◽  
Christine Gohl ◽  
Maike Lücht ◽  
Katja N. Baumann ◽  
...  

AbstractA 30-year-old, intact female Indian rhinoceros (Rhinocerus unicornis) was presented with ongoing erosive, ulcerative skin lesions over a 4-year-period. The lesions appeared to be non-pruritic and non-seasonal. A systemic antibiotic therapy had been unsuccessful. The dermatological examination showed 8 diffusely demarcated areas of erosion, focal ulceration, mild crusting, and moderate erythema ranging from 8 to 20 cm in diameter, bilaterally on the lateral edges of the torso armor plates. The patient had no other clinical abnormalities. Coccoid and rod-shaped bacteria were identified on cytology and a bacterial culture revealed Escherichia coli spp., Staphylococcus dysgalacticae, Stenotrophomonas maltophilia, Corynebacterium spp. and Micrococus spp. A topical product line containing essential fatty acids and plant extracts was administered daily, using a spot-on, spray and balm. Within 3 weeks a substantial alleviation of clinical signs was observed. Multiple impression smears of the lesions and a bacterial culture were negative by day 21. The patient achieved complete remission within 4 months of treatment and maintained remission for the 2-year observation period with continued use of the medication. Topically administered therapeutics containing essential fatty acids and plant extracts may offer a viable treatment option for recurrent cases of bacterial infectious skin lesions in Indian rhinocerotidae.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Abd El-Naeem Sallam ◽  
Mohamed Taha Mahmoud El-Sayed ◽  
Rania Mahmoud El-husseiny ◽  
Sara Hossam Abd El-Aleem Ibrahim Shaheen

Abstract Background Pityriasis versicolor is a chronic superficial fungal infection seen worldwide, with high prevalence observed in hot and humid climates. Objectives The aim of this work was to isolate and identify Malassezia species from pityriasis versicolor using specific fast gtowth media; Chrom agar to obtain a better understanding of the role of each species in the etiology of disease. Patients and Methods This study was conducted on 70 patients with clinical diagnosis of pityriasis versicolor with positive KOH test. All of the participants were subjected to a well informed consents, full history taking including age, sex, site of the lesions and any previous treatment, full general and dermatological examination to determine site, color of the lesions and Wood's light examination. Results Our results reported 94.3% of studied patients yielded growth on culture while 5.7% did not show any growth. The predominant age group was ≥ 25 years old. Furthermore it was found that PV affected male subjects (62.90%) more than the females (37.1%). Conclusion Malassezia yeasts, although are considered a part of normal skin microbiome, is a known cause of pityriasis versicolor. PV was more common in males in the age group ≥ 25yrs. The most affected body site was the chest, the most common variant is hyperpigmented type, and the commonest isolate was M.furfur.


Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.

The aim of the study was to show the effectiveness of treatment of acne with moderate severity in women with ovarian hyperandrogenism. A total of 25 female reproductive voerast patients with moderate acne and ovarian hyperandrogenism who were not planning pregnancy were examined. All patients were examined, which included a consultation with a gynecologist with a gynecological examination, ultrasound examination of the pelvic organs, a study of the hormonal status, a biochemical blood test, as well as a dermatological examination with the determination of the dermatological index of acne (DIA). After the examination, the patients underwent complex therapy using the external treatment recommended by the dermatovenerologist (skin cleansing, gel with azelaic acid and / or gel with adapalene), as well as the appointment of a combined oral contraceptive (COC) Jes Plus. Based on this study, it can be concluded that complex therapy, including local treatment and taking Jes Plus, is the first choice in the treatment of androgen-dependent dermopathy, manifested by moderate acne, in patients with ovarian hyperandrogenism due to PCOS. Such therapy contributes not only to the formation of a pronounced clinical result, but also causes a low probability of side effects. The administration of COC containing drospirenon and the active form of folate, in the form of the calcium salt levomefolate, allows a favorable effect on the metabolic processes in the body as a whole, and in particular, provides a positive effect on the skin, the cardiovascular system, reduces the risk of systemic and local inflammation, relieving the state of hyperhomocysteinemia, providing prevention of cardiometabolic risks.


Author(s):  
Gemma Simcox

Skin disease has a serious impact on an individual’s quality of life. It is well recognized that conditions such as psoriasis may have a similar impact on a patient’s quality of life to chronic diseases such as diabetes, hypertension, and depression. Skin problems account for approximately 20% of all patient consultations in primary care in the UK. It is important that clinicians are able to diagnose common skin diseases such as acne, eczema, psoriasis, and cutaneous malignancies and initiate an appropriate management plan. This requires the ability to take a full history and conduct a complete examination. A complete dermatological examination involves examination of the entire skin, mucous membranes, hair, and nails. The description of cutaneous pathologies should include the location and distribution of lesions. The morphology of a lesion or each component of a generalized eruption should be noted. Other organ systems may also need to be examined. The questions in this chapter will test your knowledge of the skin problems that are frequently encountered in non-specialist clinical practice. Other more rare skin disorders are also covered, either because they are potentially life-threatening or because they are a sign of systemic disease. The questions are designed to improve your ability to recognize the morphology and distribution of cutaneous physical signs. Hopefully you will find these questions stimulating and an aid to improving your knowledge of skin disease.


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