scholarly journals Immunocompromised Districts of Skin: A Case Series and a Literature Review

2019 ◽  
Vol 7 (18) ◽  
pp. 2969-2975 ◽  
Author(s):  
Aleksandra Vojvodic ◽  
Michael Tirant ◽  
Veronica Di Nardo ◽  
Torello Lotti ◽  
Uwe Wollina
Keyword(s):  
Literature Review ◽  
Skin Diseases ◽  
Case Reports ◽  
Case Series ◽  
Skin Disorders

BACKGROUND: The concept of immunocompromised districts of skin has been developed by Ruocco and helps to explain certain aspects of the macromorphology of skin diseases. This concept unites the isomorphic response of Koebner and the isotopic response of Wolf. CASE REPORTS: We present different cutaneous conditions which can lead to immunocompromised districts of skin such as scars, radiodermatitis, lymphedema, disturbed innervation or mechanical friction etc. Typical and rarer skin disorders associated with them are discussed and illustrated by their observations. CONCLUSION: At this moment, we wish to inform dermatologists and non-dermatologists about Ruocco’s concept and its implications.  

Reticular erythematous mucinosis: Literature review and case report of a 24-year-old patient with systemic erythematosus lupus

Lupus ◽  
2020 ◽  
pp. 096120332096570
Author(s):  
Juliana P Ocanha-Xavier ◽  
Camila O Cola-Senra ◽  
Jose Candido C Xavier-Junior
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Literature Review ◽  
English Language ◽  
Case Reports ◽  
Histopathological Diagnosis ◽  
Skin Disorders ◽  
Histopathological Findings ◽  
Inflammatory Skin

Reticular erythematous mucinosis (REM) was first described 50 years ago, but only around 100 case reports in English have been published. Its relation with other inflammatory skin disorders is still being debated. We report a case of REM, including the clinical and histopathological findings. Also, a systematic review of 94 English-language reported cases is provided. The described criteria for clinical and histopathological diagnosis are highlighted in order to REM can be confidently diagnosed.

Analysis of Clinical, Imaging, and Pathologic Features of 36 Patients with Primary Intraspinal Primitive Neuroectodermal Tumors: A Case Series and Literature Review

2021 ◽  
Author(s):  
Xuefeng Wei ◽  
Xu Zhang ◽  
Zimu Song ◽  
Feng Wang
Keyword(s):  
Literature Review ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Subtotal Resection ◽  
Study Cohort ◽  
Primitive Neuroectodermal Tumors ◽  
Pathologic Features ◽  
Neuroectodermal Tumors ◽  
The Mean

Abstract Background and Study Aims Primary intraspinal primitive neuroectodermal tumors (PNETs) account for ∼0.4% of all intraspinal tumors, but information about these tumors in the medical literature is limited to single case reports. We report four cases of primary intraspinal PNETs and present a systematic literature review of the reported cases. Materials and Methods We retrospectively reviewed and analyzed the clinical data of 4 patients with primary intraspinal PNETs who underwent neurosurgical treatment at our clinic between January 2013 and January 2020, and of 32 cases reported in the literature. Results The female-to-male ratio was 2.6:1. The mean patient age was 21.42 ± 15.76 years (range: 1–60 years), and patients <36 years of age accounted for 83.30% of the study cohort. Progressive limb weakness and numbness were the chief symptoms (accounting for ∼55.6%). The mean complaint duration was 0.89 ± 0.66 months for males and 2.72 ± 3.82 months for females (p = 0.028). Epidural (41.7%) was the most common site, and thoracic (47.3%) was the most frequent location. Most PNETs were peripheral, and magnetic resonance imaging (MRI) appearance was isointense or mildly hypointense on T1-weighted images and hyperintense on T2-weighted images. Homogeneous contrast enhancement was observed. The 1-year survival rate of patients who underwent chemoradiation after total or subtotal lesion resection was better compared with patients who did not undergo chemotherapy, radiotherapy, or total or subtotal resection. The modality of treatment was associated with survival time (p = 0.007). Conclusion Primary intraspinal PNETs mainly occur in young people with a female preponderance. In patients with a rapid loss of lower limb muscle strength and large intraspinal lesions on MRI, PNETs should be considered. Surgical resection and adjuvant radio chemotherapy are key prognostic factors.

Management of Refractory Intracranial Hypotension Using Percutaneous Fibrin Sealant Patch – A Case Series and Review of the Literature

2019 ◽  
pp. 13-31
Author(s):  
Kevin Wong
Keyword(s):  
Literature Review ◽  
Fibrin Sealant ◽  
Intracranial Hypotension ◽  
Case Reports ◽  
Case Series ◽  
Retrospective Case ◽  
Percutaneous Injection ◽  
Retrospective Case Series ◽  
Blood Patch

Background: Intracranial hypotension (IH) among patients with persistent cerebrospinal fluid (CSF) leakage remains a challenging problem. The majority of these cases resolve spontaneously with conservative measures. The customary treatment for IH is epidural blood patch (EBP). In some cases, CSF leaks can persist for months or even years despite multiple trials of EBP. To date, there are only a limited number of published studies documenting the percutaneous injection of fibrin sealant for treatment of IH refractory to conservative measures and EBP. Objective: Our objective was to perform a literature review and retrospective case series regarding patients who underwent percutaneous injection of fibrin sealant for treatment of refractory IH at our institution. Study Design: This case series used a singlecentered retrospective observational study design and literature review. Setting: Patients in this case series were treated at a community-based tertiary care medical center. Methods: Five consecutive patients with the diagnosis of IH refractory to conservative measures and EBP who underwent percutaneous patching with fibrin sealant were identified at our institution between January 1, 2000 and January 1, 2016. A retrospective chart review was performed and data including demographics, characteristics, interventions, clinical outcomes, and complications were collected. A critical review of the current literature regarding the percutaneous use of fibrin sealant for treatment of IH was conducted. Results: Four of the 5 patients (80%) experienced no further symptoms of IH and no adverse events were noted. One patient (20%) ultimately required surgical duroplasty. Review of the current literature showed a total of 2 prospective case series, 4 retrospective case series, and 11 case reports. Our present case series and literature review demonstrated that fibrin sealants were well-tolerated by most patients and associated with low incidences of complications and recurrence. Limitations: This study is limited by the small retrospective case series of 5 patients. Conclusions: Percutaneous injection of fibrin sealant may be considered in refractory cases of IH when repeated trials of EBP have persistently failed. It appears to be a highly effective, safe, and easy-touse alternative therapy for patients with refractory IH in an ambulatory setting. Our review of the literature revealed only studies with low quality of evidence, including case series and case reports. There is a substantial need for high-quality studies and clinical evidence to corroborate the efficacy and safety of this percutaneous technique. However, this ideal is very challenging because of the relative rarity and heterogeneous etiologies of cases. Keywords: Fibrin sealant, intracranial hypotension, CSF leak, epidural blood patch, orthostatic headache, refractory, quality of life, percutaneous

Conservative Management in Two Penetrating Fishbone Injuries: A Case Series and Literature Review

2021 ◽  
Keyword(s):  
Foreign Body ◽  
Literature Review ◽  
Conservative Management ◽  
Case Reports ◽  
Case Series ◽  
Foreign Body Ingestion ◽  
Medical Referral

Foreign body ingestion is a regular medical referral. Patients present with different objects such as chicken bones, nails, coins, and fishbones. It is usually managed in causality and passes without any intervention. However, occasionally, we come across fishbone complications requiring intervention. We discuss the course and management of two case reports of fishbone injuries in different abdominal regions.

scholarly journals Hereditary haemorrhagic telangiectasia and pregnancy: a review of the literature

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Olivier Dupuis ◽  
Laura Delagrange ◽  
Sophie Dupuis-Girod
Keyword(s):  
Heart Failure ◽  
Literature Review ◽  
Arteriovenous Malformations ◽  
Case Reports ◽  
Case Series ◽  
Main Body ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Review Of The Literature ◽  
Management Decisions ◽  
Recurrent Epistaxis

Abstract Background Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited genetic vascular disorder that has prevalence of 1:5000 to 1:8000, and which is characterised by recurrent epistaxis, cutaneous telangiectasia, and arteriovenous malformations (AVMs) that affect many organs including the lungs, gastrointestinal tract, liver, and central nervous system. The aim here was to carry out a review of the literature on HHT complications during pregnancy in order to guide management decisions. Main body A literature review was carried out to analyse all publications on complications that occurred during pregnancy in women with HHT. The PubMed/Medline and Scopus databases were searched. The complications observed in HHT women during pregnancy were then described. The authors identified 5 case series and 31 case reports that describe the evolution of 1577 pregnancies in 630 women with HHT. The overall maternal death rate described in the case series was estimated at 1.0% of pregnancies in the case series and 2 maternal deaths occurred in 31 pregnancy case reports. Severe maternal complications occurred in 2.7 to 6.8% of pregnancies in the case series. Severe complications occurred mostly in the second and third trimester in non-diagnosed and non-screened HHT patients. Severe complications were related to visceral involvement. The most frequent complications were related to pulmonary arteriovenous malformations (PAVMs) (haemothorax (n = 10), haemoptysis (n = 4), and severe hypoxaemia (n = 3)). Neurological complications were related to PAVMs in one case (right to left shunt) and to cerebral arteriovenous malformations (CAVM) and intracranial haemorrhage in 2 cases. Complications were related to hepatic arteriovenous malformations (HAVMs) in 8 cases (acutely decompensated heart failure due to hepatic involvement (n = 1), dyspnoea related to heart failure (n = 5), and hepatobiliary necrosis (n = 2)). Conclusion Based on the literature review, most pregnancies in HHT women occur normally. However, these pregnancies should be considered high-risk, given the potential life-threatening events related to AVM rupture. Furthermore, there is currently no international consensus regarding the medical follow-up of pregnancy in women with HHT and the aim here was to carry out a review of the literature in order to guide screening and management decisions for this rare disease.

Subcutaneous levetiracetam for the management of seizures at the end of life

2017 ◽  
Vol 8 (2) ◽  
pp. 129-135 ◽  
Author(s):  
Anna Elizabeth Sutherland ◽  
John Curtin ◽  
Victoria Bradley ◽  
Olivia Bush ◽  
Maggie Presswood ◽  
...  
Keyword(s):  
Palliative Care ◽  
Literature Review ◽  
End Of Life ◽  
Terminal Care ◽  
Seizure Control ◽  
Case Reports ◽  
Subcutaneous Administration ◽  
Case Series ◽  
Comprehensive Literature Review ◽  
Randomised Controlled

ObjectivesTo report the results of a combined case series analysis of subcutaneous levetiracetam (Keppra) for the management of seizures in palliative care patients.MethodsA comprehensive literature review on the use of subcutaneous levetiracetam was performed, and these data were combined with a prospective observational audit of its use in terminal care undertaken in a regional palliative care network.Results7 papers were identified from the literature review-four case reports and three observational case series-reporting on a total of 53 cases where subcutaneous levetiracetam was administered.We report 20 further cases of subcutaneous levetiracetam administration from a prospective observational audit. Doses ranged from 250mg to 4000 mg daily. Oral to subcutaneous conversion ratios where stated were 1:1. Levetiracetam was reported as the sole administered antiepileptic drug (AED) in eight cases, and no seizures were reported until death in five cases. Five were switched back to enteral levetiracetam. In seven cases, levetiracetam was combined with AEDs to provide seizure control at the end of life. There was one report of a sterile abscess after 25 days of continuous subcutaneous administration.ConclusionsCombined analysis of 73 reported cases of subcutaneous levetiracetam suggests this treatment may have a role in the management of seizures at the end of life. However, randomised controlled trials are urgently needed to establish the efficacy and tolerability of subcutaneous levetiracetam administration. If proven to be safe and effective, subcutaneous levetiracetam offers the potential to prevent and treat seizures without causing unnecessary sedation at the end of life.

scholarly journals Vibrio cholerae non-O1 bacteraemia: description of three cases in the Netherlands and a literature review

2016 ◽  
Vol 21 (15) ◽  
Author(s):  
Madelon F Engel ◽  
Mariette A Muijsken ◽  
Esther Mooi-Kokenberg ◽  
Ed J Kuijper ◽  
David J van Westerloo
Keyword(s):  
Literature Review ◽  
The Netherlands ◽  
Vibrio Cholerae ◽  
Case Reports ◽  
Case Series ◽  
Case Fatality ◽  
Neonatal Meningitis ◽  
Elderly Male ◽  
Severe Condition ◽  
Water Contact

Vibrio cholerae non-O1 serogroup (VCNO) bacteraemia is a severe condition with a high case–fatality rate. We report three cases diagnosed in the Netherlands, identified during a national microbiological congress, and provide a literature review on VCNO bacteraemia. A search strategy including synonyms for 'VCNO' and ‘bacteraemia' was applied to PubMed, Medline, Web of Science and Embase databases. The three cases were reported in elderly male patients after fish consumption and/or surface water contact. The literature search yielded 82 case reports on 90 cases and six case series. Thirty case reports were from Asia (30/90; 33%), concerned males (67/90; 74%), and around one third (38/90; 42%) involved a history of alcohol abuse and/or liver cirrhosis The presenting symptom often was gastroenteritis (47/90; 52%) which occurred after seafood consumption in 32% of the cases (15/47).Aside from the most frequent symptom being fever, results of case series concurred with these findings. Published cases also included rare presentations e.g. endophthalmitis and neonatal meningitis. Based on the limited data available, cephalosporins seemed the most effective treatment. Although mainly reported in Asia, VCNO bacteraemia occurs worldwide. While some risk factors for VCNO were identified in this study, the source of infection remains often unclear. Clinical presentation may vary greatly and therefore a quick microbiological diagnosis is indispensable.

scholarly journals Icatibant for Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema in Intubated Patients: Case Series and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Erin K. Yeung ◽  
Haritha Saikumar ◽  
Jose Castaneda-Nerio ◽  
Sandra G. Adams ◽  
Mark Wong
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Converting Enzyme Inhibitor ◽  
Enzyme Inhibitor ◽  
Case Reports ◽  
Case Series ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitor

Purpose. A case series of icatibant use in intubated patients with angiotensin-converting enzyme inhibitor- (ACEI-) induced angioedema is presented along with a relevant literature review and recommendations for utilization. Summary. Three intubated patients admitted to the intensive care unit for ACEI-induced angioedema were treated with icatibant. A literature search identified one controlled study and four case reports describing the use of icatibant in intubated ACEI-induced angioedema patients. Conclusion. Icatibant administration in intubated patients may be beneficial in decreasing time to extubation and length of intensive care unit stay. In the three cases described, icatibant administration did not appear to elicit a response in intubated patients, which has been described in previous case reports. For clinicians considering icatibant in the treatment of ACEI-induced angioedema, earlier administration upon arrival to the ED or immediately upon arriving to the intensive care unit is strongly advised. The suggested benefit of icatibant in intubated ACEI-induced angioedema patients should be verified by randomized clinical trials and cost-benefit analyses should be performed at individual institutions.

scholarly journals Wound myiasis in Western Europe: prevalence and risk factors in a changing climate scenario

2021 ◽  
Author(s):  
Erika Andreatta ◽  
Luigi Bonavina
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Western Europe ◽  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Climate Scenario ◽  
Cutaneous Myiasis ◽  
Artery Disease ◽  
Wound Myiasis

Summary Background Myiasis is an infestation of neglected open wounds by fly larvae. Global warming, related climate changes, and increased traveling in tropical countries may contribute to the worldwide diffusion of new fly species. Common risk factors for myiasis are advanced age, poor hygiene, malnourishment, social isolation, diabetes, cancer, and peripheral artery disease. The aim of this study was to review the characteristics of cases of myiasis reported in Europe. Methods A narrative review of cutaneous myiasis was performed using PubMed, EMBASE, Web of Science database, and the search terms “human,” “myiasis,” “cutaneous myiasis,” “maggot,” “Europe,” “wound,” with the combination of “AND” and “OR.” In addition, hospital charts were reviewed to add personal experience to the literature review. Results Overall, 52 articles, both single case reports and case series reporting cutaneous myiasis, were found in the medical literature of the past two decades. A total of 64 patients living in Europe were identified, of whom 36% had wound myiasis. In addition to the literature review, we report the case of a male patient who presented with myiasis within a deep scalp ulcer occurring after radiotherapy for basal cell carcinoma. Conclusion Myasis is rare and possibly under-reported in Europe. The epidemiology of this infestation may be changing in the future due to climate variability, a rise in travel to tropical areas, and the migration of fly species.

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