scholarly journals Skin Darkening in COVID-19 Patients: Case Series of Eight Patients in a Hemodialysis Unit.

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Habib Ullah Rind ◽  
Nadia Iftikhar ◽  
Fazal ur Rehman ◽  
Abdul Kareem Zarkoon ◽  
Syed Mohkam ◽  
...  

The Pandemic of COVID-19 has grasped the whole world and changed dramatically, together with our social, occupational and personal life with high mortality and morbidity with other consequences since December 2019 started from Wuhan and then declared pandemic in March. It has been observed to involve every organ of the body including skin. Various skin manifestations, but most cases reported were like urticarial rash, xanthemas,  chickenpox-like vesicle, vasculitidic type, pressure sores, contact dermatitis and a single case was reported in china with skin darkening. The COVID-19 and cutaneous manifestations are recognized by physicians and dermatologist treating COVID-19. We have observed around eight cases of COVID -19 who had skin darkening in our center Baluchistan Institute of Nephrology and Urology Quetta, among these included were six dialysis technicians one chronic maintenance dialysis patient and a physician. We present the representative cases and discuss the skin manifestations of COVID-19.

2021 ◽  
Author(s):  
Maryam Saeedi ◽  
Kayvan Mirnia ◽  
Razieh Sangsari ◽  
Zeinab Jannat Makan ◽  
Vahid Ziaee

Abstract Introduction:Immune dysregulation following exposure to Covid-19 results in MIS-N (Multi-system Inflammatory Syndrome in Neonates). MIS-N affects various systems in the body and is diagnosed with a positive history of PCR test, positive serologic test, and a history of contact with those vectors of COVID-19 infection. This case series aimed to differentiate from possible misdiagnosis about MIS-N.Case Presentation:Both cases are term neonates with positive serology of COVID -19 and the 2nd case with a mother's positive history of Covid-19 PCR at 30 weeks of pregnancy. The first case was admitted with diarrhea, dehydration, fever for three days, and rash on the 3rd day of hospitalization. We admitted the 2nd case on the 22nd day of birth with a cough, rashes on the head, palms, and soles for two days. Both cases responded to corticosteroid treatment that confirmed MIS-N. Finally, we discharged them with a stable and normal condition in follow-ups.Conclusions:In inflammatory syndromes, especially in delayed phases of COVID cytokine storms, the mortality and morbidity caused by infections diminish with proper interventions and inhibited cytokine cascade inflammations.


Author(s):  
Kirthi Sampath K. ◽  
Haritha S. ◽  
Mahesh B.

<p class="abstract"><strong>Background:</strong> It is a well-known fact that the skin is referred to as a window or mirror to the body. The present study was undertaken to know the spectrum of cutaneous manifestations in endocrinological disorders.</p><p class="abstract"><strong>Methods:</strong> A total of 500 patients with endocrinological disorders attending the Medical and Dermatology OPD at Dr. PSIMS&amp;RF were studied. Among the 500 cases studied, 417 patients had diabetes, 81 cases had thyroid disorder and 2 patients had Addison’s disease.<strong></strong></p><p class="abstract"><strong>Results:</strong> Most common dermatoses observed in patients with diabetes mellitus were infections {(fungal 25.3%), bacterial (6.92%), viral (5.42%)} followed by eczemas (13.2%), psoriasis (8.13%). Among 81 patients with thyroid disease, 78 patients were hypothyroid and 3 patients had hyperthyroidism and skin manifestations were observed in 55 (67%) of the patients with thyroid disorders. Most common dermatoses observed in patients with hypothyroidism were fungal infections (23.07%), urticaria (19.23%), xerosis (13.46%), bacterial infections (13.46%), psoriasis (11.53%). All 3 hyperthyroid patients have shown skin manifestations. 2 patients had diffuse hair loss and 1 patient had vitiligo. 2 cases of Addison’s disease were observed and both of them showed diffuse hyperpigmentation with accentuation over palmar creases, knuckles and gums.</p><p><strong>Conclusions:</strong> The present study shows the wide range of skin lesions in patients with endocrinological disorders paerticularly diabetes mellitus and thyroid disease. Through knowledge of the associated skin lesions helps in early diagnosis of underlying endocrine abnormality and thereby appropriate treatment provided at the earliest helps in preventing complications. </p>


2020 ◽  
pp. postgradmedj-2020-138513
Author(s):  
Bilal Bashir ◽  
Ahmed A Fahmy ◽  
Farheen Raza ◽  
Moulinath Banerjee

The genesis of ketone bodies by organisms is a protective mechanism. This metabolic process helps organisms to survive acute metabolic derangements in times of nutrient deficiency. When prolonged, ketogenesis leads to ketoacidosis, which is a potentially life-threatening metabolic disorder due to the accumulation of keto-acids in the body. The most common cause is diabetic ketoacidosis, though starvation ketoacidosis and alcoholic ketoacidosis are not uncommon. The presentation of all ketoacidotic states is similar—being generally unwell, abdominal pain, rapid and shallow breathing, vomiting and dehydration. Non-diabetic ketoacidotic states are very commonly overlooked due to relative unawareness among the clinicians, leading to misdiagnosis and thereby inappropriate management culminating in added mortality and morbidity. We describe here six cases of alcoholic and starvation ketoacidosis, review the literature currently available and discuss the common pitfalls in managing such cases.


2017 ◽  
Vol 1 (3) ◽  
pp. 156-160
Author(s):  
Jacqueline Watchmaker ◽  
Sean Legler ◽  
Dianne De Leon ◽  
Vanessa Pascoe ◽  
Robert Stavert

Background: Although considered a tropical disease, strongyloidiasis may be encountered in non-endemic regions, primarily amongst immigrants and travelers from endemic areas.  Chronic strongyloides infection may be under-detected owing to its non-specific cutaneous presentation and the low sensitivity of commonly used screening tools. Methods: 18 consecutive patients with serologic evidence of strongyloides infestation who presented to a single urban, academic dermatology clinic between September 2013 and October 2016 were retrospectively included.  Patient age, sex, country of origin, strongyloides serology titer, absolute eosinophil count, presenting cutaneous manifestations, and patient reported subjective outcome of pruritus after treatment were obtained via chart review.  Results: Of the 18 patients, all had non-specific pruritic dermatoses, 36% had documented eosinophila and none were originally from the United States. A majority reported subjective improvement in their symptoms after treatment. Conclusion:  Strongyloides infection and serologic testing should be considered in patients living in non-endemic regions presenting with pruritic dermatoses and with a history of exposure to an endemic area.Key Points:Chronic strongyloidiasis can be encountered in non-endemic areas and clinical manifestations are variableEosinophilia was not a reliable indicator of chronic infection in this case series Dermatologists should consider serologic testing for strongyloidiasis in patients with a history of exposure and unexplained pruritus


Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.


Author(s):  
Xuefeng Wei ◽  
Xu Zhang ◽  
Zimu Song ◽  
Feng Wang

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.


2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Juan Carlos Palomo-Pérez ◽  
Maria Elisa Vega-Memije ◽  
David Aguilar-Blancas ◽  
Erik González-Martínez ◽  
Lucia Rangel-Gamboa

China officially recognized atypical pneumonia outbreak in December 2019; on 11 March 2020, the World Health Organization declared COVID-19 as a pandemic that is produced by a new coronavirus, named SARS-CoV-2, of rapid transmissibility, which can be asymptomatic, with mild to severe respiratory symptoms, and with cardiovascular, neurological, gastrointestinal, and cutaneous complications. Considering that the pandemic prolonged more than initially expected was prognostic, it is essential for the medical community to identify the signs and symptoms of COVID-19. Thus, this work’s objectives were to present cases of cutaneous lesions observed in COVID-19 Mexican patients. We register cutaneous lesions in COVID-19 patients referred from internal medicine and otorhinolaryngology services to dermatology. We presented four interesting cases with cutaneous lesions, including exanthema morbilliform, urticaria, chilblains, ecchymosis, and facial edema, and review the available literature. The most frequent cutaneous markers are rash, chilblains, and urticaria. Skin lesions may be the first manifestation of COVID-19, accompany initial respiratory symptoms, or appear during the disease course. Symptoms associated with vascular changes (livedo reticularis and vasculitis) are considered of poor prognosis.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Harry Knights ◽  
Elizabeth Minas ◽  
Faraan Khan ◽  
Lindsay Shaw ◽  
Muthana Al Obaidi ◽  
...  

Abstract Background The aim of this study was to: (i) describe the abnormalities seen on brain imaging in a group of children with en coup de sabre (EDCS) with/without Parry-Romberg syndrome (PRS); and (ii) identify clinical predictors of brain imaging abnormalities. Methods This was a single centre (Great Ormond Street Hospital, London) retrospective case series of patients with ECDS/PRS seen from 2000 to 2018. We identified patients with cutaneous manifestations consistent with the clinical descriptions of ECDS/PRS. Presenting clinical, laboratory, and radiological brain findings are described. Results are expressed as medians and ranges or frequencies and percentages. Fisher’s exact test was used to identify clinical associations with magnetic resonance imaging (MRI) abnormalities. Results Fourteen patients were studied: 6 males and 8 females; median age 14 years (range 3–20). We observed neuroimaging abnormalities in 2/6 ECDS and 5/8 ECDS/PRS patients. White matter signal abnormality, dystrophic calcification, leptomeningeal enhancement, and sulcal crowding were the typical findings on brain imaging. A total of 50% of patients had no MRI abnormality despite some of these patients having neurological symptoms. The presence of seizures was significantly associated with ipsilateral enhanced white matter signalling on MRI (p < 0.05). Conclusions In summary, we observed several distinct radiographic patterns associated with ECDS/PRS. Seizure disorder was strongly associated with the presence of ipsilateral enhanced white matter signalling. Improved neuroimaging techniques that combine morphological with functional imaging may improve the detection rate of brain involvement in children with ECDS/PRS in the future.


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