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Osborne W, Langman G, Ladoyanni E, Chue A. Nodular lesions of the buttock for 20 years: the challenge of chromoblastomycosis in non-endemic settings. BMJ Case Rep 2024; 17:e258097. [PMID: 38490708 PMCID: PMC10946373 DOI: 10.1136/bcr-2023-258097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Chromoblastomycosis is an implantation mycosis of the skin caused by certain species of melanised fungi. A man in his 50s, born in Kerala but living in England for 14 years, presented with a nodular lesion on his left buttock, which had been present for 20 years. Biopsy revealed muriform cells and fungal culture isolated Fonsecaea spp, consistent with a diagnosis of chromoblastomycosis. Treatment with oral terbinafine was initiated and changed to itraconazole based on results of antifungal susceptibility. Drug intolerance and low drug levels of itraconazole necessitated change to voriconazole and topical terbinafine. Despite long-term combined therapy, the lesions worsened, and the patient opted for surgical excision abroad. Recurrence was evident at surgical sites and combined therapy continues. Chromoblastomycosis is an insidious and burdensome neglected tropical disease. Within non-endemic countries, diagnosis remains challenging. A travel history and appropriate fungal investigations are vital.
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Affiliation(s)
- William Osborne
- Infectious Diseases & Tropical Medicine, Heartlands Hospital, Birmingham, UK
| | | | | | - Amy Chue
- Infectious Diseases & Tropical Medicine, Heartlands Hospital, Birmingham, UK
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2
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Wu P, Wang C, Jiang Y, Zhang Z, Gao J, Fan Z. Diagnosis and therapy of giant epidermoid double cysts with infection on the buttock: A case report and literature review. Medicine (Baltimore) 2024; 103:e37193. [PMID: 38335398 PMCID: PMC10861019 DOI: 10.1097/md.0000000000037193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
RATIONALE Epidermoid cyst (EC) is a common clinical condition and it can be filled with keratinized material. EC often represents painless, slow progressive growth, and single cyst. The cyst is usually 1 to 5 cm in size. Giant epidermoid cysts on the buttock area are extremely rare, and reports of giant epidermoid double cysts on the buttock are even rarer. PATIENT CONCERNS This paper reports a patient with a painless mass was on the left buttock. DIAGNOSIS A giant epidermoid double cysts with infection in a left buttock paranal location. INTERVENTIONS The mass was surgically removed. OUTCOMES The patient recovered well after surgical treatment and currently has no recurrence. CONCLUSION For patients with EC, MRI is recommended as a routine examination before surgery in order to detect the variation and extent of the cyst early. This lays a foundation for the complete resection of the lesion during the operation. The review of relevant literature will hopefully be helpful to clinicians.
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Affiliation(s)
- Peiliang Wu
- Department of General Surgery, the Third People’s Hospital of Dalian, Dalian Medical University, Dalian, China
| | - Cong Wang
- Department of General Surgery, the Third People’s Hospital of Dalian, Dalian Medical University, Dalian, China
| | - Yiran Jiang
- Department of Clinical Medicine (2020341116), China Medical University, Shenyang, China
| | - Zhi Zhang
- Department of Cardiology, the Third People’s Hospital of Dalian, Dalian Medical University, Dalian, China
| | - Junlan Gao
- Department of Critical Care Medicine, The Second Affiliated Hospital of Dalian Medical University Dalian, Liaoning, China
| | - Zhe Fan
- Department of General Surgery, the Third People’s Hospital of Dalian, Dalian Medical University, Dalian, China
- Liaoning Province Key Laboratory of Corneal and Ocular Surface Diseases Research, The Third People’s Hospital of Dalian, Dalian, China
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3
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Berlin BL, Rosen JR, Sarro RA. Pedunculated Verrucous Tumor on the Buttock. Cutis 2023; 112:260-278. [PMID: 38290072 DOI: 10.12788/cutis.0905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Brittany L Berlin
- Brittany L. Berlin and Dr. Sarro are from Florida Atlantic University, Boca Raton. Dr. Rosen is from and Dr. Sarro also is from Premier Dermatology Partners, Boca Raton
| | - Jason R Rosen
- Brittany L. Berlin and Dr. Sarro are from Florida Atlantic University, Boca Raton. Dr. Rosen is from and Dr. Sarro also is from Premier Dermatology Partners, Boca Raton
| | - Robert A Sarro
- Brittany L. Berlin and Dr. Sarro are from Florida Atlantic University, Boca Raton. Dr. Rosen is from and Dr. Sarro also is from Premier Dermatology Partners, Boca Raton
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Neblett C, Collie CJ, Ho JD. A 32-Year-Old Afro-Caribbean Female With a Slow-Growing Nodule on the Left Buttock: Challenge. Am J Dermatopathol 2023; 45:e99-e100. [PMID: 37982475 DOI: 10.1097/dad.0000000000002539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Affiliation(s)
- Carlos Neblett
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Kingston Public Hospital, Kingston, Jamaica
| | - Chico J Collie
- Department of Pathology, The University of the West Indies, Mona Campus, Jamaica; and
| | - Jonathan D Ho
- Department of Pathology, The University of the West Indies, Mona Campus, Jamaica; and
- Section of Dermatology, Department of Medicine, The University of the West Indies, Mona Campus, Jamaica
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Abe A, Nishimura A, Okano K, Suzuki T, Hakamada K. [A Case of Triple Negative Breast Cancer with Left Buttock Metastasis]. Gan To Kagaku Ryoho 2023; 50:1624-1626. [PMID: 38303362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
A female patient in her 50s was diagnosed with triple negative breast cancer in the left breast with a buttock metastasis. After neoadjuvant chemotherapy, the patient underwent surgery on the left breast. As the histopathological findings indicated a residual tumor, she was further treated with capecitabine postoperatively. Twenty months postoperatively, a CT scan revealed a tumor on her left buttock. She was also diagnosed with a relapse of the breast cancer after a core needle biopsy. She was treated with atezolizumab and nab-paclitaxel as first-line therapy for the metastasis and with eriburlin as second- line therapy. As she became uncomfortable sitting owing to the regrowth of the buttock tumor, the left buttock tumor was resected. She has been treated with bevacizumab and paclitaxel for subsequent lung metastases.
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Affiliation(s)
- Atsumi Abe
- Dept. of Breast Surgery, Hirosaki University Hospital
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E TY, Yang XJ, Bi C, Xue F, Cao YQ. Idiopathic calcinosis cutis of the buttocks: A case report and review of the literature. Medicine (Baltimore) 2023; 102:e31129. [PMID: 37058037 PMCID: PMC10101305 DOI: 10.1097/md.0000000000031129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 04/15/2023] Open
Abstract
RATIONALE Calcinosis cutis is a rare skin disease, and idiopathic cases are rarely reported. It is characterized by the deposition of insoluble calcium salts in the skin, subcutaneous tissue, superficial muscles, and tendon sheaths. However, no abnormal changes were found in the bone. In this article, we introduce a case of idiopathic calcinosis cutis of the buttocks with a long course and large lesion area. PATIENT CONCERNS A 51-year-old male patient was admitted to the hospital with a chief complaint of 'Due to the discovery of hard nodules with pruritus in the buttocks for 32 years. The patient was a male who was 51 years old. He has been in good health and reported no history of surgery, trauma, infection, metabolic disease, tumor, or other diseases. There was no family history. It is worth noting that the patient has the occupation of driving trucks, which keeps him sedentary. DIAGNOSES The accurate diagnosis of calcinosis cutis was confirmed by postoperative histopathological examination with many local calcifications and multinucleated giant cells in subcutaneous tissue. INTERVENTIONS The patient underwent skin lesion excision and autologous skin grafting under general anesthesia. A medium-thickness skin graft from the left lateral thigh was transplanted into the hip operation area, and a bolus tie-over pressure dressing was applied. After the operation, the patient received anti-infection treatment and was advised to rest in the prone position to prevent extrusion of the operation area. OUTCOMES The postoperative recovery was good, and there was no recurrence after 4 months of follow-up. LESSONS The incidence rate of cutaneous calcinosis is not clear. This patient had a large lesion area, long onset time, an invasion of the fat layer, and the onset site was located in the sacrococcygeal region. It is necessary to choose appropriate treatment methods.
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Affiliation(s)
- Tian-Yu E
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
| | - Xin-Jun Yang
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
| | - Chen Bi
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
| | - Feng Xue
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yong-Qian Cao
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Oda S, Hisatome T, Cho E, Fujimaki H, Nakanishi K. MRI Findings of Muscle Damage after Total Hip Arthroplasty Using the Complete Muscle Preserving Anterolateral Supine Approach. Medicina (B Aires) 2022; 58:medicina58060713. [PMID: 35743976 PMCID: PMC9228776 DOI: 10.3390/medicina58060713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: We performed anterolateral total hip arthroplasty (ALS THA) with the purpose of complete muscle-tendon preservation without muscle-tendon dissection. This study aimed to evaluate muscle damage in the periprosthetic hip joint muscles of patients undergoing ALS THA at 1-year post-operative hip magnetic resonance imaging (MRI). Materials and Methods: We evaluated changes in the muscle cross-sectional area (M-CSA) and fatty atrophy of the periprosthetic muscles. We also assessed the Harris hip score on pre-operative and 12-month post-operative MRI in 66 patients who underwent ALS THA. The grade of M-CSA atrophy was classified into no atrophy, slight atrophy, moderate atrophy, and severe atrophy. Fatty atrophy was classified as improved, no change, and worsened using the Goutallier classification. Results: More than 90% of patients’ M-CSA had no atrophy in the obturator internus (Oi), obturator externus (Oe), gluteus medius (Gmed), and gluteus minimus (Gmin), and some improvement was observed in terms of fatty atrophy. In contrast, M-CSA of the tensor fascia latae (TFL) muscle was clearly decreased, and there was no improvement in the TFL fatty atrophy. However, the presence or absence of TFL atrophy did not affect clinical outcome. Conclusions: We performed the complete muscle preserving procedure, ALS THA, with attention to preserving the Oi and Oe by direct visual confirmation and gentle treatment of the Gmed and Gmin with effective retraction. Post-operative M-CSA atrophy evaluation on MRI showed that the Oi, Oe, Gmed, and Gmin were satisfactorily preserved; however, the TFL was clearly atrophic. In the ALS approach, where entry is made between Gmed and TFL, atrophy of the TFL due to superior gluteal nerve injury must be tolerated to some extent.
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Affiliation(s)
- Shuhei Oda
- Department of Orthopedic Surgery, Nihon University Hospital, 1-6, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; (T.H.); (E.C.); (H.F.)
- Correspondence: ; Tel.: +81-3-5694-4976
| | - Takashi Hisatome
- Department of Orthopedic Surgery, Nihon University Hospital, 1-6, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; (T.H.); (E.C.); (H.F.)
| | - Eiji Cho
- Department of Orthopedic Surgery, Nihon University Hospital, 1-6, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; (T.H.); (E.C.); (H.F.)
| | - Hirohisa Fujimaki
- Department of Orthopedic Surgery, Nihon University Hospital, 1-6, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; (T.H.); (E.C.); (H.F.)
| | - Kazuyoshi Nakanishi
- Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, 30-1, Ohyaguchikami-cho, Itabashi-ku, Tokyo 173-8610, Japan;
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8
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Sethi M, Garg V, Lee JB, Yang S. PD1 inhibitor induced inverse lichenoid eruption: a case series. Dermatol Online J 2020; 26:13030/qt66b8298z. [PMID: 33423421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023] Open
Abstract
The increased use of monoclonal antibodies that target the immune checkpoint T cell receptor programmed death-1 (PD1) to treat numerous solid tumors has led to several reports describing associated cutaneous adverse events. Although lichenoid reactions have been well described, we propose that PD1 inhibitor-induced inverse lichenoid eruption (PILE) is a distinct variant. We describe two patients who presented with nearly identical deeply erythematous, malodorous, eroded anogenital plaques with focal crusting. Diagnosis of PILE was established given the biopsy findings and temporal association with PD1 inhibitor therapy. Treatment with clobetasol ointment was successful without necessitating discontinuation of immunotherapy. The findings were consistent with the only other previously published case of inverse lichenoid eruption in the groin secondary to PD1 inhibitors.
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Affiliation(s)
- Mansha Sethi
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA.
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9
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Kheterpal AB, Harvey JP, Husseini JS, Martin SD, Torriani M, Bredella MA. Hip abductor tears in ischiofemoral impingement. Skeletal Radiol 2020; 49:1747-1752. [PMID: 32514583 DOI: 10.1007/s00256-020-03497-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/23/2020] [Accepted: 05/27/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE Ischiofemoral impingement (IFI) is associated with abnormalities of the quadratus femoris muscle and narrowing of the ischiofemoral (IF) and quadratus femoris (QF) spaces. The hip abductors play an important role in pelvic stability and abductor tears might play a role in the pathophysiology of IFI. The purpose of our study was to assess the association between hip abductor tears and IFI on MRI. MATERIALS AND METHODS The study was IRB approved and HIPAA compliant. Inclusion criteria were MRI findings of IFI (narrowing of the IF space ≤ 15 mm or QF space ≤ 10 mm with associated ipsilateral quadratus femoris edema or fatty infiltration/atrophy). Two MSK radiologists assessed hip/pelvic MRIs and integrity of the tensor fascia lata, gluteus medius, and minimus tendons. IFI and control groups were compared with a two-tailed Student t test or chi-squared test. RESULTS We identified 140 patients with MRI findings of IFI (mean age 56 ± 13 years, 130 f, 10 m) and 140 controls of similar age and sex. Patients with IFI had a higher prevalence of gluteus medius/minimus partial tears (37 vs 21, p = 0.02) and full-thickness tears (24 vs 21, p = 0.03). Patients with IFI had a higher prevalence and higher grade of gluteal muscle atrophy compared with controls (p < 0.03). There were no tears of the tensor fascia lata in either group. CONCLUSION Patients with IFI had a higher prevalence of abductor tears and abductor muscle atrophy compared with matched controls. This suggests that abductor tears might play a role in the pathophysiology of IFI.
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Affiliation(s)
- Arvin B Kheterpal
- Department of Radiology, Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Joel P Harvey
- Department of Radiology, Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jad S Husseini
- Department of Radiology, Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Scott D Martin
- Sports Medicine, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, 175 Cambridge Street, Boston, MA, 02114, USA
| | - Martin Torriani
- Department of Radiology, Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Miriam A Bredella
- Department of Radiology, Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
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10
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You T, Yang B, Zhang XT, Ren SY, Bai L, Jiao FJ, Jiang XC, Guan SY, Zhang WT. A possible prediction of dystocia at the time of cesarean delivery: Gluteal muscle contracture, a single center experience from China. Medicine (Baltimore) 2020; 99:e19138. [PMID: 32049835 PMCID: PMC7035071 DOI: 10.1097/md.0000000000019138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The study assessed the pelvic dimensions by computed tomography (CT) performed for gluteal muscle contracture women, and evaluated the impact of malformations on several essential obstetric parameters.The CT pelvimetry was retrospectively performed in 25 gluteal muscle contracture women selected consecutively whether they had delivery history or not. Among the pelvic inlet plane, the mid plane and the outlet plane, 12 indicators including the transverse diameter of the pelvic inlet, the conjugate vera, the diagonal conjugate, the biischial diameter, the anteroposterior diameter of the middle pelvis, transverse outlet, the posterior sagittal diameter of outlet, the conjugate of the outlet, the anterior sagittal diameter of the outlet, the curvature and length of the sacrum, the angle of pubic arch were collected.Finally, the mean age of these women was 26.6 ± 5.0 years. Most pelvises had anteroposterior elliptical appearance in inlet and size of the female pelvis. The most statistically different and most clinically significant indicator was the biischial diameter, gluteal muscle contracture women were 95.6 ± 9.3 mm and the normal women from other study were 105.0 ± 7.9 mm, the comparison showed a significant difference (P < .001).Generally, most gluteal muscle contracture women had features of anthropoid pelvis which were quite different from normal Chinese female. These results may serve as a basis for future studies to assess its utility and prognostic value for a safe vaginal delivery in gluteal muscle contracture women.
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Affiliation(s)
- Tian You
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Bei Yang
- Gynecology Department, Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Xin-tao Zhang
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Shi-you Ren
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Lu Bai
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Fu-jia Jiao
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Xiao-cheng Jiang
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Si-yao Guan
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Wen-tao Zhang
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
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Al Dandan O, Hassan A, Al Muhaish M, AlMatrouk J, Almuhanna H, Hegazi T. Concomitant bilateral elastofibroma in the infrascapular and gluteal regions: a report of a rare case. BMC Musculoskelet Disord 2020; 21:16. [PMID: 31914985 PMCID: PMC6950919 DOI: 10.1186/s12891-020-3037-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Elastofibroma is a benign soft tissue tumor characterized by the presence of elastic fibers in a stroma of collagen and mature adipose tissue. It is reported to have a prevalence of 2.73%, as shown by a study through computed tomography (CT) images. However, multiple elastofibromas are uncommon. CASE PRESENTATION We report a case of concomitant bilateral elastofibroma in the infrascapular and gluteal regions. A 63-year-old male patient presented with a 6-month history of gradually increasing painless swellings in the upper back. On physical examination, firm, painless bilateral infrascapular masses were identified; these masses were more noticeable on forward arm flexion. Contrast-enhanced computed tomography showed well-defined bilateral infrascapular masses deep to the serratus anterior muscles as well as poorly defined bilateral gluteal masses with attenuation similar to that of the adjacent skeletal muscle. Magnetic resonance imaging revealed heterogenous masses with internal fatty streaks, consistent with elastofibroma. The histopathological diagnosis of elastofibroma was established based on the results of image-guided core-needle biopsy. The patient underwent surgical excision of both infrascapular elastofibromas with no post-operative complications. As the gluteal masses were incidental, surgical management was not warranted. CONCLUSION The presence of multiple elastofibromas is unusual. This report describes a rare case of multiple elastofibromas and its typical imaging features, and alerts us that elastofibromas are not exclusive to the periscapular region.
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Affiliation(s)
- Omran Al Dandan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Ali Hassan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Mona Al Muhaish
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Jumanah AlMatrouk
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Haidar Almuhanna
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Tarek Hegazi
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
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12
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Terrell JR, Urban JR, Fung MA, Tartar DM, Kiuru M. Pink verrucous plaque in a man with systemic mastocytosis. Dermatol Online J 2019; 25:13030/qt4js2h2cj. [PMID: 31735012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023] Open
Abstract
Porokeratosis ptychotropica is a rare and commonly misdiagnosed subtype of porokeratosis involving the body folds. We present a 53-year-old man with systemic mastocytosis who presented with a pruritic, verrucous plaque in the gluteal fold that showed multiple cornoid lamellae on histopathologic evaluation, diagnostic of porokeratosis ptychotropica. Various treatments have been reported, including topical corticosteroids, retinoids, vitamin D analogs, calcineurin inhibitors, imiquimod, phototherapy, cryotherapy, or ablative laser therapy, but recurrences are common.
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Affiliation(s)
| | | | | | | | - Maija Kiuru
- Department of Dermatology, University of California Davis, Sacramento, CA Department of Pathology and Laboratory Medicine University of California, Davis, CA.
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Trpeski S, Ilieva MM, Apostolovska N, Andonovski A, Gavrilovski A, Pop-Jordanova N. A Rare Case of Superior Gluteal Artery Pseudo Aneurysm after Blunt Trauma. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2019; 40:99-102. [PMID: 31605586 DOI: 10.2478/prilozi-2019-0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Prevailing over in rotationally unstable pelvic fractures, acetabular fractures or hip dislocations, superior gluteal artery pseudo aneurysm imperceptibly could be found after blunt force trauma of the pelvic region. We present a case of superior gluteal artery pseudo aneurysm after blunt force trauma that became gradually symptomatic in two months following the prime malevolence. Non-resolving gluteal hematoma presented two months after the incident, disregarding standard treatment methods led the diagnosis to plausible entity of pseudo aneurysm. Standard protocol was followed. CT angiography was indicated and it confirmed the suspected diagnosis. Upon indication a treatment plan was established with correspondent angioembolization of the pathologic substrate. Pseudo aneurism of the superior gluteal artery should be considered as differential diagnosis for unexplained hematomas in the posterior pelvic region following a trauma regardless of its nature.
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Affiliation(s)
- Sime Trpeski
- University clinic for traumatology, Skopje, Republic of Macedonia
| | | | | | - Alan Andonovski
- University clinic for traumatology, Skopje, Republic of Macedonia
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14
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Velasco FG, Sluzevich JC. Chronic Eroded Perianal Plaque in a Patient with Limited Systemic Scleroderma. Skinmed 2019; 17:338-339. [PMID: 31782710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 58-year-old African-American woman presented with a variably painful perianal eruption for 5 years (Figure 1). Prior treatment with topical zinc oxide, oral fluconazole, and Amoxicillin/clavulanic acid resulted in no improvement. She denied chronic diarrhea or cutaneous blistering. Past medical history included limited scleroderma and autoimmune hemolytic anemia treated with daily azathioprine; however, the eruption preceded iatrogenic immunosuppression. Physical examination revealed a well-defined glistening red, ovoid focally eroded plaque involving the intergluteal cleft. The vulva was uninvolved. Oral mucosa was also clear.
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Graham DS, Kadera BE, Eilber FC. Irregular Lipomatous Extremity Tumor. JAMA 2019; 321:1718-1719. [PMID: 30951173 DOI: 10.1001/jama.2019.3719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Danielle S Graham
- Division of Surgical Oncology, University of California, Los Angeles Medical Center
- UCLA-Jonsson Comprehensive Cancer Center Sarcoma Program, University of California, Los Angeles Medical Center
| | - Brian E Kadera
- Division of Surgical Oncology, University of California, Los Angeles Medical Center
- UCLA-Jonsson Comprehensive Cancer Center Sarcoma Program, University of California, Los Angeles Medical Center
| | - Fritz C Eilber
- Division of Surgical Oncology, University of California, Los Angeles Medical Center
- UCLA-Jonsson Comprehensive Cancer Center Sarcoma Program, University of California, Los Angeles Medical Center
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17
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Alves K, Godwin CL, Chen A, Akellot D, Katz JN, Sabatini CS. Gluteal fibrosis, post-injection paralysis, and related injection practices in Uganda: a qualitative analysis. BMC Health Serv Res 2018; 18:892. [PMID: 30477506 PMCID: PMC6258157 DOI: 10.1186/s12913-018-3711-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/14/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Iatrogenic injection injury is a major cause of disability in Ugandan children. Two injuries thought to result from injection of medications into the gluteal region include post-injection paralysis (PIP) and gluteal fibrosis (GF). This study aimed to describe perceptions of local health care workers regarding risk factors, particularly injections, for development of GF and PIP. Specifically, we examine the role of injection practices in the development of these injuries by interviewing a diverse cohort of individuals working in the health sector. METHODS We conducted a qualitative study in the Kumi and Wakiso Districts of Uganda in November 2017, utilizing 68 key informant interviews with individuals working in healthcare related fields. Interviews were structured utilizing a moderator guide focusing on injection practices, gluteal fibrosis and post-injection paralysis. RESULTS We identified six themes regarding perceptions of the cause of GF and PIP and organized these themes into a theoretical framework. There was a consensus among the individuals working in healthcare that inadequacies of the health care delivery system may lead to inappropriate intramuscular injection practices, which are presumed to contribute to the development of GF and PIP. Poor access to medications and qualified personnel has led to the proliferation of private clinics, which are often staffed by under-trained practitioners. Misaligned economic incentives and a lack of training may also motivate practitioners to administer frequent intramuscular injections, which cost more than oral medications. A lack of regulatory enforcement enables these practices to persist. However, due to limited community awareness, patients often perceive these practitioners as appropriately trained, and the patients frequently prefer injections over alternative treatment modalities. CONCLUSION This qualitative study suggests that inappropriate intramuscular injections, may arise from problems in the health care delivery system. To prevent the disability of GF and PIP, it is important to not only address the intramuscular injections practices in Uganda, but also to examine upstream deficits in access, education, and policy enforcement.
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Affiliation(s)
- Kristin Alves
- Harvard Combined Orthopaedic Surgery Residency Program, 75 Francis Street, Boston, MA BTM 02115 USA
- Brigham and Women’s Hospital, Department of Orthopaedic Surgery, Division of Rheumatology, Immunology and Allergy, Harvard Medical School, Boston, MA USA
| | | | - Angela Chen
- Brigham and Women’s Hospital, Department of Orthopaedic Surgery, Division of Rheumatology, Immunology and Allergy, Harvard Medical School, Boston, MA USA
| | | | - Jeffrey N. Katz
- Brigham and Women’s Hospital, Department of Orthopaedic Surgery, Division of Rheumatology, Immunology and Allergy, Harvard Medical School, Boston, MA USA
| | - Coleen S. Sabatini
- Department of Orthopaedic Surgery, University of California San Francisco and UCSF Benioff Children’s Hospital Oakland, Oakland, CA USA
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Wang JF, Melnick LE, Penn LA, Brinster NK, OzaMD VS. Cutaneous Crohn disease without gastrointestinal involvement in a 9-year-old boy. Dermatol Online J 2018; 24:13030/qt5028s12w. [PMID: 30677850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 10/02/2018] [Indexed: 06/09/2023] Open
Abstract
Cutaneous Crohn disease (CCD) is a rare dermatologic manifestation of Crohn disease and is defined as noncaseating, granulomatous skin lesions noncontiguous with the gastrointestinal tract. It most commonly affects the skin of the legs, although genital CCD is the most common presentation in children. Diagnosis of CCD is made by a combination of clinical and histopathological findings. Therapeutic options include topical, intralesional, and systemic corticosteroids as well as topical and systemic immunosuppressants and immunomodulators. Surgical excision may be considered for refractory cases. We report CCD in a 9-year old boy with penile swelling, granulomatous cheilitis-like lesions, and perianal plaques.
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Affiliation(s)
- Jason F Wang
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
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19
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Pruimboom T, Scheltinga M. Massive Buttock Necrosis Following Aortobifemoral Bypass Surgery. Eur J Vasc Endovasc Surg 2018; 56:86. [PMID: 29759375 DOI: 10.1016/j.ejvs.2018.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/14/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Tim Pruimboom
- Department of General Surgery, Máxima Medical Centre, Veldhoven, The Netherlands
| | - Marc Scheltinga
- Department of General Surgery, Máxima Medical Centre, Veldhoven, The Netherlands.
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20
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Cohen PR. Basal Cell Carcinoma of the Buttock. Skinmed 2018; 16:105-110. [PMID: 29911527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Basal cell carcinoma of the buttock is rare, and only 28 patients have been described. An extensive literature search was performed on basal cell carcinoma and buttock using the PubMed database. The literature was evaluated, and the characteristics of individuals with basal cell carcinoma of the buttock were summarized. The calculated prevalence of basal cell carcinoma of the buttock was 0.35%. The majority of patients had no obvious basal cell carcinoma-associated risk factors. Carcinomas were observed 1.2 times more often in women than in men, and more often on the right buttock. They frequently presented as an asymptomatic nodule. The buttock tumor was typically associated with a nodular histologic subtype of basal cell carcinoma. The prognosis for these patients was excellent after complete removal of the tumor. In conclusion, basal cell carcinoma of the buttock is a rare clinical variant of this type of skin cancer that usually presented as an asymptomatic nodule in an individual who did not have any traditional risk factors for this malignancy. The cancer was typically associated with a nonaggressive histologic subtype. Recurrence or metastasis was not observed after treatment of the primary tumor.
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Affiliation(s)
- Philip R Cohen
- Division of Dermatology, University of California San Diego School of Medicine, San Diego, CA;
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21
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Bari O, Vazirnia A, Cohen PR, Romero LS. Genitogluteal porokeratosis in an HIV-positive man: a case report and review of the literature on genital porokeratosis. Dermatol Online J 2018; 24:13030/qt0sg0z14s. [PMID: 29634882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 06/08/2023] Open
Abstract
Genitogluteal porokeratosis is a disorder of keratinization that may present in men in their fourth decade of life. We describe a 52-year-old human immunodeficiency virus (HIV)-positive man with history of anal squamous cell carcinoma who developed verrucous lesions on the buttocks and genitals. The buttock lesions presented shortly after radiotherapy for anal carcinoma a decade prior, whereas the genital lesions presented three months prior in areas treated with injectable medication for erectile dysfunction. Skin biopsy revealed a cornoid lamella, leading to the diagnosis of genitogluteal porokeratosis. The buttock lesions were treated with shave excision and the genital lesions were treated with topical agents. Using the PubMed database, a literature search was performed with combinations of the following key words: acuminata, condyloma, cornoid lamella, genital, genitogluteal, HIV, penile, porokeratosis, verrucous, vulvar. The generated papers and their references were reviewed. To the best of our knowledge, we present the first reported case of genitogluteal porokeratosis in an HIV-positive man. Notably, these lesions developed in sites of prior radiation or injection. This condition should be included in the differential diagnosis of chronic lesions of the genitals and buttocks in patients with HIV and/or history of radiation treatment and/or trauma to the genitogluteal region.
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Affiliation(s)
| | | | | | - Laura S Romero
- Department of Dermatology, University of California San Diego, La Jolla, California.
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22
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Spinelli M, Gillibrand R. Metastasis to gluteal muscle from high grade transitional cell carcinoma of bladder. Report of a case and review of literature. Pathologica 2018; 110:78-81. [PMID: 30259916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
High grade bladder malignancies have tendency to local and distant invasion. The most commonly involved sites are lymph nodes, lungs, bone and liver. Muscle metastases are generally rare and have been described in few cases of Genito-Urinary cancer. In this work we describe a rare case of high grade transitional cell carcinoma from bladder metastatising to the left gluteal muscle together with the review of the pertinent literature.
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Affiliation(s)
- M Spinelli
- Department of Cellular Pathology, north Middlesex University Hospital, Sterling Way London (UK), N18 1XQ
| | - R Gillibrand
- Department of Cellular Pathology, north Middlesex University Hospital, Sterling Way London (UK), N18 1XQ
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23
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Balea AM, Streba L, Vreju AF, Schenker M, Săndulescu DL, Bondari S, Gheonea IA, Rogoveanu OC, Mogoantă L, Vere CC. Left gluteal metastasis from a hepatocellular carcinoma - an unusual finding. Rom J Morphol Embryol 2018; 59:549-555. [PMID: 30173261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Hepatocellular carcinoma (HCC) is the primary malignant tumor of the liver that is directly derived from parenchymal cells. It is usually encountered in patients already suffering from a long-established liver disease that has evolved past the stage of liver cirrhosis. It is usually associated with viral liver infections, alcohol consumption or other dietary habits that lead to liver damage. Metastases are not rare and are usually found incidentally after a period of monitoring the main liver disease. We present here a rare case of HCC metastasis found in the right gluteal region, in a hepatitis C virus-infected patient also displaying lung tumor lesions. Diagnosis of both the metastasis and of the primary tumor were found during the same hospital visit, employing contrast-enhanced computed tomography, magnetic resonance imaging and ultrasound (US), with positive biopsy of the metastatic lesion, performed under US guidance. The patient received oncological treatment, with good prognosis and stable evolution during the next eight months since diagnosis.
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Affiliation(s)
- Alina Maria Balea
- Department of Medical Oncology, University of Medicine and Pharmacy of Craiova, Romania; ,
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24
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Binder W, Cohen P, Musisca N, Sullivan F. A Woman with a Necrotizing Soft-Tissue Infection. R I Med J (2013) 2017; 100:29-31. [PMID: 29190840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
[Full article available at http://rimed.org/rimedicaljournal-2017-12.asp].
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Affiliation(s)
- William Binder
- Associate Professor of Emergency Medicine, Alpert Medical School, Brown University
| | - Paul Cohen
- Resident in Emergency Medicine, Department of Emergency Medicine, Brown University
| | - Nicholas Musisca
- Assistant Professor of Emergency Medicine, Alpert Medical School, Brown University
| | - Francis Sullivan
- Clinical Associate Professor of Emergency Medicine, Alpert Medical School, Brown University
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25
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Abstract
In the differential diagnosis of patients with ulcers on the lips characteristics like the duration of the ulcer, number, size, depth, shape, base, margins, and distribution are considered. Such ulcers arise from many diseases particularly, viral and bacterial infections, malignancies can also be responsible. Classic syphilitic chancres are painless erosions settled on hard papule; these are evident in the genital area in more than 90% of patients. This study describes a case of a 38-year-old female patient presenting with a painful ulcer covering 3 quarters of the upper lip showing settlement on erythematous, edematous, and indurated plaque covered with hemorrhagic crusts. The aim of this study was to consider differences between the classic syphilitic chancre typically found in the genital region from extragenital chancres and to raise awareness of the possibility of primary syphilis when patients present with painful ulcers on the lip.
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Affiliation(s)
- Filiz T Demir
- Department of Dermatology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey. E-mail.
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26
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Neagu TP, Sinescu RD, Enache V, Achim SC, Ţigliş M, Mirea LE. Metastatic high-grade myxofibrosarcoma: review of a clinical case. Rom J Morphol Embryol 2017; 58:603-609. [PMID: 28730250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We present the particular clinical and histological features of a metastatic high-grade myxofibrosarcoma (MFS) of the left buttock in a 77-year-old male patient. The tumor was biopsied and surgically removed in order to increase the patient's comfort, due to its increased size and aggressive clinical behavior. Computed tomography (CT) revealed metastases in the pleura and mediastinal lymph nodes, so limb-sparing tumor excision followed by palliative care was the best practice for the patient until the fatal outcome. The histological assessment revealed a tumor composed partly of solid sheets of spindled and pleomorphic cells, partly of areas with prominent myxoid matrix and numerous elongated capillaries. Mitotic figures are frequent, often atypical, followed by numerous giant cells with abundant eosinophilic elongated cytoplasm, resembling myoid cells often multinucleated. A panel of immunohistochemical stainings, including muscle-specific actin (MSA), S-100, CD34, desmin and myogenin were performed with a negative result, which aided excluding other soft tissue tumors like rhabdomyosarcoma and leiomyosarcomas, while Ki-67 was highly expressed in more than 70% of the tumor cells. This tumor received 6 points in accordance with the Fédération Nationale des Centres de Lutte Contre le Cancer (modified FNCLCC) and was defined as a high-grade MFS [stage IV, G3 pT2bN0M1, according to the 8th edition of TNM Classification of Malignant Tumors, ICD-O 8811÷3 in World Health Organization (WHO) Classification 2013]. Due to the clinical findings combined with the histological profile, the fatal prognosis was expected, though the time period was shorter than predicted, confirming the aggressive nature of the tumor. Even if traditionally was considered MFS as a non-metastatic lesion, recent case reports and studies, including our case revealed that this tumors in fact have the potential to be fatal due to metastatic disease.
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Affiliation(s)
- Tiberiu Paul Neagu
- Department of Plastic Surgery and Reconstructive Microsurgery, Emergency Clinical Hospital of Bucharest, Romania;
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27
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Christman MP, Belkin D, Geronemus RG, Brauer JA. An Anatomical Approach to Evaluating and Treating Cellulite. J Drugs Dermatol 2017; 16:58-61. [PMID: 28095534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cellulite is the common rippling or dimpling of skin of the thighs and buttocks of women, formed from a confluence of skin laxity, tethering fibrous septa, and fat herniation. We describe an anatomical approach to evaluating the cellulite patient and selecting the best treatment from among available non-invasive, minimally invasive, and invasive therapies. It is crucial to consider the anatomy of the patient and the morphology of cellulite while choosing a treatment. Diffuse rippling represents increased adiposity and/or increased skin laxity which may stand to benefit from lipolytic and skin tightening modalities. Dimpling represents tethering by fibrous septa which may stand to improve from subcision by minimally invasive devices such as Cell na. Patients with both morphologies may be treated with a combination of treatments or Cellulaze. Careful evaluation of the patient can help identify the best therapeutic strategy. <em>J Drugs Dermatol. 2017;16(1):58-61.</em>.
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28
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Affiliation(s)
- A G Kriger
- A.V. Vishnevsky Institute of Surgery, Ministry of Health, Russia, Moscow, Russia
| | - A O Gushcha
- Neurological research center, Moscow, Russia
| | - D S Gorin
- A.V. Vishnevsky Institute of Surgery, Ministry of Health, Russia, Moscow, Russia
| | - A R Kaldarov
- A.V. Vishnevsky Institute of Surgery, Ministry of Health, Russia, Moscow, Russia
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29
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Kumar Bhardwaj N, Khera D. Mongolian Spots in GM1 Gangliosidosis. Indian Pediatr 2016; 53:1133. [PMID: 28064276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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30
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Abstract
OBJECTIVES Spindle cell lipomas (SCLs) are benign lipomatous neoplasms that classically arise in the posterior neck, upper back, and shoulders of older male patients. We sought to characterize the occurrence of this entity at nonclassic sites. METHODS All cases of SCL arising at atypical sites were retrieved from our archives. RESULTS Of 439 total cases of SCL, 57 arose at atypical locations in 32 men and 25 women (age range, 27-79 years). The tumor sites included leg (n = 23), buttock/perineum/inguinal (n = 10), forearm (n = 9), finger (n = 9), foot (n = 2), toe (n = 2), hand (n = 1), and flank (n = 1). CD34 was positive staining in all cases tested (52/52), while desmin was negative in most tumors (48/50). Thirty-eight of 38 cases tested exhibited loss of Rb expression. No cases showed CPM/MDM2 amplification (0/48). No local recurrences have been reported (n = 39). CONCLUSIONS SCLs may arise in the trunk, lower extremities, and distal upper extremities. While most SCLs arising in classic sites occur in male patients, there is a relatively equal sex distribution in tumors at atypical sites. Pathologists should be aware that SCLs arise at atypical locations to avoid misclassification as other lipomatous neoplasms, including atypical lipomatous tumor.
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Affiliation(s)
- Nasir Ud Din
- From the Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | | | | | | | - Sarah M Jenkins
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Leona A Doyle
- Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA
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31
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Stojkovic-Filipovic J, Skiljevic D, Brasanac D, Medenica L. Gianotti-Crosti syndrome associated with Ebstein-Barr virus and Parvovirus B-19 coinfection in a male adult: case report and review of the literature. GIORN ITAL DERMAT V 2016; 151:106-111. [PMID: 25034095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Gianotti-Crosti syndrome (GCS) is a self-limiting, mostly childhood-appearing, cutaneous eruption with characteristic symmetric areal distribution. The original cases, described by Gianotti in 1955, were associated with hepatitis B virus infection, but other viral and bacterial infections, as well as immunizations, have been implied in etiology of this condition. Adult cases are rare and have been reported almost exclusively in women. We present the case of a 20-year-old Caucasian man who had typical clinical presentation: monomorphic pale, pink-to-flesh - colored or erythematous papules and papulovesicles localized symmetrically over the extensor surfaces of the extremities, buttocks and the face; some lesions were detected on knees, elbows and palms, as well. Laboratory tests revealed slight bilirubin and alanine aminotransaminase elevation. Serology tests demonstrated antibodies against Epstein-Barr virus and parvovirus B-19. Histology of skin biopsy specimens revealed a vesicular dermatitis with perivascular lymphocytic infiltrate. Oral and topical corticosteroids and oral antihistamines led to complete resolution of lesions in 3 weeks. GCS is rare in adults, especially men. To the best of our knowledge, this is the fifth male adult case and the first with Parvovirus B-19 and EBV coinfection.
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Affiliation(s)
- Jelena Stojkovic-Filipovic
- Clinic of Dermatovenereology, Clinical Center of Serbia, Department of Dermatovenereology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia -
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32
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Affiliation(s)
- Caroline Z Tan
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Roberto Novoa
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Jennifer K Chen
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
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33
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Arunachalam K. Refractory sciatica could be a sign of malignancy: A unique case presentation. R I Med J (2013) 2016; 99:25-27. [PMID: 26726859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
t Renal cell carcinoma is one of the highly aggressive tumors and notorious for late presentations. It is associated with high morbidity and mortality. Renal cell carcinoma is known for rare metastatic sites. In clinical practice, it is often important not to anchor to a particular diagnosis but rather revisit and revaluate entire history and clinical examination. We describe a case of metastatic renal cell carcinoma that was initially treated as sciatica and later found to have advanced debilitating malignancy. Internal medicine physicians should be able to recognize one of the rare metastatic sites of renal cell carcinoma and understand the importance of imaging studies if patient has persisting sciatica symptoms without improvement.
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Affiliation(s)
- Karuppiah Arunachalam
- Department of Hospital Medicine, Alpert Medical School of Brown University, Providence, Rhode Island
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34
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Sandberg Y, Dijkshoorn ML, Schoots IG. [A woman with subcutaneous nodules after buttock augmentation]. Ned Tijdschr Geneeskd 2016; 160:D443. [PMID: 27827288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Volume augmentation of the buttocks with injectable soft-tissue fillers is a cosmetic procedure; delayed adverse effects include the formation of granulomatous inflammatory nodules. We describe a 35-year-old woman with early-stage Hodgkin's lymphoma with multiple nodular subcutaneous densities on CT scans in both gluteal regions. These were the result of frequent injections with human collagen.
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35
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Dutta A, Dutta M, Nag SS. Candidal Diaper Dermatitis. Indian Pediatr 2015; 52:1100. [PMID: 26713999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Abhijit Dutta
- Departments of Pediatric Medicine, North Bengal Medical College, and #Microbiology, School of Tropical Medicine; Kolkata, West Bengal. India.
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36
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Pasichniy DA. [A SACRAL BEDSORE PLASTY, USING ROTATIONAL CUTANEO-FASCIAL GLUTEAL FLAPS]. Klin Khir 2015:57-60. [PMID: 26946664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The method of rotational cutaneo-fascial plasty, applying preservation of perforating arteries in subfascial dissection with mobilization and subsequent rotation of the flaps was improved, guaranteeing preservation of blood flow from multiple perforating arteries in them. The method was successfully applied in 3 patients with a Grade IV sacral bedsores.
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37
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Games KE, Kollock RO, Windham J, Fischer GS, Sefton JM. Tissue Changes During Operational Load Bearing in UH-60 Aircrew Using Magnetic Resonance Imaging. Aerosp Med Hum Perform 2015; 86:815-8. [PMID: 26388089 DOI: 10.3357/amhp.4227.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Warfighters involved in mounted operations often experience prolonged periods of tissue loading, leading to injury. Determining how anatomical structures are affected during loading aids in the prevention and treatment of injury. The purpose of this study was to develop a magnetic resonance imaging (MRI) compatible seat system that simulates a UH-60 Blackhawk in-flight sitting posture. METHODS Eight men were scanned with a 3.0 Tesla MRI. Scans were collected with and without 6.38 psi of pressure applied to the buttocks via two air bladders and an MRI-compatible robot controller system. RESULTS Scans revealed that 6.38 psi of pressure applied to the buttocks significantly decreases total soft-tissue thickness beneath the left and right ischial tuberosities by 3.6 and 3.8 mm, respectively. DISCUSSION At operational load bearing pressures seen in the UH-60, the soft tissue structures of the buttocks are compressed. These findings aid in our understanding of the etiology of repetitive trauma disorders in aircrew due to prolonged sitting. This study serves as the foundation for future work examining the anatomical changes associated with prolonged restricted sitting and other operational activities. A better understanding of the anatomical characteristics associated with mounted operations is invaluable to the prevention and treatment of injuries reported by warfighters and civilian populations.
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Affiliation(s)
- Kenneth E Games
- Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN, USA
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38
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Helm MF, Haddad F, Farah R. What is your diagnosis? Verrucous carcinoma. Cutis 2015; 96:82-90. [PMID: 26367754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Matthew F Helm
- Upstate Health Care Center, 90 Presidential Plaza, Syracuse, NY 13202, USA.
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39
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Stehr RC, Kim N, LoGiudice JA, Ludwig K. Fox Den Disease: An Interesting Case Following Delayed Diagnosis. Wounds 2015; 27:170-173. [PMID: 26061492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Pyoderma fistulans sinifica, also known as fox den disease, is a rare and poorly understood inflammatory disorder of the skin and subcutaneous tissues. This disorder is often mistaken for other inflammatory skin disorders and treated inappropriately. The authors describe the case of a 53-year-old male who presented to the colorectal surgery service with a longstanding diagnosis of perirectal Crohn's disease. Despite aggressive immunosuppression and numerous surgical procedures, the patient continued to have unrelenting purulent drainage from the skin of his buttocks. Following wide excision of the affected skin and subcutaneous tissues by the colorectal surgeon, the plastic surgery team reconstructed the 30 cm x 55 cm wound using a combination of local flaps and skin grafts. The initial pathology report of the excised specimen confirmed the presence of nonspecific abscesses and inflammation. Upon special request by the plastic surgery team, the sample was resectioned with the specific intent of establishing a diagnosis of fox den disease. The additional slides met the criteria for an unequivocal diagnosis of fox den disease. Immunosuppression was discontinued and the patient healed his wounds without complication. Fox den disease is often overlooked because of the obscurity of the disease and the special histological sectioning needed to establish a diagnosis. In this case, the patient was unnecessarily treated with immunosuppressive drugs for more than 3 decades because of a misdiagnosis. With increased awareness of fox den disease, perhaps its pathophysiology can be better elucidated as more patients are appropriately diagnosed and treated.
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MARCHI M, BATTAGLIA S, MARCHESE S, INTAGLIATA E, SPATARO C, VECCHIO R. Surgical reconstructive procedures for treatment of ischial, sacral and trochanteric pressure ulcers. G Chir 2015; 36:112-116. [PMID: 26188755 PMCID: PMC4511039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Pressure ulcers are frequent complications for long term hospitalized bed-ridden patients which are not able to move or move very little. In fact, the lesion forms in a skin and muscle region which undergoes a constant pressure between an underlying bone protrusion and a support structure such as a bed or a wheelchair. Initially only the outer layers are involved but in time, the ulcer can spread to the deeper structures and reach the bone. PATIENTS AND METHODS In our work we described the anatomical areas that are most often subject to developing a pressure ulcer and we considered the surgical treatment and reconstructive procedures which are applied using a logical and rigorous sequence. RESULTS We considered 4 clinical cases (2 ischiatic sores, 1 sacral sore and 1 gluteal-trochanteric sore) which demonstrate the surgical treatment and the reconstructive procedures. CONCLUSIONS It is crucial to cover the defects with a thick flap to give more support and protection to the areas which undergo pressure and to lower the incidence of recurrences.
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Affiliation(s)
- M. MARCHI
- Department of Plastic Maxillo-Facial Surgery and Reconstructive Microsurgery, “Azienda Ospedaliera Vittorio Emanuele II”, Catania, Italy
| | - S. BATTAGLIA
- Department of Surgery, University of Catania, Catania, Italy
| | - S. MARCHESE
- Department of Surgery, University of Catania, Catania, Italy
| | - E. INTAGLIATA
- Department of Surgery, University of Catania, Catania, Italy
| | - C. SPATARO
- Department of Surgery, University of Catania, Catania, Italy
| | - R. VECCHIO
- Department of Surgery, University of Catania, Catania, Italy
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Tausend WE, Stewart LR, Rapini RP. Morphea-like complications to illicit gluteal silicone injections. Dermatol Online J 2015; 21:13030/qt0xv5g3sn. [PMID: 25933074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 04/15/2015] [Indexed: 06/04/2023] Open
Abstract
We present a case of a 39-year-old Hispanic woman who was referred to our clinic for treatment of several indurated plaques on her buttocks that developed one year prior to presentation, after she received injections of an unknown substance for augmentation. Biopsy of one nodule revealed silicone in the dermis.
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Krasner DL, Stewart TP. SCALE wounds: unavoidable pressure injury. Wounds 2015; 27:92-94. [PMID: 25855852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Skin Changes at Life's End (SCALE) wounds include wounds of many underlying etiologies that accompany the dying process. These wounds occur due to unmodifiable intrinsic and extrinsic factors unique to each individual. This article describes the case of a dying patient who sustained a skin tear that deteriorated into a SCALE wound that meets the criteria for a National Pressure Ulcer Advisory Panel unavoidable pressure injury.
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Mandal RK, Dutta A, Ghosh SK. Nevus lipomatosus cutaneous superficialis. Indian Pediatr 2015; 52:265-266. [PMID: 25849021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Rajesh Kumar Mandal
- Departments of *Dermatology and Pediatric Medicine, North Bengal Medical College and #Dermatology, RG Kar Medical College; Kolkata, West Bengal, India.
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Chou CY, Huang ZY, Chiao HY, Wang CY, Sun YS, Chen SG, Chen TM, Chang SC. Squamous cell carcinoma arising from a recurrent ischial pressure ulcer: a case report. Ostomy Wound Manage 2015; 61:48-50. [PMID: 25654781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Marjolin's ulcer is the malignant transformation of long-standing chronic pressure ulcers and requires prompt diagnosis and treatment. A 46-year-old man with an 8-year history of traumatic spinal injury with paraplegia presented with a recurrent ischial pressure ulcer. The initial ulcer, which developed 6 years earlier, was a Stage IV sacral ulcer. The wound was debrided and pathology showed epithelial hyperplasia, acanthosis, hyperkatosis accompanied by mild inflammation, and fibrosis without any malignant transformation. The lesion was covered with a fasciocutaneous bipedicled flap. Four years later, the patient presented with a similar ulcer in the same location. Histology showed the presence of a well-differentiated squamous cell carcinoma (SCC). Following a wide excision, the lesion was covered with a gluteal maximal V-Y musculocutaneous advancement flap. At last follow-up 14 months postoperatively, there was no evidence of recurrence or metastatic disease. Clinicians must be aware of known risk factors for the development of SCC.
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Chahar M, Dhali TK, D'souza P. Multifocal tuberculosis verrucosa cutis. Dermatol Online J 2015; 21:13030/qt80j7q792. [PMID: 25612118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 01/15/2015] [Indexed: 06/04/2023] Open
Abstract
Tuberculosis Verrucosa Cutis (TBVC), a verrucous form of cutaneous tuberculosis, occurs from inoculation of tubercle bacilli into the skin of a previously sensitized patient with moderate to high degree of immunity. This disease is now rare in western countries and in India; the incidence of cutaneous tuberculosis has fallen from 2% to 0.15%. However two recent studies from the Indian subcontinent have reported the prevalence of cutaneous tuebrculosis as 0.7% (Varshney et al) and 0.26% (Patra et al) This case is reported to demonstrate the indolent and extensive nature of tuberculosis verrucosa cutis in an immunocompetent individual and to highlight the importance of histopathology and empirical antitubercular therapy as an adjunct diagnostic tool.
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Affiliation(s)
- Monica Chahar
- Department Of Dermatology, ESI PGIMSR, New Delhi, India.
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de Jong-Met R, Opstelten W. [An 87-year-old man with a rough skin on his buttocks]. Ned Tijdschr Geneeskd 2015; 159:A9292. [PMID: 26732208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An 87-year-old man consulted the general practitioner with skin lesions on his buttocks. Dermatological findings were erythema without a sharp border, vesicles or crusts. He had a habit of sprawling in his seat, which is the cause of senile gluteal dermatosis, also named sitter's sign or grandfather's disease. After having a better sit habit the skin healed within a few weeks, without application of dermal therapy.
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Wincewicz A, Lewitowicz P, Matykiewicz J, Głuszek S, Sulkowski S. Intramuscular high-grade myxofibrosarcoma of left buttock of 66-year-old male patient - approach to systematic histopathological reporting. Rom J Morphol Embryol 2015; 56:1523-1528. [PMID: 26743304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Here we present a systematic approach to histopathological reporting of high-grade myxofibrosarcoma of 66-year-old male patient. The tumor was biopsied with fine-needle aspiration (FNA) and core-needle biopsy (CNB) and then the whole myxoid tumor was excised with left musculus gluteus maximus. The lesion was stained with Hematoxylin-Eosin (HE), Periodic acid-Schiff (PAS), Alcian blue, Masson's trichrome, Ki67, alpha-smooth muscle actin (α-SMA), S100, CD34 and vimentin. FNA material grounded the diagnosis of non-epithelial neoplasia, while CNB was enough to produce diagnosis of myxoid sarcoma. The tumor lied under superficial fascia with no extension beyond deep fascia or any invasion of skin, vessels or nerves, either. The tumor was intramuscular, mainly myxoid with hypercellular areas of highly atypical cells with bizarre giant multinucleated cells that clearly belonged to category of high-grade sarcoma. According to Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC), the case was assessed for 5 points. Ki67 index reached more than 80% malignant cells. Alcian blue was strongly positive in myxoid background. Masson's trichrome emphasized fibrillary structure of tumor. Negativity for S100, α-SMA with strong co-expression of CD34 and vimentin supported the diagnosis of myxofibrosarcoma. The lesion was diagnosed as high-grade myxo-fibrosarcoma (formerly myxoid malignant fibrous histiocytoma) G2 pT2b [7th edition pTNM (pathological tumor-node-metastasis), code ICD-O 8811/3 in World Health Organization (WHO) Classification 2013]. In approach to diagnosis of soft tissue malignancies, a strict sequence of procedures should be applied as only meticulous and ordered diagnostic pathway would succeed in and correct identification of a peculiar type of sarcoma.
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Affiliation(s)
- Andrzej Wincewicz
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland; ,
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Moulton KM, Aly AR, Rajasekaran S, Shepel M, Obaid H. Acetabular anteversion is associated with gluteal tendinopathy at MRI. Skeletal Radiol 2015; 44:47-54. [PMID: 25158908 DOI: 10.1007/s00256-014-1991-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 08/10/2014] [Accepted: 08/14/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Gluteal tendinopathy and greater trochanteric pain syndrome (GTPS) remain incompletely understood despite their pervasiveness in clinical practice. To date, no study has analyzed the morphometric characteristics of the hip on magnetic resonance imaging (MRI) that may predispose to gluteal tendinopathy. This study aimed to evaluate whether acetabular anteversion (AA), femoral neck anteversion (FNA), and femoral neck-shaft angle (FNSA) are associated with MRI features of gluteal tendinopathy. MATERIALS AND METHODS A total of 203 MRI examinations of the hip met our inclusion and exclusion criteria. A single blinded investigator measured AA, FNA, and FNSA according to validated MRI techniques. Two blinded subspecialty-trained musculoskeletal radiologists then independently evaluated the presence of gluteal tendinosis, trochanteric bursitis, and subgluteal bursitis. Statistical analysis was performed using a one-way analysis of variance (ANOVA; post-hoc Tukey's range test). RESULTS At MRI, 57 patients had gluteal tendinosis with or without bursitis, 26 had isolated trochanteric bursitis, and 11 had isolated subgluteal bursitis. AA was significantly (p = 0.01) increased in patients with MRI evidence of gluteal tendinosis with or without bursitis [mean: 18.4°, 95 % confidence interval (CI): 17.2°-19.6°] compared with normal controls (mean: 15.7°, 95 % CI: 14.7°-16.8°). Similarly, AA was significantly (p = 0.04) increased in patients with isolated trochanteric bursitis (mean: 18.8°, 95 % CI: 16.2°-21.6°). No association was found between FNA or FNSA and the presence of gluteal tendinopathy. Interobserver agreement for the presence and categorization of gluteal tendinopathy was very good (kappa = 0.859, 95 % CI: 0.815-0.903). CONCLUSION Our MRI study suggests that there is an association between increased AA and gluteal tendinopathy, which supports a growing body of evidence implicating abnormal biomechanics in the development of this condition.
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Affiliation(s)
- Kyle M Moulton
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada,
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Snelder SM, Engels LK, van der Valk H, van Praag MCG. [Skin disorder as an indication of viral infection]. Ned Tijdschr Geneeskd 2015; 159:A8708. [PMID: 26083843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Gianotti-Crosti syndrome (GCS) is a dermatosis primarily affecting children between 2 and 6 years of age. It is characterized by multiple, itching, monomorphous, pink to red-brown papules or papulovesicles between 1 and 5 mm in size. GCS is associated with viral infections such as hepatitis B virus and Epstein-Barr virus (EBV). It is often accompanied by fever, hepatosplenomegaly and lymphadenopathy. The syndrome is self-limiting and disappears within 2 months. No treatment is therefore required. CASE DESCRIPTION We report a case of a 16-year-old female who presented with itching papulovesicles on the extremities and on the buttocks. She was diagnosed with GCS because of the clinical findings, histopathological tests and positive EBV serology. CONCLUSION GCS can also affect patients older than 6 years of age. Moreover, this syndrome may be a first sign of infection with Epstein-Barr virus, hepatitis B virus, HIV or other viral infections.
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Perkins J, Scarbrough C, Sammons D, Magro C. Reed syndrome: an atypical presentation of a rare disease. Dermatol Online J 2014; 21:13030/qt5k35r5pn. [PMID: 25780965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 10/03/2014] [Accepted: 12/14/2014] [Indexed: 06/04/2023] Open
Abstract
Reed syndrome, also known as Multiple Uterine and Cutaneous Leiomyomas (MCUL), is an autosomal dominant defect in the fumurate hydrase gene, leading to a predisposition of leiomyomas of the skin and uterus. Patients with Reed syndrome may present with cutaneous leiomyomas, uterine leiomyomas and/or leiomyosarcomas. A 37-year-old woman presented to the dermatology clinic with several subcutaneous nodules. Punch biopsy was performed and the diagnosis of angioleiomyosarcoma with supervening degenerative changes was made. Medical history was positive for uterine leiomyomas. These concomitant findings led to the diagnosis of Reed syndrome. At the present time, genetic counseling is a suggested screening parameter for patients with multiple cutaneous leiomyomas. The superficial nature of these lesions and the low staging made surgical excision the preferred and actual treatment method. Adjunct radiation and chemotherapy have not been shown to provide clear benefit of survival. Owing to an association with renal cell carcinoma, a referral for nephrology consultation is also recommended.
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