Emphysematous pancreatitis is typically managed with broad-spectrum antibiotics and early surgical debridement. Here, a case that supports more recent evidence for conservative therapy.
Extensive condylomata acuminata are beyond the capacity of all topical therapies. The area was initially treated by carbon dioxide laser ablation, and residual small foci of infection were subsequently treated with topical 5% imiquimod cream.
A tender, crusting eruption first arose on a 69-year-old man's ear 10 days earlier; an antibiotic failed to clear the lesion. The patient is otherwise healthy, with no predisposing diseases or history of trauma… Read More
A 72-year-old man slipped and fell backward in the bathroom, hitting his
head on the toilet seat; he suffered only minimal discomfort. The following
day, he presented with mild back pain and extensive bruising. More »
Match each picture with the phrase below that best describes it. The organisms in these pictures might be microscopic
or macroscopic, and they can be recovered from skin lesions or clothing by the patient and/or clinician. More »
Foot ulcerations and infections are the leading cause of hospitalization
among patients with diabetes; they occur in about
15% of these patients. Given the rapidly increasing incidence
of diabetes, physicians can expect to see a growing number
of diabetic foot problems. Here, a group of experts,... More »
Dendritic cells (DCs) are professional antigen-presenting cells that play a crucial role in the initiation and modulation of immune responses. Human circulating blood DCs are divided into two major subsets: myeloid DCs (mDCs); and plasmacytoid DCs (pDCs). Furthermore, mDCs are subdivided into two subsets: Th1-promoting mDCs (mDC1s); and Th2-promoting mDCs (mDC2s). Although CD1a, CD1c, and CD141 are generally used for classifying mDC subsets, their adequacy as a specific marker remains unclear. We performe
Primary hyperparathyroidism ( PHPT) is the third most common endocrine disorder globally. ... Symptomatic disease is routinely treated with parathyroidectomy, and the revised National Institutes of Health consensus guidelines from 2002 have further
Behçet's disease (BD) is an auto-inflammatory disorder, characterised by recurrent oral aphtosis, genital ulcers, uveitis and pustular skin lesions.1 Associated cutaneous diseases include Sweet's syndrome,2 erythema nodosum and pyoderma gangrenosum.3 Next to BD, bot
Rubinstein-Taybi syndrome (RTS) is a rare autosomal dominant disorder (prevalence 1:125,000) characterised by broad thumbs and halluces, facial dysmorphism, psychomotor development delay, skeletal defects, abnormalities in the posterior fossa and short stature. The known genetic causes are point mutations or deletions of the cAMP-response element binding protein-BP (CREBBP) (50-60% of the cases) and of the homologous gene E1A-binding protein (EP300) (5%).|Rubinstein-Taybi syndrome (RTS) is a rare autosomal
Behet's disease (BD) is a recurrent systemic inflammatory disorder of unknown origin characterized by oral and genital mucous ulcer, uveitis, and skin lesions. Involvement of large vessels, central nervous system (CNS), gastrointestinal tract and thrombotic events are less frequent but can be life threatening. The aim of this review is to provide new insights into the pathogenesis of BD. Over the past year substantial advances have been done in the understanding of the genetic [1,2] and immunology [3] of BD. BD is at the crossroad between autoimmune and autoinflammatory syndromes. In common with autoimmune diseases BD shares class I MHC association. However, in contrast to autoimmune disorders, BD has clinical features that seem to be mostly autoinflammatory. The pathogenesis of BD is still unknown, but major determinants of the genetic and immune system abnormalities have been reported recently. Triggering infectious factors are supposed to participate in the outbreak of BD in
Post-transplant lymphoproliferative disorder (PTLD) is a lymphoid proliferation that develops as a complication of solid organ or bone marrow transplants. PTLD limited to the skin is very rare. Plasmacytoma-like PTLD is an uncommon variant of monomorphic PTLD. Its presentation in the skin is extraordinary with very few cases reported in the literature. We report a new case of plasmacytoma-like PTLD presenting as multiple skin nodules on the leg of a 74-year-old kidney transplant recipient. Histopathologic and immunohistochemical examination of one nodule revealed atypical plasmacytoid and plasmablastic cells that showed kappa light chain restriction and stained positive for CD138. Staging investigations excluded extracutaneous manifestations of the disease. This case is unusual for several reasons including involvement limited to the skin, plasmacytoid phenotype of the tumor, presentation 18 years following transplantation and Epstein-Barr virus negativity.
Peeling skin diseases (PSD) refer to a group of rare autosomal recessive dermatosis which are characterized by spontaneous, continual peeling of the skin. Three different clinical pictures can be distinguished: Inflammatory PSD also referred to as peeling skin syndrome (PSS) type B, non-inflammatory PSD also referred to as PSS type A, and localized forms i.e. acral type PSS.|To characterize the clinical and histopathological features of PSD in Turkey.|We retrospectively reviewed the medical records and clinical photographs of patients who were given diagnosis of PSD and conducted histopathological evaluation of skin biopsies to identify the site of cleavage. Also we evaluated the cases including age, gender, age onset, clinical and histological findings, family history, associated disorders and PSD type.|Twenty-one patients with PSD were seen at Gulhane School of Medicine in Ankara between the years 1994 and 2010 in this retrospective study. All patients were men. Their ages were
Lichen planus (LP) is a papulosquamous eruption of the skin, scalp, nails, and mucous membranes. Although LP is more common in adults, it has become an established pediatric disorder. Its classic presentation is characterized by 4 p's: purple, polygonal, pruritic papules. Histopathologic examination reveals characteristic interface dermatitis. Although its pathogenesis is not fully understood, there is evidence that an imbalance of immunologic cellular reactivity is central. Lichen planus usually resolves within a few months. Treatment that primarily consists of topical and/or oral steroids will expedite recovery and alleviate symptoms. Resolution of this cutaneousdisease often is accompanied by postinflammatory hyperpigmentation. Long-term sequelae of LP in the pediatric population are rare, but cutaneous atrophy and pterygium unguis may occur.
Melasma is an acquired pigmentary disorder classically manifesting as symmetric hyperpigmented macules and patches on the face. It most commonly affects women of reproductive age with darker skin tones but may also affect adolescents, older women, and men. Although its pathogenesis remains unclear, known risk factors include ultraviolet radiation, hormonal variations of pregnancy, thyroid disease, oral contraceptives, and antiseizure medications. Hydroquinone-containing topical agents are the current standard for melasma treatment, but concern about side effects and long-term safety has spurred efforts to develop alternative treatment options.|To review recent advances in melasma treatment.|MEDLINE was searched from 2006 to the present for randomized controlled trials (RCTs) of melasma treatments.|Nineteen published RCTs were found covering interventions such as topical therapies, chemical peels, and electromagnetic devices. The outcomes of the studies were summarized into tabular
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Primary Care Can't Thrive Without Nurse Practitioners Courtney H. Lyder, ND, May 17, 2013 With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.