Pilomatrixoma of the Ankle: A Case Report.

Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a rare benign skin tumor originating from hair follicle matrix cells. It typically presents as a firm, painless subcutaneous nodule, most commonly found in the head, neck, and upper extremities. Pilomatrixoma can occasionally appear in atypical locations, posing a diagnostic challenge due to its nonspecific clinical presentation. A 43-year-old female presented with a painless, slowly enlarging mass on the lateral side of her left ankle, which had been present for approximately one year. Physical examination revealed a firm, well-circumscribed subcutaneous nodule measuring about 2 cm in diameter with normal overlying skin. An MRI of the left ankle demonstrated a well-circumscribed, subcutaneous mass with heterogeneous signal intensity, consistent with calcifications, suggesting pilomatrixoma. A fine-needle aspiration biopsy confirmed the presence of basaloid cells, shadow cells, and areas of calcification. The lesion was surgically excised, and histopathological examination validated the diagnosis of pilomatrixoma. The patient had an uneventful postoperative course, with no recurrence at the six-month follow-up. This case underscores the importance of considering pilomatrixoma in the differential diagnosis of subcutaneous nodules, even in unusual locations. A comprehensive diagnostic approach, including clinical evaluation, imaging, and histopathological examination, is essential for an accurate diagnosis. Surgical excision with clear margins is the treatment of choice, ensuring low recurrence rates and excellent patient outcomes. This report enhances the understanding of pilomatrixoma and highlights the necessity for a multimodal diagnostic strategy in managing this rare condition effectively.

Cocaine-Induced Bilateral Internal Carotid Artery Dissection: A Case Report.

Internal carotid artery dissection is a rare vascular condition with potentially life-threatening consequences, often resulting in intramural hematomas and luminal narrowing. Various etiological factors, including cocaine use, contribute to its occurrence. This case report explores a striking instance of bilateral internal carotid artery dissection in a middle-aged man with a history of chronic cocaine use, shedding light on the intricate relationship between substance abuse and vascular pathology. We present the case of a 47-year-old man with a significant history of chronic cocaine use presented with sudden-onset severe headaches and visual disturbances, including blurred vision and diplopia. Physical examination revealed signs of Horner's syndrome and neurological involvement. Diagnostic imaging confirmed bilateral internal carotid artery dissections, primarily on the right side, with mural hematoma formation and luminal narrowing. Immediate management included pain control, blood pressure regulation, and discontinuation of cocaine use. The patient's symptoms gradually resolved with anticoagulation therapy, and he was discharged with a comprehensive follow-up plan. This case of bilateral internal carotid artery dissection in a middle-aged man with a history of chronic cocaine use underscores the intricate relationship between this condition and substance abuse. It highlights the need for a comprehensive clinical history to identify potential links between substance use and vascular pathologies. The multidisciplinary approach to diagnosis and management is crucial in optimizing patient outcomes. Addressing substance abuse as a contributing factor to vascular pathology is essential, emphasizing the importance of comprehensive care and support for affected individuals, and contributing valuable insights to the existing literature on vascular pathology.

Formulation and pharmacokinetics of multi-layered matrix tablets: Biphasic delivery of diclofenac.

The rapid availability of the drug at the site of action followed by maintaining its effect for a long period of time is of great clinical importance. Thus, the purpose of the present study was to prepare and evaluate multi-layered matrix tablets of diclofenac using Eudragit RL/RS blend to achieve both immediate and sustained therapeutic effects. Diclofenac potassium (25 mg) was incorporated in an outer immediate release layer to provide immediate pain relief whereas diclofenac sodium (75 mg) was incorporated in the inner core to provide extended drug release. Wet granulation was employed to prepare the inner core of the tablets that were further layered with an immediate release drug layer in the perforated pan coater. The in-vitro and in-vivo performance of the developed formulation was compared with the marketed products Voltaren® SR 75 mg and Cataflam® 25 mg. The in-vitro drug release of the prepared formulation showed similarity (f2 = 66.19) to the marketed product. The pharmacokinetic study showed no significant difference (p > 0.05) in AUC0-24 and Cmax between the test and reference formulations. The AUC0-24 values were 105.36 ± 83.3 and 92.87 ± 55.53 µg h/ml whereas the Cmax values were 11.25 ± 6.87 and 12.97 ± 8.45 µg/ml, for the test and reference, respectively. The multi-layered tablets were proved to be bioequivalent with the commercially available tablets and were in agreement with the observed in-vitro drug release results. Stable physical characteristics and drug release profiles were observed in both long term and accelerated conditions stability studies.