Systemic Sclerosis Presenting With Frank Exhibition of Mizutani's Sign.

Systemic sclerosis is an autoimmune connective tissue disease (AICTD) known for its hallmark feature of fibrosis affecting the skin, blood vessels, and viscera. The maintenance of the extracellular matrix (ECM) involves fibroblasts and other cells, which play a vital role in the degradation and replacement of damaged proteins such as collagens with new ones. The continuous stimulation of fibroblasts results in the overproduction of extracellular matrix proteins, leading to the progression of fibrosis. Although the exact etiology of scleroderma is not clear, the onset of the condition has been attributed to genetic and environmental factors. Excessive collagen buildup in the dermis is the telltale sign of the disease. Clinicians face significant challenges in managing systemic sclerosis. Management is based on reducing or eliminating complaints to improve organ function, and frequently, multidisciplinary involvement is required. The aim of this case report is to emphasize the importance of the recognition of Mizutani's sign, which makes it prudent to rule out the presence of systemic sclerosis.

Catastrophic ocular complications in leprosy: a case report.

Leprosy is a chronic, granulomatous infectious disease commonly affecting the skin, nerves, mucosa and eyes. The stigma associated with the disease frequently leads to delay in presentation to health professionals. Treated patients, though considered cured presumptively, many continue to live with physical disabilities and deformities. Intact visual acuity prevents humans from trauma and any reduction in visual acuity, especially in leprosy, increases the risk of getting injured by many folds. Here, we present a case of leprosy with complete loss of vision due to bilateral anterior staphyloma secondary to keratitis and his physical deformities preventing him to take care of his eyes. This paper aims to emphasize on the importance of a baseline ophthalmology consultation in all newly diagnosed leprosy patients and repeat examination at onset of any new symptoms of the eye.

Ocular Adverse Effects of Gefitinib: A Case Report.

Gefitinib is a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor. It is used for treating locally advanced or metastatic non-small cell lung carcinoma and is well tolerated systemically. However, sight-threatening ocular adverse effects, like corneal ulcer and perforation, can occur due to the expression of EGFR on limbal and conjunctival epithelia. In this report, we describe a case of a 36-year-old female who presented with loss of eyebrow hair and eyelashes of both eyes and blurring of vision in the right eye. On ocular examination, the patient had anterior blepharitis, madarosis, punctuate epithelial erosions and reduced corneal sensation in both eyes, and corneal thinning in the right eye. On specular microscopy, there was decreased central corneal thickness in both eyes. Treatment with topical antibiotics and lubricating drops led to the resolution of blepharitis and punctate epithelial erosions. This case report aims to create awareness among ophthalmologists and oncologists about the early detection of gefitinib-related ocular adverse effects and timely intervention in patients.

Puzzling painful nodules on back: a case report.

Cutaneous leiomyomas are known to arise from three locations viz, arrector pili muscle, dartos muscle in the scrotal sac, and smooth muscle layer of blood vessels. Cutaneous piloleiomyoma (arising from arrector pili) is an uncommon benign skin tumor presenting clinically as a single or numerous painful nodules. They can either appear diffuse or zosteriform/segmental in rare cases. We report an unusual case of multiple tender papulonodular lesions on the right infrascapular region. Histology from one of the nodules showed a dermal tumor consisting of interlacing fascicles of spindle cells, consistent with the diagnosis of piloleiomyoma. We prescribed our patient with oral calcium channel blocker, amlodipine, to provide symptomatic relief from pain and which can be considered used it to treat similar cases.