RESUMEN
Transjugular intrahepatic portosystemic shunt (TIPS) is a recently introduced angiographic technique for achieving portal decompression. New invasive radiographic procedures such as TIPS can result in radiation exposure equal to that received by patients during radiation therapy. With these high doses of radiation, patients are at increased risk for radiodermatitis and long-term sequelae, such as scarring and carcinoma. Ours is the first reported case of radiodermatitis after TIPS.
Asunto(s)
Angiografía/efectos adversos , Derivación Portosistémica Intrahepática Transyugular/efectos adversos , Radiodermatitis/etiología , Radiografía Intervencional/efectos adversos , Carcinoma/etiología , Cicatriz/etiología , Estudios de Seguimiento , Humanos , Hipertensión Portal/cirugía , Masculino , Persona de Mediana Edad , Neoplasias Inducidas por Radiación/etiología , Dosis de Radiación , Traumatismos por Radiación/etiología , Factores de RiesgoRESUMEN
A case of childhood granulomatous periorificial dermatitis is described. This disorder occurs predominantly in prepubertal black children and is characterized by a monomorphous, papular eruption occurring around the mouth, nose, and eyes. It is benign and self-limited. Treatment may include topical metronidazole in young patients and tetracycline in those over 8 years of age.
Asunto(s)
Dermatitis Perioral/patología , Administración Cutánea , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Niño , Dermatitis Perioral/tratamiento farmacológico , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/uso terapéutico , Femenino , Estudios de Seguimiento , Granuloma/patología , Humanos , Metronidazol/administración & dosificación , Metronidazol/uso terapéutico , Tetraciclina/administración & dosificación , Tetraciclina/uso terapéuticoRESUMEN
We encountered a clinical problem in a young man who presented with a left upper lobe mass and a diffuse reticular-nodular infiltrate. We thought we had appropriately applied Murphy's Law (the famed bank robber who "went where the money is"), and Ockham's Razor (the philosopher William of Ockham [1285 to 1349]-"Entities are not to be multiplied beyond necessity") as we rapidly diagnosed the lung mass with computed tomography, scintigraphy, and fine-needle aspiration. However, when his invaluable previous chest radiographs arrived, bronchoscopy with transbronchial biopsy, bronchoalveolar lavage, brushings, and postbronchoscopy sputum revealed the more ominous diagnosis in this patient. This case illustrates the complementary nature of current imaging and bronchoscopy techniques; but, even more importantly, it demonstrates the value of the history coupled with the previous radiograph. Even an unusual case can provide lessons in cost containment.