RESUMEN
Verrucous cysts are uncommon types that cannot be distinguished from epidermal inclusion cysts clinically and require histopathological analysis and human papillomavirus (HPV) polymerase chain reaction (PCR) for accurate diagnosis. The pathogenesis of verrucous cysts is thought to involve HPV infection, either of an existing cyst or through direct infection of keratinocytes, leading to new cyst formation. While verrucous cysts can affect individuals of any sex and are typically found on the trunk, extremities, and face, they are particularly notable for their potential association with high-risk HPV types, such as 16 and 18, which may lead to malignant transformation. In this report, we present the case of a 48-year-old female with a history of endometriosis and pelvic inflammatory disease, who sought evaluation for a persistent subcutaneous nodule on her right flank. The patient reported pain, a recent color change, and an increase in the nodule size. Clinical examination revealed a 2.7 cm subcutaneous nodule with a central brown-gray papule. Despite no history of dermatologic malignancies, the nodule was excised, and subsequent histopathological examination confirmed a diagnosis of a ruptured verrucous cyst. The cyst exhibited acanthotic papillomatous squamous epithelium without cytologic atypia and koilocytic change in cells. This case offers direct and valuable insights into the clinical presentation, diagnosis, and management of verrucous cysts. It highlights the importance of a thorough diagnostic approach, combining histopathological examination with HPV PCR testing, to accurately differentiate verrucous cysts from other similar cutaneous lesions. The report also emphasizes the need for vigilance in managing these cysts due to their potential association with high-risk HPV types and the consequent risk of malignant transformation. These insights contribute significantly to the existing body of literature on verrucous cysts and aim to enhance clinical awareness and patient care in dermatology.
RESUMEN
Herpes Zoster Ophthalmicus (HZO) is a common manifestation of the reactivated Varicella Zoster virus, primarily affecting the eye and trigeminal nerve. This case study presents the clinical course of a 51-year-old male who underwent a renal transplant due to end-stage renal disease, further complicating the management of HZO. The patient's medical history also includes hypertension, type 2 diabetes mellitus, chronic kidney disease (CKD), cerebrovascular accident (CVA), and retinal detachment. Upon examination, the diagnosis of HZO was confirmed based on the presence of a characteristic unilateral vesicular rash in the V1 cranial nerve dermatomal distribution, accompanied by ophthalmic symptoms such as eyelid swelling and visual impairment. Given the patient's immunosuppressive regimen post-transplant, intravenous acyclovir was initiated for antiviral therapy, while supportive care was provided for pain control. Notably, the patient experienced a subsequent decrease in pain intensity and improvement in the vesicular rash. This case highlights the challenges in managing HZO in patients with a history of renal transplant and multiple comorbidities, emphasizing the importance of tailored treatment strategies to optimize patient outcomes. Further research is warranted to better understand the impact of immunosuppression and comorbidities on the course and management of HZO in this population.
RESUMEN
Background: People with mental illnesses commonly experience stigma, discrimination, and prejudice from the general public and medical professionals around the world. Numerous research has looked into the unfavourable perceptions that medical students have of those who suffer from mental illness. Objective: The objective was to study the attitude of undergraduate medical students towards patients with psychiatric illnesses. Materials and Methods: A cross-sectional study was carried out among undergraduate medical students who were exposed (n = 69) to 2-week psychiatry posting and attended lectures and those who were not exposed (n = 163) to psychiatry training using self-reported Attitude Scale for Mental Illness (ASMI) questionnaire via Google form distributed among medical students. Results: The findings indicate there is no change in attitude toward the patient with psychiatric illness after exposure to psychiatry training among medical students. However, urban residence and female gender were the factors found to be influencing students' attitudes towards patients with psychiatric illnesses. Conclusions: There was no change in attitude towards patients with psychiatric illness after psychiatry exposure. Students belonging to urban domicile and female students showed more sympathetic attitudes toward those with mental illnesses.
RESUMEN
IgA vasculitis, also known as Henoch-Schonlein Purpura (HSP), is an inflammatory disorder of small blood vessels that can present with palpable purpura, arthralgias, abdominal pain, and kidney disease. It is most commonly found in pediatric patients after an inciting infection but has been seen across all ages and associated with certain drugs and vaccines. COVID-19 has been associated with various cutaneous manifestations, but HSP is a rarely reported one. We present a case of a 21-year-old female presenting with a petechial rash found to be seronegative IgA vasculitis presenting concurrently with dyspnea secondary to COVID-19. She was initially seen by an outside practitioner, tested negative for COVID, and was prescribed a course of oral prednisone. Shortly thereafter, she visited the ED for worsening shortness of breath and tested positive for COVID-19, for which she received Paxlovid. Biopsy after a visit to a dermatologist confirmed intramural IgA deposition on immunofluorescence, and she was tapered off prednisone and started on azathioprine.