ABSTRACT
A 25-year-old, 7-month pregnant woman presented with rapidly progressive multiple ulcerated nodules present for 5 months on her left thigh. The lesions began as small red-colored papules, becoming nodular within few days. Initially, she was treated with systemic antibiotics and analgesics, and later a local physician performed incision and drainage. The lesions further increased, becoming indurated and ulcerated. Two months after her delivery, the lesions had extended to the middle of the medial side of her left thigh. On admission, she had a history of fever and weight loss, but there was no trauma. She delivered a full-term healthy baby boy. Past and family history was not significant. Examination revealed 15-20 ill-defined, erythematous, immobile, and irregular nodules of varying sizes, measuring 4 × 5 cm2, and extending from the inguinal region to the middle portion on medial aspect of the left thigh (Figure 1). Some of the nodules ulcerated with yellow color discharge with crusting, attributed to secondary bacterial infection. Multiple palpable and matted inguinal lymph nodes were present in the left inguinal region.
Subject(s)
Lymphoma, T-Cell, Peripheral , Adult , Female , Humans , Male , Pregnancy , Anti-Bacterial Agents/therapeutic use , Thigh , Pregnancy Outcome , Pregnancy Complications, NeoplasticABSTRACT
Addisonian pigmentation usually presents with nonspecific symptoms and signs, which are often ignored or misdiagnosed as a sign of other more common diseases. We present a case of 12-year-old child in whom diffuse Addisonian hyperpigmentation of skin was associated with underlying acute lymphoblastic leukemia (B-type), a rare paraneoplastic phenomenon in hematological malignancies.
Subject(s)
Hyperpigmentation , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Child , Humans , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Hyperpigmentation/etiology , Skin , PigmentationABSTRACT
We report a rare case of disseminated cysticercosis in a 7-year-old Indian girl with recent onset seizures treated with antiepileptics for 2 months. When she presented to dermatology clinic, she had multifocal subcutaneous and submucosal nodules. The subsequent diagnostic workup revealed extensive neurocysticercosis as well as orbital and myocysticercosis.
Subject(s)
Cysticercosis , Neurocysticercosis , Female , Humans , Child , Cysticercosis/diagnosis , Cysticercosis/drug therapy , Neurocysticercosis/diagnosis , Neurocysticercosis/drug therapy , Seizures , Anticonvulsants/therapeutic use , Subcutaneous TissueABSTRACT
BACKGROUND: Combination of microneedling and chemical peeling is a simple cost-effective treatment for acne scars. OBJECTIVE: To compare efficacy and safety of combining microneedling with 35% glycolic acid (GA) peel versus microneedling with 15% trichloroacetic acid (TCA) peel in facial atrophic acne scars. METHODS: Forty acne scars patients were randomly divided into 2 groups of 20 each. Patients underwent microneedling followed by 35% GA peeling in Group 1 and 15% TCA peeling in Group 2 at 2 weekly intervals. Improvement was graded by Goodman and Baron's qualitative and quantitative global acne scar grading systems, physician's global assessment, and visual analogue scale (VAS). Skin texture was graded by VAS. RESULTS: On comparing qualitative and quantitative acne scar grading within groups, there was significant difference from the baseline. When the two groups were compared for quantitative and qualitative acne scar grading, the difference was statistically not significant at the end of therapy. In VAS, greater number of patients assessed response as excellent and good in Group 1 than in Group 2 indicating better skin texture improvement in Group 1. CONCLUSION: Both combinations were equally efficacious in treating acne scars. Glycolic acid peel delivered additional advantage of improvement in skin texture.
Subject(s)
Acne Vulgaris , Connective Tissue Diseases , Humans , Cicatrix/etiology , Cicatrix/therapy , Cicatrix/pathology , Trichloroacetic Acid/adverse effects , Needles , Acne Vulgaris/complications , Acne Vulgaris/therapy , Atrophy , Treatment OutcomeABSTRACT
A 25-year-old male patient presented with palmoplantar keratoderma, dystrophic nails, severe plantar pain and oral leukokeratosis since birth. On genetic analysis, a heterozygous KRT6A gene missense mutation (c.1381G > A, p.Glu461Lys in exon 7) was identified by next-generation sequencing technology, consistent with pachyonychia congenita 6a. Oral simvastatin 40 mg was started once daily, and after 16 weeks of therapy, excellent improvement was noted in palmoplantar keratoderma and plantar pain. The maximum thickness of his foot callosity reduced by 4 mm on ultrasonography, and the Dermatology Life Quality Index score dropped significantly by eight points. These benefits may be attributed to inhibition of KRT6A gene expression, modulation of autophagy and mitophagy and Keap1-Nrf2 signalling activation; the latter two mechanisms of statins previously undiscussed in the context of pachyonychia congenita. Simvastatin and other statins are pathogenesis-targeted, disease-modifying therapy in pachyonychia congenita, therefore qualifying as a promising treatment avenue and warranting further clinical trials.
