-
Indian Journal of Pathology &... Jun 2024Granulomatosis with polyangiitis, a form of necrotizing vasculitis can present as a limited variant with the involvement of a single organ system. The superficial...
Granulomatosis with polyangiitis, a form of necrotizing vasculitis can present as a limited variant with the involvement of a single organ system. The superficial protracted form can present as face and scalp ulceration for chronic periods of time. Diagnosis can be established histopathologically by examining the involvement of blood vessels. Here, we present a case of scalp ulceration that was diagnosed as a limited variant and started on steroids and immunosuppressants with excellent response.
PubMed: 38847195
DOI: 10.4103/ijpm.ijpm_874_23 -
Annals of Medicine and Surgery (2012) Jun 2024Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma characterized by chromosome 8 MYC gene translocation. It manifests in three clinical types:...
INTRODUCTION
Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma characterized by chromosome 8 MYC gene translocation. It manifests in three clinical types: immunodeficiency-related, sporadic (nonendemic), and endemic (African), each differing in epidemiology and clinical behavior. Treatment typically involves enrollment in clinical trials or intensive chemotherapy regimens like R-CODOX-M/IVAC. The authors present a case of recurrent BL following treatment.
CASE REPORT
A 13-year-old female presented with a gradually progressive swelling in the left parieto-occipital region. Examination revealed normal vital signs and a Glasgow coma scale, with seronegative findings on investigations. An excision of a subganglion soft tissue tumor was performed, revealing histopathological features suggestive of a small round blue cell tumor. After chemotherapy, the patient experienced a recurrence in the scalp region, diagnosed as BL.
DISCUSSION
While scarce reports exist on BL in the scalp region, cases have been documented in various body locations. Treatment strategies, including chemotherapy and surgery, have shown promising results in managing the disease and improving symptoms.
CONCLUSION
The recurrence of BL is rare, highlighting the importance of vigilance in monitoring patients post-treatment. The authors report a case of recurrent BL in a 13-year-old female, emphasizing the need for continued research and surveillance in managing this aggressive malignancy.
PubMed: 38846844
DOI: 10.1097/MS9.0000000000002089 -
Annals of Medicine and Surgery (2012) Jun 2024The spinal accessory nerve is at risk when performing neck dissections for head and neck cancers. Injury to this nerve can result in shoulder syndrome, which can be...
INTRODUCTION AND IMPORTANCE
The spinal accessory nerve is at risk when performing neck dissections for head and neck cancers. Injury to this nerve can result in shoulder syndrome, which can be challenging to manage. Various nerve repair or grafting methods are available to prevent this condition. A safe, simple, and cost-effective option is the ansa cervicalis to spinal accessory transposition graft.
CASE PRESENTATION
A 60-year-old Afro-Trinidadian female presented to the Outpatient clinic for evaluation of a scalp lesion and a large neck mass for a duration of one year. Preoperative tissue biopsies confirmed she had squamous cell cancer with metastatic spread to the cervical nodes. The patient underwent surgical excision of the scalp lesion and left neck dissection with the sacrifice of the sternocleidomastoid and the left spinal accessory nerve due to tumour involvement. During the procedure, the ansa cervicalis was successfully joined to the distal remainder of the spinal accessory nerve. After the surgery, the patient fully recovered and achieved a good quality of life during the 24-month follow-up.
CLINICAL DISCUSSION
This is the first reported case of using the ansa cervicalis to reinnervate the trapezius muscle through the spinal accessory nerve. This procedure aims to prevent pain, muscle wasting, and adhesive capsulitis. A quality-of-life questionnaire and adequate range of motion proved the success of this procedure, demonstrating that this option provides practical, functional, and aesthetic benefits for patients.
CONCLUSION
The ansa cervicalis to spinal accessory transposition nerve graft is a valuable option for reinnervation. This case report highlights the effectiveness of this single-stage procedure in preventing shoulder syndrome.
PubMed: 38846817
DOI: 10.1097/MS9.0000000000002129 -
Frontiers in Public Health 2024To analyze the epidemiological characteristics and wound healing conditions of common unintentional skin lacerations in children.
OBJECTIVE
To analyze the epidemiological characteristics and wound healing conditions of common unintentional skin lacerations in children.
METHODS
A retrospective analysis was conducted on data from 1,107 children, aged 0-12 years, with skin lacerations who received emergency treatment at Qilu Hospital of Shandong University from January 1, 2019, to December 30, 2022. Data on age, injury site, time from injury to suturing, and wound healing conditions were statistically analyzed.
RESULTS
Among the 1,107 cases, 714 (64.5%) were male and 393 (35.5%) were female, with a male-to-female ratio of 1.8:1; median age was 5 years (IQR, 3-7). Infants and toddlers (0-3 years old) constituted the highest proportion, accounting for 36.3% (402 cases). The number of children aged over 3 years gradually decreased with increasing age. In younger children, the most common injuries were to the forehead, scalp, and lower jaw; in school-aged children, the proportion of limb and trunk injuries significantly increased. Age (OR, 1.34; 95% CI, 1.23-1.46), outdoor injuries (OR, 2.21; 95% CI, 1.18-4.16), lower limb injuries (OR, 5.35; 95% CI, 2.86-10.00), and wound length greater than 3 cm (OR, 10.65; 95% CI, 5.02-22.60) were significant risk factors for poor wound healing. The risk of poor wound healing increased by 34% for each additional year of age.
CONCLUSION
In children, the common sites of unintentional skin lacerations show distinct age and gender distribution characteristics. Older age, outdoor injuries, longer wound lengths, and lower limb injuries are independent risk factors for poor wound healing.
Topics: Humans; Male; Female; Child, Preschool; Infant; Retrospective Studies; Child; Wound Healing; China; Lacerations; Infant, Newborn; Risk Factors; Accidental Injuries; Wounds and Injuries
PubMed: 38846603
DOI: 10.3389/fpubh.2024.1352176 -
JAAD International Sep 2024
Review
PubMed: 38846362
DOI: 10.1016/j.jdin.2024.03.027 -
Clinical Case Reports Jun 2024Palliative surgical resection of extra-calvarial metastatic lesions from renal cell tumors is crucial for controlling metastatic spread, improving quality of life, and...
KEY CLINICAL MESSAGE
Palliative surgical resection of extra-calvarial metastatic lesions from renal cell tumors is crucial for controlling metastatic spread, improving quality of life, and preventing associated morbidity. Careful surgical planning, including selective preoperative embolization and controlled resection around critical structures such as the sagittal sinus, is essential for successful outcomes. Cranioplasty with Titanium mesh and bone cement post-resection can provide symptomatic relief, better cosmesis, and overall improved quality of life.
ABSTRACT
Renal cell carcinomas are aggressive tumors with distant systemic disease. The calvarium appears to be an unusual and rare site for distant metastasis. The treatment modalities are challenging and out of the normal realm for the management of these tumors. We report a case of a 63-year-old woman with a previous history of nephrectomy who presented with symptoms of severe headaches, and swelling of bi-frontal and bi-parietal scalp regions due to multifocal extracalvarial disease. Preoperative bilateral superficial temporal artery embolization was performed to control the intraoperative bleeding. Surgical technique has been described with the critical steps involved, and a literature review has been conducted. Palliative tumor resection surgery was performed to improve the patient's quality of life as well as to confirm the histopathological diagnosis. Gross total resection of the extracalvarial metastatic tumor was achieved. Biopsy confirmed renal cell tumor with the clear cell subtype. The patient recovered well from her surgery with slow healing of the scalp wound. At 6-month follow-up, no recurrence of the extracalvarial disease was observed on serial imaging. Extracalvarial metastasis is a rare presentation in renal cell carcinoma. Considering the inherent radioresistant nature of the tumor, palliative surgical resection can be offered to control the metastatic spread, relieve agonizing pain symptoms, and to improve the quality of life. Preoperative embolization helps to decrease intraoperative blood loss. Moreover, palliative surgical resection of extracalvarial diseases helps to treat the metastasis as well as avoiding the associated morbidity that may occur if left untreated.
PubMed: 38845800
DOI: 10.1002/ccr3.8967 -
Indian Dermatology Online Journal 2024
PubMed: 38845667
DOI: 10.4103/idoj.idoj_668_23 -
Indian Dermatology Online Journal 2024Tinea capitis (TC) is a common fungal infection of the scalp, especially in children. Trichoscopy is a noninvasive technique that allows rapid and magnified observation...
INTRODUCTION
Tinea capitis (TC) is a common fungal infection of the scalp, especially in children. Trichoscopy is a noninvasive technique that allows rapid and magnified observation of the hair with the visualization of morphologic features that are often imperceptible to the naked eye.
AIM
This study aimed to evaluate the usefulness of trichoscopy in clinical diagnosis and to study various clinico-morphological patterns of TC.
MATERIALS AND METHODS
This cross-sectional, observational study included 140 clinically diagnosed cases of TC seen during a period of 1 year (April 2021 to March 2022). All patients were evaluated using a dermoscope (DermLite DL4 Multispectral 3 Gen, San Juan Capistrano, CA, USA,10×).
RESULTS
The prevalence rate of TC in this study was 2.69 per thousand population. The most common clinical variant was gray patch followed by kerion and black dot, and the most common etiological agent was . The characteristic trichoscopic features were as follows: comma hairs (80%), followed by corkscrew hairs (68.6%), bent hairs (54.2%), zigzag hairs (35.7%), and morse code-like hairs (15%). Other findings included scaling (89.2%), followed by black dot (67.1%), broken hairs (42.8%), and crusting and pustules (32.1% each). Comma and corkscrew-shaped hairs were most common in the black dot type, whereas zigzag, bent hairs, and morse code hairs were common in the gray patch type of TC. There was a significant association between trichoscopic findings and type of TC.
CONCLUSION
Trichoscopy can be considered a novel tool for rapid diagnosis and selection of the appropriate therapy and in the monitoring of treatment efficacy in TC.
PubMed: 38845633
DOI: 10.4103/idoj.idoj_439_23 -
Indian Journal of Dermatology,... Apr 2024
PubMed: 38841975
DOI: 10.25259/IJDVL_428_2023