1/5. Mechanical treatment of phthiriasis palpebrarum.Phthiriasis palpebrarum is a rare disease in which crab lice infest the eyelashes. It can cause pruritic lid margins or unusual blepharoconjunctivitis and is difficult to diagnose and treat. We diagnosed and managed a case of phthiriasis palpebrarum in both upper eyelids, accompanied by nits, on the scalp of a 6 year-old female child. We removed the eyelashes, including lice and nits, by pulling with fine forceps without sedation. On the second month after treatment, all lice and nits were eradicated without recurrence and the eyelashes grew back. In conclusion, phthiriasis palpebrarum can be diagnosed by close examination of the eyelashes and eyelid margins with slit lamp and can be managed mechanically.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
2/5. anthrax of the eyelids.anthrax is a disease caused by bacillus anthracis. The disease affects primarily herbivores including sheep, cattle, horses, and other domestic animals. humans may rarely be affected. We examined one male and two female patients with a localised itchy erythematous papule of the eyelid. A necrotising ulcer formed in each of the three cases resulting in a black lesion. Scraping in each case showed Gram positive rods and culture grew bacillus anthracis. All three patients responded to the intravenous administration of penicillin g, and the lesion resolved leaving scars in two cases. anthrax is a rare disease but should be considered in the differential diagnosis of ulcers or pustules of the eyelids.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
3/5. Cutaneous anthrax on eyelids.BACKGROUND: Ophthalmologists should be aware of the signs and symptoms of anthrax, although it is a rare disease in humans. We report our successful treatment of three patients with cutaneous lesions in the periorbital area. CASES: In this study, we report on the treatment of three female patients who were initially diagnosed as having preseptal cellulitis. OBSERVATIONS: Gram-positive robs were revealed in the microscopic examination of scrapings taken from the lesions. bacillus anthracis was found in only two of the three scraping-material cultures. Intravenous penicillin g was administered in all cases. Black and necrotic eschar, which is characteristic of anthrax, developed on the eyelids of all three patients during treatment. At the final examinations of the patients after the completion of treatment, we recognized the development of cicatrisation, lagophthalmos, and slight ectropion in the upper eyelid of the first patient, and, in the second patient, restriction of upper eyelid movement and development of a corneal scar from exposure keratopathy and ectropion. The cutaneous lesions healed without any eyelid pathology in the third patient. CONCLUSION: Although it is a rare disease in humans, anthrax should be considered in the differential diagnosis of preseptal and orbital cellulitis.- - - - - - - - - - ranking = 2keywords = rare disease (Clic here for more details about this article) |
4/5. Upper and lower eyelid reconstruction for severe disfiguring necrobiotic xanthogranuloma.BACKGROUND: necrobiotic xanthogranuloma is a rare disease featuring generalized xanthomatous inflammatory skin lesions associated with paraproteinemia and possible lymphoproliferative diseases. Eyelid involvement can be unilateral or bilateral and ranges from minor xanthelasma-like lesions to severe ulcerative disease with consecutive keratitis and scleritis. CASE REPORT: The authors report the case of a 67-year-old woman with extensive necrobiotic xanthogranuloma involving the eyelids, head and neck, anterior chest, and both upper and lower extremities. Periorbital involvement caused severe upper and lower lid ectropium with chronic conjunctival inflammation and unilateral exposure keratitis. During a persistent period of low disease activity, granulomatous lesions and scars were widely excised, lids partially shortened and large full-thickness skin grafts applied. Uninvolved parts of the upper arms had to serve as donor sites, as other possible donor sites were not available. After successful reconstruction of the left side and no local recurrence of the disease, the right side was corrected in the same way. Full eyelid closure was achieved and skin grafts healed without complications. No recurrence of the disease appeared at the sites of operation, despite continuous new lesions elsewhere. CONCLUSION: Severe cicatricial eyelid deformation caused by necrobiotic xanthogranuloma can be treated with success by excision and free skin grafting. The mechanisms of recurrence at excision sites described by others remain unclear, but at least during phases of low activity, the described treatment is safe and recurrence is not to be expected.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |
5/5. Chondrodystrophic myotonia: electromyographic and cardiac features of a case.TheSchwartz-Jampel syndrome or chondrodystrophic myotonia is a rare disease characterized by dwarfism, diffuse osteoarticular alterations, blepharospasm, perioral muscular contractions and electromyographic alterations. The authors present a case of chondrodystrophic myotonia focusing mainly on facial electromyographic and cardiac findings. The electromyography of the orbicularis oculi muscles showed abundant myotonic discharges like other facial muscles as well as muscles of the members. It was not possible to obtain true electrical silence between myotonic discharges, suggesting that the blepharospasm is a consequence of persistent muscular contraction. No conclusive evidence of myocardiopathy was given by clinical or laboratory cardiac examinations. General characteristics of the syndrome are discussed as well as the treatment with procamide and phenytoin.- - - - - - - - - - ranking = 1keywords = rare disease (Clic here for more details about this article) |