1/25. Ulcerative balanoposthitis of the foreskin as a manifestation of chronic lymphocytic leukemia: case report and review of the literature.Ulcerative lesions of the penis have many possible etiologies, including infectious, neoplastic, traumatic, drug-induced, and autoimmune. Although the most frequent neoplasm presenting as an ulcerative penile lesion is squamous cell carcinoma, it may rarely be a manifestation of other malignancies, including those of hematolymphoid origin. We report a case of ulcerative balanoposthitis as a manifestation of chronic lymphocytic leukemia. Chronic lymphocytic leukemia and other hematolymphoid malignancies should be considered in the large differential diagnosis of nonhealing penile ulcers.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/25. Five cases of livedo-like dermatitis (Nicolau's syndrome) due to bismuth salts and various other non-steroidal anti-inflammatory drugs.The authors report five cases of Nicolau's syndrome observed over a period of about 25 years. The disease had occurred after intramuscular injections of different drugs (bismuth, diclofenac and ibuprofen). In all the described cases the clinical aspect was characterized by a livedoid pattern followed by a slow necrotizing evolution with scar formation; in some cases surgical debridement and plastic reconstructive surgery were performed. In the past Nicolau's syndrome was described after intramuscular injections of bismuth salts for the treatment of syphilis; now, although still rare, it is described after injections of various aqueous drug solutions. The pathogenesis of Nicolau's dermatitis appears to be more complex than the previous hypothesized embolism caused by oleous drugs.- - - - - - - - - - ranking = 0.97254682010448keywords = complex (Clic here for more details about this article) |
3/25. diagnosis of werner syndrome by immunoblot analysis.werner syndrome (WS) is caused by mutations in the gene encoding RecQ type dna helicase (WRN). We report a 53-year-old Japanese male with WS who initially presented with skin ulcers on the feet and the left elbow. The patient had a high-pitched voice, hoarseness, a characteristic bird-like facial appearance with a beak-shaped nose, canities and juvenile cataracts. Immunoblot analysis using a monoclonal antibody directed against the WS gene product dna helicase revealed that the patient's leucocytes lacked this particular molecule, confirming the diagnosis of WS. This new immunoblot system therefore enables the diagnosis of WS to be made without the need to undertake more complex mutational analysis.- - - - - - - - - - ranking = 0.97254682010448keywords = complex (Clic here for more details about this article) |
4/25. An unusual case of tissue breakdown secondary to TB.Despite the many advances in technology, research and educational initiatives in tissue viability, wound management remains a complex and challenging area for healthcare professionals. This article describes the management of an unusual groin wound that developed as a result of tissue breakdown secondary to tuberculosis.- - - - - - - - - - ranking = 0.97254682010448keywords = complex (Clic here for more details about this article) |
5/25. Expanding tissue viability practice through telemedicine.telemedicine can be defined as the electronic transfer of medical information to remote sites in order to support patient care and medical education (Norton et al, 1997). The concept of telemedicine has been around for more than 20 years; however, with the advantages of affordable technology it is set to play a major role in the future of health care. The use of telemedicine within the field of dermatological practice is well documented in the literature but the use of this referral system by clinical nurse specialists in tissue viability appears to be in its infancy. This article seeks to dispel the myths around the use of technology to enhance clinical practice and uses the authors' personal experience to describe its effectiveness for referring patients with complex tissue viability needs.- - - - - - - - - - ranking = 0.97254682010448keywords = complex (Clic here for more details about this article) |
6/25. Detection of cytomegalovirus antigens in phagocytosed serum complexes from a patient with rheumatoid arthritis, vasculitis, peripheral neuropathy, cutaneous ulceration, and digital gangrene.A patient with rheumatoid arthritis, vasculitis, peripheral neuropathy, cutaneous ulceration, and digital gangrene was studied. Circulating immune complexes were detected by C1q binding although serum complement levels were within the normal range. Immunofluorescent staining of buffy coat cells with specific antisera showed the presence of IgG and IgM in phagocytosed inclusions but complement c3 was not detected. A monoclonal antibody specific for cytomegalovirus detected antigens in phagocytosed inclusions on one occasion. These results may suggest that cytomegalovirus antigens are a hitherto unidentified component of serum complexes in patients with rheumatoid arthritis and may contribute to the pathogenesis of the vasculitic complications of rheumatoid arthritis by participating in immune complex formation.- - - - - - - - - - ranking = 6.8078277407313keywords = complex (Clic here for more details about this article) |
7/25. Cytological diagnosis of nonulcerative penile neoplasms: report of two cases.Nonulcerative penile mass lesions are rare. Pathological diagnosis of these lesions would traditionally be a biopsy. We report two such primary penile lesions which were diagnosed by fine-needle aspiration cytology (FNAC). Both lesions were present in the shaft and were diagnosed as squamous cell carcinoma (SCC). The first patient had a recurrence on the penile stump of partial amputation without any ulceration. The second had a primary urethral carcinoma on the terminal penile shaft infiltrating the corpora cavernosa dorsally. Open biopsies were avoided in both cases. FNAC was associated with very little and tolerable discomfort. There were no complications. The aspirate yield was sufficient for cytological diagnosis. FNAC of nonulcerated penile lesions is safe, well tolerated, and capable of providing a cytological diagnosis. Hence, it is a very useful outpatient procedure and could be the procedure of choice for diagnosis.- - - - - - - - - - ranking = 4keywords = neoplasm (Clic here for more details about this article) |
8/25. Trigeminal trophic syndrome--report of four cases and review of the literature.BACKGROUND: Trigeminal trophic syndrome is a unilateral, frequently crescent-shaped neurotrophic ulceration of the face occurring after injury to the trigeminal nerve. The appearance of the ulcers resembles other disease entities such as granulomatous disease, neoplasm, vasculitis, infection, and factitial dermatitis. OBJECTIVES: The objectives of this study are to increase awareness of this disorder and to emphasize the importance of eliciting a thorough neurologic history when evaluating facial ulcerations. methods: Four cases are reported and, using medline, the English and non-English literature from 1982 to 2002 is reviewed. RESULTS: Including this report, there have been 60 cases of trigeminal trophic syndrome reported from 1982 to 2002. The age at presentation ranged from 14 months to 93 years. time of onset from injury to the trigeminal ganglion or its branches and the development of the ulcers ranged from 2 weeks to 30 years. One-third of the patients had undergone trigeminal nerve ablation for the treatment of trigeminal neuralgia and another third had a history of stroke. Other causes included craniotomy, head trauma, herpes infection. CONCLUSION: The majority of cases of trigeminal trophic syndrome are associated with a history of stroke or trigeminal nerve ablation. Successful surgical outcome can be achieved if the underlying neurologic pathology is addressed before the reconstructive procedure.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
9/25. Type III mixed cryoglobulinemia associated with digital necrotic ulcer successfully treated with intermittent intravenous pulse cyclophosphamide--a case report.Cryoglobulinemic vasculitis is an immune complex-mediated vasculitis predominantly affecting small vessels. The authors report an 18-year-old woman with painful digital necrotic ulcer due to type III cryoglobulinemic vasculitis on the basis of systemic lupus erythematosus. serum protein electrophoresis and immunoelectrophoresis demonstrated a polyclonal peak of the immunoglobulin Glambda (IgGlambda) and IgMlambda type. The patient was successfully treated with intermittent intravenous pulse cyclophosphamide.- - - - - - - - - - ranking = 0.97254682010448keywords = complex (Clic here for more details about this article) |
10/25. Efficacy of a skin-protection powder for use as a dressing for intractable ulcers.OBJECTIVE: Stomahesive skin-protection powder has been reported to be useful as a skin-care and skin-barrier product for the management of stomas.This study aimed to evaluate its efficacy, in terms of wound healing, moisture retention and pain management, as an alternative to conventional dressing materials. Both clinical and animal studies were undertaken. METHOD: The efficacy of the Stomahesive powder was tested by measuring the thickness of granulation tissue formed in a total skin defect in a db/db mouse model. We then compared the healing process using either the skin-protection powder or a conventional film dressing material. In the clinical study 17 patients with various intractable ulcers were treated with Stomahesive powder, and healing was evaluated. RESULTS: In the mouse model, granulation tissue in the wounds treated with the powder was 2.86 times thicker than that of the wounds treated with the film dressing. In the clinical study, 16 out of 17 wounds healed completely. CONCLUSION: The Stomahesive powder could be an effective treatment modality for contact ulceration, superficial ulcers with complex contours and morphology, and superficial ulcers contaminated by liquid faeces or vaginal discharge that have not responded to conventional dressings. Declaration of interest: None.- - - - - - - - - - ranking = 0.97254682010448keywords = complex (Clic here for more details about this article) |
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