what is a lateral femoral cutaneous nerve?
and how can it be treated
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Meralgia paresthetica is the term that describes a painful mononeuropathy of the lateral femoral cutaneous nerve (LFCN).
It is an entrapment neuropathy (pinched nerve) that develops as the nerve passes through the inguinal ligament. It may be due to direct trauma, stretch injury, or loss of blood flow to the nerve. The clinical history and examination is usually enough to make the diagnosis. The LFCN is a purely sensory nerve and is responsible for sensation of the anterolateral thigh. The LFCN has no motor component.
The LFCN originates from the lumbar plexus (with root innervation from L2-3). The nerve runs through the pelvis along the lateral border of the psoas muscle to the lateral part of the inguinal ligament. Here, it passes to the thigh through a tunnel formed by the lateral attachment of the inguinal ligament and the anterior superior iliac spine. This is the most common site of entrapment.
When meralgia paresthetica develops, it causes tingling and numbness of the upper outer thigh area. The tingling can be quite uncomfortable.
Symptoms are usually on one side only. Walking or standing may aggravate the symptoms, while sitting tends to relieve them.
Examination reveals numbness of the anterolateral thigh in all or part of the area involved with the paresthesias. Sometimes, patients are very sensitive in this area.
Tapping over the upper and lateral aspects of the inguinal ligament or extending the thigh and stretching the nerve may reproduce or worsen the symptoms.
Muscle strength in the involved leg is normal.
Common causes are pregnancy, tight clothing, and obesity.
Meralgia paresthetica is more common in diabetics than in the general population.
Rarely, pinching of the LFCN by masses [eg, neoplasms, iliopsoas hematomas (clots)] in the retroperitoneal space before it reaches the inguinal ligament can cause the same symptoms.
A lumbar disk bulge or herniation should be excluded as part of the work-up.
Most patients with meralgia paresthetica will have mild symptoms that respond to conservative management.
The treatment involves removing the cause of compression, weight loss and wearing loose clothing, if these are suspected.
When the pain is severe, a nerve block can be done at the inguinal ligament with a combination of lidocaine and corticosteroid. This may relieve the symptoms for several days to weeks.
In rare and particularly painful cases that are unresponsive to nerve block, surgical decompression may be warranted.
The numbness and tingling typically resolves over time, but it may persist.
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What is "cutaneous abscess/paronychia"?
Hi i am a nail-tech .one of my client she said she had a cutaneous abscess/paronychia" on her finger nails......Is that cause by Acrylic nails?(fake nails) by her own skin or by my tool not clean enought?
please help me thanks............
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Cutaneous means pertaining to the skin.
Abscess is like a pus filled pimple that is infected.
Paronychia is an abscess of the nail folds.
This can be due to injury to the area or use of unclean manicure equipment. (
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Systemic Mastocytosis: Mortal or life-threatening?
Hi there. Mi doctor believe that I have Mastocytosis, and Mastocytosis in an adult like me could mean: Systemic Mastocytosis. A lot of tests will have to be done to confirm the diagnosis but now I scared to dead: I surfed the web and in some webs they says that Systemic Mastocytosis is a mortal illness but in some others they says that systemic Mastocytosis have no cure but is a life-threatening condition. What is the true?
Thank you,
P
Well. Doctor believes I have mastocytosis, he believes that my arms rash is mastocytosis. A skin biopsy was made and today they will give me the results. What scare me is that my hematology exams have never been normal: Since I was child I have leucopeny and hight-ferritine. A lot of exams have been made Through my life and nothing bad have been found (even in three bone marrow biopsies). I have lived 30 years of a normal life and no serious illness although my hematology condition, but today if a doctor says me that I have mastocytosis, maybe it could mean the beginning of the end for me.
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Sorry to hear that this may be the case. I'm curious as to what signs you presented with that led your doctors to this diagnosis. Bottom line is that a bone marrow biopsy will need to be done (don't be afraid of this, it isn't that bad/painful) unless the disease is limited to the skin. Buuut you're saying it's possibly systemic so the bottom line is:
1.The disease is too rare to know a prognosis for sure but,
2.The prognosis is variable and depends on your age, degree of symptoms and spread of disease.
3.Unfortunately the median survival time is probably 2-6 yrs, but there isn't too much data.
Hope this helps and best of luck.
Edit:I know it's a difficult thing to do but try to relax until a definitive diagnosis is established. A bone marrow biopsy (or biopsy of other suspected organs) will need to be done before any plan can be decided. I don't think even the best dermatologist can diagnose mastocytosis just from looking at a rash, IMO. Again, good luck mate. (
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Has anyone got a (digital)picture of Cutaneous b cell lymphoma?
yes, Goolgle image search has a few.
http://images.google.com.au/images?q=%22Cutaneous+b+cell+lymphoma%22&hl=en&btnG=Search+Images (
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Severe Stomach Pain & Systemic Mastocytosis??
Hi there... I've been diagnosed with systemic mastocytosis. I've had it under control for about 3 years now, but suddenly have had a huge flare-up that no one can explain.
I've been sick since the first of the year with severe nausea, stomach pain and vertigo. While changing up my antihistimines has helped, I can't seem to get rid of the stomach pain, and am still experiencing some nausea!
I'm taking 40 mg of Pepcid daily and I'm still suffering. Seems to happen anytime I eat, so I've pretty much stopped eating (I know, not good -- but what would YOU do if you were in agony every time you ate?).
I know it's not an ulcer -- we've checked that. I know mastocytosis can cause stomach pains like this, but the Pepcid has always fixed it in the past.
Does anyone else have mastocytosis? Any ideas for me?? I'm leaving for my honeymoon in 4 days and I REALLY don't want to be sick the whole time!!!
Thank you for your help!
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There is currently no cure for mastocytosis. However, there are a number of medicines to help treat the symptoms of mastocytosis:
Antihistamines block receptors targeted by histamine released from mast cells. Both H1 and H2 blockers may be helpful.
Leukotriene antagonists block receptors targeted by leukotrienes released from mast cells.
Mast cell stabilizers help prevent mast cells from releasing their chemical contents. Cromolyn Sodium Oral Solution (Gastrocrom® / Cromoglicate) is the only medicine specifically approved by the U.S. FDA for the treatment of mastocytosis. Ketotifen is available in Canada and Europe, but is only available in the U.S. as ophthamic drops (Zaditor®).
Proton pump inhibitors help reduce production of gastric acid, which is often increased in patients with mastocytosis. Excess gastric acid can harm the stomach, esophagus, and small intestine.
Epinephrine constricts blood vessels and opens airways to maintain adequate circulation and ventilation when excessive mast cell degranulation has caused anaphylaxis.
Albuterol and other beta-2 agonists open airways that can constrict in the presence of histamine.
Corticosteroids can be used topically, inhaled, or systemically to reduce inflammation associated with mastocytosis.
Immunotherapy (Allergy Shots) may rarely be beneficial to select patients with mastocytosis. The benefits of the shots should be weighed against the substantially increased risk of severe and potentially fatal anaphylaxis triggered by the shots themselves.
Antidepressants are an important and often overlooked tool in the treatment of mastocytosis. The stress and physical discomfort of any chronic disease may increase the likelihood of a patient developing depression. Depression and other neurological symptoms have been noted in mastocytosis (see Rogers et al.). Some antidepressants such as doxepin are themselves potent antihistamines and can help relieve physical as well as cognitive symptoms.
In rare cases in which mastocytosis is cancerous or associated with a blood disorder, the patient may have to use steroids and/or chemotherapy. The novel agent imatinib (Glivec® or Gleevec®) has been found to be effective in certain types of mastocytosis (Droogendijk et al.).
There are clinical trials currently underway testing stem cell transplants as a form of treatment.
There are support groups for persons suffering from mastocytosis. Involvement can be emotionally therapeutic for some patients. (
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in aromatherapy can you define cutaneous innervation?
Cutaneous innervation is the nerves for your skin. These nerves receive and transmit data that comes in contact with your skin. Aromatherapy oils can be used transdermally (taken in topically) to give a therapeutic effect (
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Anyone out here dealing with MASTOCYTOSIS?
I work for a 71-year-old woman with Mastocytosis, a mast cell disease. She is on Type 2 antihistamines, Gastrocom (sp?), Lyrica, and other pain and nerve medications, but is still having swelling of the mouth, tongue, hands and feet. She flushes almost daily, sometimes for hours, and often her feet and/or hands are swollen, red, and "feel as though they are burning." Is there anywhere we can turn for additional information and/or help? Any kind of input would be helpful, whether you are a doctor, research scientist, or a patient who has this rare disease. To my knowledge, blood work has not been done to test for the systemic, cancerous form of Mastocytosis. She is a member of the Mastocytosis Society and receives their newsletter. Any help and/or suggestions will be greatly appreciated.
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She should also be on an H1 inhibitor (zyrtec, claritan). Flushing can be caused by an excess of progestiglandarin D2. Her doctors should test her for that and, if it is elevated, an aspirin program may be warranted (if she doesn't have a reaction to aspirin).
Blood work can only tell if she has elevated tryptase. She needs to have a bone marrow biopsy to determine if she is systemic. The blood work can also determine if she is aggressive or smoldering (or cancerous).
I'd recommend she get an appointment with one of the mastocytosis specialists. I see Dr. Castells in Boston. I travel a great way to see her but it's worth it to have someone who truly knows this disease on your side.
Finally, if your friend is on facebook, there are several mastocytosis groups. All are wonderful and a great resource. I also particpate on a mast cell disorder forum at http://mastcelldisorders.lefora.com/. She is welcome to join.
I wish your friend good health. (
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Anyone heard of mastocytosis?
Sure, it is a disorder due to the formation of too many mast cells. Usually it presents in the skin but can also be present in other places like the stomach, bone marrow, etc. No one knows why some people produce too many mast cells but the disorder is usually "triggered". The trigger varies from person to person and can be a medication, heat, cold, stress, insect bites, etc.
Symptoms vary according to what part of the body is affected. Symptoms can include a rash, lump, diarrhea, stomach pain, hives, trouble breathing, fainting, etc.
Treatment involves antihistamines, ultraviolet light and avoiding the trigger. Other treatment is also provided to give symptom relief. (
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Is anyone familiar w/ Mastocytosis?
Is there anything that can be done to stop the growth of mast cells, instead of taking medication every day to keep the attacks from happening?
If anyone has any information in this area, I'd sure love to hear it.
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I have Systemic Mastocytosis and have just been started on the Chemotherapy agent, Gleevec. The Zyrtec, Ranitidine, and Singulair I have taken only help by decreasing the frequency and duration of my attacks. The Gleevec actually helps kill off the excess mast cells so that the attacks stop. I am hoping for positive results and wish you well in dealing with your symptoms!! (
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Could I have Mastocytosis or MCAS?
I have struggled with gastrointestinal problems for years: diarrhea, nausea, vomiting, weight loss, painful radiating abdominal cramps. I saw a pediatric gastroenterologist when I was an adolescent (I am now 22) and was checked for Crohn's disease, ulcers, bacterial infections, etc. I am hypersensitive to foods (dairy, greasy or oily foods, high fat content foods) and sometimes get sick after heat and high activity exposure. Usually when I eat these foods, I get stomach pain that develops into diarrhea or nausea very quickly, sometimes before I am even done with the meal. I also was diagnosed with acid reflux disease and have unexplained bone pain and dizzy spells sporadically. When I was younger I used to get LARGE, red, itchy hives across my stomach area for unexplained reasons, but have not seen any in years. I was wondering if anyone has been diagnosed with systemic mastocytosis (particularly that affecting the GI) and would like to know how and if I should get tested for this disease?
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Hi....I was diagnosed with Systemic Mastocytosis in 2000 at N.I.H. in Bethesda, MD. following 2 skin biopsies, a 24 hr. urine for HISTAMINES, and a Bone Marrow Biopsy. I have both the Cutaneous and the Systemic Forms of this rare blood disorder, and, over the years, it has progressed to the point where I am now receiving IV Infusion of a Chemotherapy drug called CLADRIBINE. I have been treated at the Univ. of Michigan by Dr. Cem Akin(who originally diagnosed me at N.I.H.,) as well as at Mayo Clinic, Rochester, MN. I also have a contact at the Dept. of Leukemia, MD Anderson Cancer Center, Houston, TX. All that being said, your symptoms reflect many possible other sources...have you had your gall bladder checked? That could account for the diarhhea and stomach pain when you eat foods with a high fatty content. Have you had your Calcium and Parathyroid levels checked? Hyperparathyroidism can cause extreme bone pain, vomiting, diarrhea, and Gastrointestinal Reflux Disease. The large, itchy hives you get in the abdominal area are anybody's guess...but because they seem to only be in the stomach area, instead of all over, that probably rules out Cutaneous Mastocytosis. Hives can also arise from anxiety and stress, or an allergic reaction to SOMETHING, but again, an allergy that produces hives in only one area probably isn't due to an allergen like a new detergent, new body lotion, etc. As the previous source mentioned, a high Tryptase level is usually indicative of a MCAS. Get your Alkaline Phosphytase level checked..a high serum level might confirm that you are indeed having bone involvement and might be a starting point from which your dr. can correlate your unexplained bone pain....although you are very young, a DEXA Scan of your bones could show Osteopenia or Osteoporosis and Bone Fragility, but those scans are more often used in older women.
It has taken me YEARS to find appropriate help and I know just how nerve wracking it can be to find out what's going on with you. How you ever even thought to think of any MCAS's tells me you're doing alot of online research, or that some Dr. at some time said something in an off handed manner about this group of disorders. If the latter is the case, GO BACK TO HIM!!! BTW, for your stomach cramps and diarrhea, see a Gastroenterologist and get a prescription for Gastrocrom...it really helped me! Also, when I was first diagnosed, all that was available to treat the symptoms were Histamine Blockers, such as Zantac, Zyrtec, Benadryl, and later Allegra, and Singulair. Also, real relief for my Reflux Disease as well as my Masto symptoms of the GI Tract, came in the form of Prevacid..it is a Proton Pump Inhibitor which, somewhere between 2000 and today became a STANDARD drug for treatment of Mastocytosis related GI problems.
Sorry this was so long, but regardless of what is causing your symptoms, I wanted you to at least have some things to think about in your quest to find some answers!! Very best of luck to you! (
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