Cases reported "Eyelid Diseases"

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1/26. Eyelid pruritus with intravenous morphine.

    The cause of eyelid pruritus (itching) may be difficult to determine, particularly in preverbal children. Tearing, photophobia, or eye rubbing may be the first manifestation of leukemic infiltration or graft-versus-host disease, necessitating early appropriate therapy. We report a child in whom persistent eye rubbing developed after bone marrow transplantation for leukemia. morphine administration was found to be the cause of this symptom.
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keywords = bone
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2/26. Presumed periorbital lupus vulgaris with ocular extension.

    OBJECTIVE: To report an unusual case of lupus vulgaris that spread to the left anterior ocular surface. DESIGN: Case report. PARTICIPANT: An 18-year-old woman presented with an 8-month history of an infiltrative skin lesion affecting the left lower eyelid and cheek area, left globe, right lacrimal sac area, together with a cystic lesion in the foot area. TESTING/INTERVENTION: The authors describe the clinical findings, radiologic study, and histopathologic study of the conjunctiva, skin, liver, and ankle lesion. The patient was treated with antituberculous medications for 3 months. MAIN OUTCOME MEASURES: Healing of the skin, conjunctival, and bone lesions. RESULTS: The lesion of the face healed, leaving scar tissue. The left eye showed symblepharon with loss of its anterior surface features. The right eye showed no symblepharon, the bones of the foot healed with no deformity, and the liver function test results normalized after 3 months of antituberculous medications. CONCLUSION: lupus vulgaris can be associated with multiple system involvement. Its clinical presentation and behavior depend on the patient's immunity and duration of the disease. early diagnosis and appropriate management may cure the disease with no life-threatening sequelae.
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keywords = bone
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3/26. Transnasal canthoplasty.

    The reconstruction of a traumatic telecanthus, particularly the repositioning and securing of the medial canthal tendon, presents a challenge to the reconstructive surgeon. The adequate positioning of the medial canthal tendon for proper intercanthal distance, and apposition of the lid to the globe, is the cornerstone of a successful reconstruction. The authors have developed a technique for transnasal canthoplasty that is fast, relatively easy, and safe. Transnasally, a 16-gauge spinal needle is introduced over a preplaced K-wire using a 4-0 Bunnell stainless wire suture (Ethicon, Somerville, NJ). The medial canthal tendon is lassoed, secured, and then fixed to the contralateral nasal bone. Six patients have undergone this technique to date. The authors believe this procedure offers an improvement to existing methods.
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keywords = bone
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4/26. Traumatic facial nerve injuries: review of diagnosis and treatment.

    Both blunt and penetrating craniofacial trauma may lead to severe facial nerve injury and sequelae of facial paralysis. Initial evaluation involves quantitation of motor deficits using a clinical grading system, such as the House-Brackmann scale. High resolution computed tomography is used for localization of nerve injury in suspected cases of temporal bone trauma. In the absence of gross radiographic abnormalities, electrophysiologic testing helps predict the likelihood of spontaneous recovery. In patients with deteriorating facial nerve injuries by electroneuronography, surgical exploration is the preferred management. Primary end-to-end neurorrhaphy is the preferred management for transection injuries, while facial nerve decompression may benefit other forms of high-grade nerve trauma. Secondary facial reanimation procedures, such as cranial nerve crossovers, dynamic muscle slings or various static procedures, are useful adjuncts when initial facial nerve repair is unsuccessful or impossible. A review of facial nerve trauma management and case illustrations are presented.
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keywords = bone
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5/26. Primary palpebral and orbital ossification in pseudo-pseudohypoparathyroidism.

    PURPOSE: To present a case of ossification of the eyelid, episclera and orbit in a patient with pseudo-pseudohypoparathyroidism (pPHP). methods: A 20-year-old woman diagnosed with pseudo-pseudohypoparathyroidism underwent clinical and histopathological examination of calcified plaques of the right eyelid and orbit. The patient presented with a round face, tousled short hair and retarded speech. She had been diagnosed with pPHP at 3 years of age. During her first decade, calcified plaques developed in the right eyelid and orbit. Gradually, she developed horizontal diplopia, pseudo-ptosis and periorbital pain. Vertical eye movements were reduced to 10 mm, although levator function remained intact. Computer tomography scans of the orbit showed three separate dense structures. Radiographic findings also showed bilateral shortening of the fourth metacarpus and a calcified subcutaneous plaque in the left thigh. The patient's blood status revealed an elevated level of thyroid stimulating hormone, but was otherwise normal. The patient was treated with eltroxin and shortly afterwards regained normal hair and normal speech function. RESULTS: The calcified structures were removed surgically and almost normal eye movements were re-established. Histological examination of the excised tissue demonstrated bone formation. CONCLUSION: This is the first reported case of ossification of the eyelid and orbit in a patient with pseudo-pseudohypoparathyroidism.
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keywords = bone
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6/26. Recurrent solitary reticulohistiocytoma of the eyelid.

    A healthy 13-year-old female presented with a 5-month history of an enlarging red-brown, firm lower eyelid mass associated with loss of eyelashes. An excisional biopsy revealed a well-circumscribed nodule composed of coalescing nests of epithelioid cells, rare multinucleated cells, and vacuolated macrophages and spindle cells. Additional studies revealed a positive vimentin and alpha(1)-antitrypsin, and negative S100 protein and factor xiiia immunophenotype. This constellation of clinicopathologic features is diagnostic of solitary reticulohistiocytoma, but also shows overlap with xanthogranuloma, a common childhood histiocytosis. Reticulohistiocytoma should be considered in the differential diagnosis of eyelid tumors and has the potential for local recurrence. Diffuse cutaneous reticulohistiocytosis or multicentric reticulohistiocytosis should be considered if similar cutaneous lesions with or without symptoms of arthritis are present, respectively.
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ranking = 162.57932101559
keywords = macrophage
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7/26. Primary systemic amyloidosis: a unique case complaining of diffuse eyelid swelling and conjunctival involvement.

    A 52-year-old Japanese woman with the chief complaint of marked swelling of her upper eyelids and a mass over the bulbar conjunctiva is reported. She previously noticed frequent purpura after minimal trauma, which was resolved shortly after taking some ascorbic acid. Laboratory data showed Ig-G kappa type M-protein in the serum and kappa type Bence-Jones protein in the urine by immunoelectrophoresis. Systemic examination showed mild hepatosplenomegaly, 1st degree of AV block, and a mild increase in plasma cells in the bone marrow biopsy. Histologically, the whole dermis of the eyelid skin and conjunctiva was replaced by a large quantity of amorphous, eosinophilic substances, which were diffusely positive with Direct Fast Scarlet 4BS. Immunohistochemical staining was positive for anti-amyloid P component antibody. Typical amyloid fibrils were proved by electron microscopy. She was finally diagnosed as primary systemic amyloidosis with diffuse swollen eyelids and conjunctival mass, symptoms which in primary systemic amyloidosis are very rare.
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keywords = bone
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8/26. adult orbital xanthogranuloma with associated adult-onset asthma.

    : The authors report a case of adult orbital xanthogranuloma with associated adult-onset asthma in a 44-year-old man. adult orbital xanthogranuloma was diagnosed on the basis of the clinical findings of bilateral, indurated, yellow eyelid lesions in a patient presenting with adult-onset asthma. Incisional biopsy of the eyelid lesions demonstrated a diffuse histiocytic infiltrate of the orbit and Touton giant cells without evidence of necrobiosis. Systemic evaluation failed to show evidence of bone lesions or paraproteinemia. When patients present with atypical indurated yellow eyelid lesions, a biopsy should be considered. If Touton giant cells are present, a systemic evaluation should be undertaken to rule out both erdheim-chester disease and necrobiotic xanthogranuloma. If no systemic findings are present, other than the possibility of adult-onset asthma, the rare entity of adult orbital xanthogranuloma should be considered.
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keywords = bone
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9/26. Bilateral lid margin ulcers as the initial manifestation of crohn disease.

    PURPOSE: To report an unusual bilateral ulcerative lid involvement as the presenting manifestation of a severe crohn disease. DESIGN: Observational case report. METHOD: Description of an otherwise healthy woman who initially presented with bilateral ulcerative lid involvement before the discovery of an extensive ulcerative intestinal inflammatory disease. RESULTS: A 32-year-old woman presented with bilateral ulcerative blepharitis. She also complained of aphthous oral lesions and diarrheic episodes for the previous 3 days. Impression cytology of the lid ulcers showed conjunctival cells, together with the presence of lymphocytes and macrophages. colonoscopy and colonic biopsy were characteristic of crohn disease. The treatment with systemic corticosteroids healed bowel, oral, and lid margin ulcerative lesions. CONCLUSION: The simultaneous appearance of ulcerative lesions in the intestinal mucosa and in the mucocutaneous lid margin and the comparable features encountered in the cytologic studies indicate that ulcerative lid margin disease could be an ocular manifestations of crohn disease.
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ranking = 162.57932101559
keywords = macrophage
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10/26. Eyelid bleeding and atypical amyloidosis.

    PURPOSE: To describe a case of atypical systemic amyloidosis in a patient who presented with recurrent subcutaneous bleeding of the eyelids and auricles. DESIGN: Observational case report. methods: A 52-year-old man with chronic cardiac failure, hypertension, weight loss, and impotence presented with recurrent bleeding of the eyelids and auricles, and was investigated for suspected amyloidosis. RESULTS: biopsy specimens taken from the bone marrow, salivary gland, abdominal subcutaneous fat, and gastric mucosa, and eyelids were all negative for congo red. Results of a conjunctival biopsy, which were returned after the patient's death, and cardiac muscle autopsy were positive for congo red staining, indicating amyloidosis. CONCLUSION: The findings in this case show that the presentation of amyloidosis may be atypical. Ophthalmologists should consider a diagnosis of amyloidosis in patients with periorbital bleeding, even if biopsies are negative for congo red. A conjunctival biopsy may be useful in establishing a diagnosis of primary systemic amyloidosis.
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keywords = bone
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