Cases reported "Skin Ulcer"

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11/18. Trigeminal trophic syndrome.

    Trigeminal trophic syndrome is an unusual condition also known as trigeminal neurotrophic ulceration or trigeminal neuropathy with nasal ulceration. The diagnosis is suggested when ulceration of the face, especially of the ala nasi, occurs in a dermatome of the trigeminal nerve that has been rendered anesthetic by a surgical or other process involving the trigeminal nerve or its central sensory connections. A history of paresthesias and self-induced trauma to the area further support the diagnosis. Neurological deficits causing trigeminal trophic syndrome may result from surgical trigeminal ablation, vascular disorders and infarction of the brainstem, acoustic neuroma, postencephalitic parkinsonism, and syringobulbia. The following etiologies of nasal ulceration should be excluded: postsurgical herpetic reactivation and ulceration, syphilis, leishmaniasis, leprous trigeminal neuritis, yaws, blastomycosis, paracoccidioidomycosis, lethal midline granuloma, pyoderma gangrenosum, Wegener's granulomatosis, and basal cell carcinoma. In the case reported here, the diagnosis of TTS was made primarily as a result of previous experience with the syndrome, underscoring the importance of physician recognition of this unusual disorder.
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ranking = 1
keywords = leishmaniasis
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12/18. Active cutaneous leishmaniasis in Brazil, induced by leishmania donovani chagasi.

    L.d. chagasi was isolated from active cutaneous leishmaniasis in both human and canine infections in an endemic area in Rio de Janeiro, Brazil. Both isolates were identified by molecular and immunological characterization of the parasite using three different methods: electrophoretic mobility of isoenzymes; restriction endonuclease fragment analysis of kDNA and serodeme analysis using monoclonal antibodies. This seems to be the first well documented case in the New World of a "viscerotropic" Leishmania inducing a case of cutaneous leishmaniasis. This observation emphasizes that the diagnosis of the etiologic agent of human or canine visceral leishmaniasis based solely upon clinical and epidemiological criteria may lead to erroneous conclusions.
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ranking = 7
keywords = leishmaniasis
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13/18. Failure of oral ketoconazole to cure cutaneous ulcers caused by leishmania braziliensis.

    ketoconazole failed to cure cutaneous lesions caused by leishmania braziliensis in two patients. A prior study had suggested that ketoconazole was efficacious against this form of leishmaniasis.
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ranking = 1
keywords = leishmaniasis
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14/18. Febrile ulceronecrotic Mucha-Habermann's disease.

    A patient with febrile ulceronecrotic Mucha-Habermann's disease manifested the characteristic features of this entity. These include a polymorphous eruption with histopathologic findings of Mucha-Habermann's disease, large ulceronecrotic skin lesions, intermittent high fever, and constitutional symptoms. The patient was unique in that he also had malabsorption and eosinophilia. This disease may represent a hypersensitivity reaction. To our knowledge, there are five previous cases of febrile ulceronecrotic Mucha-Habermann's disease reported in the world literature.
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ranking = 0.00014118121626602
keywords = world
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15/18. sporothrix schenckii inoculation on the abdomen.

    sporotrichosis is usually transmitted by cutaneous inoculation and is, therefore, most often seen on the face, extremities, and other exposed areas. We have described the case of a pilot who contracted sporotrichosis overseas and in whom the initial lesion was on the abdomen. Since the patient reported that he had been bitten by an insect at that site, the diagnosis of leishmaniasis had been strongly considered.
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ranking = 1
keywords = leishmaniasis
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16/18. Fatal fungaemia due to sporothrix schenckii.

    A clinical case is reported of a 78-year-old male with antecedents of diabetes and alcoholism who was hospitalized because he showed cutaneous lesions on the face and extremities suggesting cutaneous tuberculosis, but after a first histological study cutaneous leishmaniasis was erroneously diagnosed. Because of some unusual characteristics of the patient, the skin biopsies were carefully re-examined, as well as blood smears, which revealed elongated yeast form-like cells suggestive of sporothrix schenckii. The diagnosis was confirmed when the fungus grew in mice and in Sabouraud cultures inoculated with blood samples from the patient. It is recommended that Sp. schenckii is included in the differential diagnosis of ulcerative cutaneous lesions in patients from Mexican humid areas.
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ranking = 1
keywords = leishmaniasis
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17/18. Disseminated American cutaneous leishmaniasis.

    BACKGROUND: While studying cutaneous leishmaniasis in the central part of western venezuela, we found four cases of disseminated American cutaneous leishmaniasis, three from the Lara State and one from Portuguesa State. methods: A clinical history was taken for each of these patients, followed by microscopic examination of the Giemsastained smears from their cutaneous lesions and by a montenegro skin test. serum from a skin lesion were grown in Novy-MacNeal-Nicolle medium (NNN). Hamsters were inoculated with suspension of tissues taken from the patient's lesions. Biopsies were taken for histopathologic examination. Isolates from cultures on NNN medium and from hamsters were subcultured in Schneider's medium for parasite identification, using molecular techniques. Treatment with injections of N-methyl glucamine antimonate, 25 mg/kg/day was prescribed for each patient for 20 consecutive days and, after a week of rest, a second course of injections was administered. RESULTS: patients had disseminated papular, ulcerous, nodular, and ulceronodular lesions on the skin. Smears of the skin lesions from all of the patients showed abundant amastigotes within histiocytes or free in the tissues. The skin test was negative in two patients. On histopathologic examination of skin lesions, mainly numerous vacuolated histiocytes filled with amastigotes were observed. Isolates from all the patients were identified as Leishmania venezuelensis. One of the patients healed after treatment with N-methyl glucamine antimonate. The others were resistant to this therapy. CONCLUSIONS: Diffuse cutaneous leishmaniasis can be caused also by Leishmania venezuelensis. patients with nodular lesions who presented a negative montenegro skin test were more resistant to treatment with specific pentavalent antimonials.
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ranking = 7
keywords = leishmaniasis
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18/18. Imported mucocutaneous leishmaniasis.

    We report a case of mucocutaneous leishmaniasis in a otherwise fit Caucasian man who had traveled in an endemic area. Initial tissue microscopy failed to identify the causative organism, which was only determined by subsequent culture as leishmania braziliensis. This case illustrates the variability in the presence of Leishman-Donovan (LD) bodies in histopathological studies and emphasizes the need for culture in suspected cases of leishmaniasis, particularly given the ability of certain Leishmania species such as L. braziliensis to cause recalcitrant and destructive infections of the nose and mouth.
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ranking = 6
keywords = leishmaniasis
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