1/23. Linear lymphatic hypopigmentation after intralesional corticosteroid injection: report of two cases. Perilesional and linear hypopigmentation, extending cephalad along the lymphatics, occurred in one patient following intralesional injection of corticosteroid suspension for treatment of a hypertrophic scar, and in a second patient following sub-lesional injection of a soft toe-web corn. atrophy did not occur. Repigmentation in both patients was complete without specific treatment. review of the literature and evaluation of these patients suggest that the linear hypopigmentation in these two cases was caused by lymphogenous uptake of the corticosteroid crystals. ( info) |
| We present a case report of a 14-year-old white male who developed hyperkeratotic plaques on the distal aspects of 2 toes. He was referred by his primary care physician for the treatment of onychomycosis. With questioning, the patient stated that he played center for his high school basketball team. After physical examination, he was diagnosed with callosities caused by his basketball activities. Proper nail hygiene and wearing of larger footwear resulted in improvement of his callosities. sports-related cutaneous injuries should be included in the differential diagnosis of nail and toe abnormalities. ( info) |
3/23. A new consideration in athletic injuries. The classical ballet dancer. The professional ballet dancer presents all of the problems of any vigorous athlete. The problems include osteochondral fractures, fatigue fractures, sprains, chronic ligamentous instability of the knee, meniscal tears, impingement syndrome, degenerative arthritis of multiple joints and low back pain. attention to minor problems with sound conservative therapy can avoid many major developments and lost hours. Observations included the extraordinary external rotation of at the hip without demonstrable alteration in the hip version angle and hypertrophy of the femur, tibia and particularly the second metatarsal (in female dancers). Careful evaluation of the range of motion of the extremities, serial roentgenographic examination, and systematic review of previous injuries, training programs and rehearsal techniques have been evaluated in a series of cases to provide the basis for advice to directors and teachers of the ballet. ( info) |
4/23. Digital arthroplasty by power surgery with minimal incision. A description of a new method for arthroplasty of the fifth toe, its postoperative considerations, complications, reoccurrence, advantages and disadvantages has been presented. ( info) |
| Knuckle pads are discrete benign cutaneous lesions overlying the extensor surfaces of the fingers and hand joints and are unrelated to trauma, whereas pseudo-knuckle pads may be considered as a form of callosity that appears after repeated trauma. This type of knuckle pad has been described in children with obsessive behavior as "chewing pads" and in adults as occupational disorder. Cases of pachydermodactyly, benign fibromatosis of the fingers, have been described as the unusual forms of knuckle pads that usually affect young adult males. We believe that pseudo-knuckle pads, chewing pads or pachydermodactyly are terms which have been used to decribe the same clinical situation reported in different patients. Here we describe a 12-year-old male patient with pseudo-knuckle pads along the metacarpophalangeal joints developed secondary to repeated trauma reflecting obsessive-compulsive disorder characterized by a tic-like habit. He received fluvaksamine 25 mg/day. The lesions started to disappear after three months of therapy. The recognition of pseudo-knuckle pads by dermatologists and pediatricians is very important in adolescent patients because these lesions may be clues for diagnosis of serious psychiatric problems. The collaboration of a dermatologist or pediatrician with a psychiatrist is essential in the follow-up of these patients. ( info) |
6/23. osteochondroma of the talar neck: a rare cause of callosity of the foot dorsum. osteochondroma is the most common benign bone tumor. It rarely affects rearfoot bones, and only a few cases of talar osteochondroma have been reported. We report a case of a solitary osteochondroma of the talus that presented as a painful callus on the anterior portion of the ankle that was refractory to dermatologic treatment. ( info) |
7/23. Talar callosity--a little-recognized common entity. An ankle callosity overlying the talus is defined and described in three patients and the lesion is considered common but often unrecognized. The aetiology is discussed. ( info) |
| We report five patients in whom localised callosities were found on the dorsum of the feet. This was bilateral in four cases and was due to repetitive minor trauma associated with the sitting posture adopted by the patients. Three of the patients also had psoriasis vulgaris which was clinically dissimilar to the lesions we describe. ( info) |
9/23. Biochemical analysis of callus tissue in osteogenesis imperfecta type IV. Evidence for transient overmodification in collagen types I and III. We analyzed tissue and cells from a stationary and a rapidly growing hyperplastic callus from a patient with osteogenesis imperfecta (OI) type IV and compared the results with those of compact bone and skin fibroblasts of an age-matched control. collagen and protein contents per cell were low in the callus tissues and collagen I and III were overmodified as evidenced by an elevated level of hydroxylysine. The degree of lysyl hydroxylation was highest in those regions that appeared most immature by histological examination. Lysyl hydroxylation approached normal levels in collagen from the stationary callus and from the center of the growing callus. Overmodification of collagen was not seen in compact bone or cell cultures (neither skin fibroblasts nor callus cells) from the patient. Elevation of hydroxylysine in collagen from OI patients is generally attributed to mutations that delay triple helix formation. Our observations suggest that the varying degree of collagen modifications may occur in consequence of regulatory mechanisms during bone development and tissue repair. These mechanisms may be defective in some patients with OI as seen in this case with hyperplastic callus formation. ( info) |
10/23. Hand lesions characteristic of bulimia. bulimia is a serious and prevalent eating disorder in the adolescent population. The pediatrician is often in a position to make the initial diagnosis of bulimia but must suspect the disorder in light of subtle physical evidence. Denial and embarrassment reduce the likelihood of self-report of symptoms. Hand lesions resulting from self-induced emesis have a distinctive configuration and appearance. Noting these characteristic lesions during a physical examination should alert a physician to the diagnosis of bulimia or to an exacerbation of symptoms in a patient whose condition was previously diagnosed. ( info) |