1/13. Dermatosis in a child with kwashiorkor secondary to food aversion.kwashiorkor is a common affliction of children worldwide. It occurs less often in developed countries, but has been reported under a variety of circumstances, including poverty, neurologic disease, and malabsorption. Because of its rare occurrence in the united states and because the affected child has an edematous rather than wasted appearance, physicians often do not consider it as a diagnostic entity. This article describes a case of kwashiorkor in a child with food aversion that manifested as "flaky paint dermatitis." Our discussion will attempt to delineate underlying conditions that may predispose to kwashiorkor. In addition, biochemical and cellular etiologic factors that may be linked with classical and nonclassical skin findings of kwashiorkor are considered. Finally, we present a differential diagnosis for any child with a generalized eczematous or desquamative rash. Our aim is to increase the ability of health care providers to identify and treat children with kwashiorkor in a timely manner.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/13. Avian mite bites acquired from a new source--pet gerbils: report of 2 cases and review of the literature.BACKGROUND: Cutaneous manifestations of avian mite bites are not well recognized by physicians or patients. Clinical signs and symptoms are usually caused by bites from avian mites that have infested domestic poultry or birds nesting in or near human habitation. This report details 2 cases of pruritic papules acquired from avian mites that had infested pet gerbils and reviews the dermatologic literature about avian mites. OBSERVATIONS: An 11-year-old boy and an unrelated 10-year-old girl each had mysterious, pruritic papules for many months before their pet gerbils were found to be infested with Ornithonyssus sylviarum (the northern fowl mite) and Dermanyssus gallinae (the chicken mite), respectively. Symptoms resolved when the gerbils were removed from the home. CONCLUSIONS: Because infestation of pet gerbils with avian mites has never been reported, cases of avian mite bites and dermatitis may have gone unrecognized or misdiagnosed. Inquiry about ownership of pet gerbils may be helpful in patients with mysterious bites.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/13. calciphylaxis: case report and literature review.Tissue calcification is a well-recognized common metabolic disease, but calciphylaxis still remains an enigmatic rarity. The latter may be induced experimentally and acquired naturally in human diseases. Although many chronic azotemic or end stage renal disease patients (ESRD) with hyperparathyroidism (HPT) are at risk of calciphylaxis not all of them do develop the disease, even non-renal, patients may also develop this disease. Out of a total of about 2000 hemodialysis, 15,000 dermatology and 26,000 medical patients seen over a three year period in a busy Saudi Arabian tertiary medical centre, we report a sentinel nephrology patient with sudden excruciatingly painful cutaneous calciphylaxis that necessitated acute dermatology emergency consultation, and present a review of the medical literature. In order to institute appropriate total quality management of this life-threatening, rare disease, it is advisable that a high index of suspicion should be entertained by dermatologists, general physicians, nephrologists, and pulmonologists in an appropriate clinical scenario.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/13. dermatitis artefacta. case reports.Patients who seek care for foot problems may present to the podiatrist with concurrent problems, such as anxiety, depression, phobias, personality disorders, and psychoses. These may or may not have any direct relationship to the pathogenesis of the foot problem. The podiatrist may learn of the presence of an emotional problem directly from the patient or from a family member. In many cases, the patient may be unaware or deny the presence of an emotional problem, leaving the podiatric physician in the dark about the patient's mental health state or its implications for the management of the skin problem. In a review of the psychosomatic aspects of dermatology, Koblenzer offered a working classification of the psychodermatoses. This is helpful to the podiatrist in recognizing those dermatologic disease states in which the various aspects of the individual participate in the disease, signs and symptoms of the disease, and the potential psychological value of the disease for the patient. It is also helpful to the podiatrist for recognizing those dermatoses in which psychiatric consultation may be useful so that recognition, treatment, improvement, and perhaps cure may be effected quickly.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/13. Ornithonyssus (acari: Macronyssidae) mite dermatitis in poultry field-workers in Almarg, Qalyobiya governorate.Cutaneous manifestations of bird and rat mite infestation in man are not easily recognized by physicians or patients. Clinical signs and symptoms are developed secondary to bites of mites that have infested rats, domestic poultry or birds nesting in or near human habitation and comes into contact with man. This study details 4 cases of pruritic dermatitis developed in four field workers in poultry farms in Al-Marg district, Qalyobia governorate, egypt. The zoonotic species of Ornithoyssus sp., (family Macronyssidae) was isolated from all samples collected from patients' habitat and the role played by Ornithonyssus mites in causing dermatitis in man was discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/13. A case of autoimmune progesterone dermatitis in an adolescent female.BACKGROUND: progesterone-induced dermatitis is a rare disorder. It typically occurs in females due to an autoimmune phenomenon to endogenous progesterone production, but can also be caused by exogenous intake of a synthetic progestin. Here, we present a case of autoimmune progesterone dermatitis (AIPD) seen in an adolescent female. CASE: The patient is a 15-year-old Caucasian female with no significant past medical history and no prior exogenous hormone use, who presented to her primary care physician complaining of cyclic skin eruptions. She noted that her dermatologic symptoms occurred monthly, just prior to her menses. An intradermal skin test using 0.1 cc of progesterone was performed. The patient immediately developed a wheal, confirming the diagnosis of AIPD. The patient was begun on a continuous regimen of an oral contraceptive pill with 30 micrograms of ethinyl estradiol and 0.15 mg of levonorgestrel. The skin eruptions have not returned since the initiation of this therapy. CONCLUSION: Autoimmune progesterone dermatitis manifests via the occurrence of cyclic skin eruptions. women with the disorder commonly present with dermatologic lesions in the luteal phase of the menstrual cycle. diagnosis of AIPD is confirmed by performing a skin allergen test using progesterone. Due to its rarity, AIPD should be considered a diagnosis of exclusion. In cases believed to be due to an endogenous production of progesterone, several methods of therapy have been attempted. The ultimate goal of therapy is the suppression of ovulation, which will prevent endogenous hormone production as progesterone is only produced in ovulatory cycles. Currently, the first-line choice of therapy is a combination oral contraceptive. If this treatment is ineffective, patients have been treated with danazol, gonadotropin releasing hormone analogs, tamoxifen, and oophorectomy with varying success.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/13. Undiagnosed purpura: a case of autoerythrocyte sensitization syndrome associated with dermatitis artefacta and pseudo-ainhum.A 23-year-old young woman presented with recurrent episodes of painful bruising along with linear erosions on the accessible areas of the body of nine years duration with a pseudo-ainhum of her left nipple for the past three months. Her case history included repeated visits to various physicians at different centers and an extensive investigative profile. A diagnosis of autoerythrocyte sensitization was made on the basis of the clinical history, dermatological examination complemented by a positive autoerythrocyte sensitization test, psychiatric evaluation and absence of any organic cause for her ailment. She was placed on psychiatric management and has remained symptom-free after six months follow-up. The case is reported for its rarity, as well as for the association of autoerythrocyte sensitization syndrome with frank dermatitis artefacta and pseudo-ainhum, which to the best of our knowledge has not yet been reported in the literature.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/13. arcanobacterium hemolyticum infection: confused with scarlet fever and diphtheria.arcanobacterium hemolyticum infections are a common cause of pharyngitis and rash in the 10- to 30-year-old age group. Despite its prevalence, many emergency and primary care physicians may not be aware of the pathogenic potential of this organism. We present a case that illustrates the distinctive clinical spectrum of A. hemolyticum infections that may be confused with drug allergy, group A streptococcal scarlet fever, diphtheria, and even toxic shock syndrome. Recognition of this syndrome will reduce misdiagnoses and facilitate appropriate treatment.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/13. Nosocomial dermatitis and pruritus caused by pigeon mite infestation.We report an outbreak of pigeon mite infestation involving two patients, two nurses, and one physician on a medical ward in a municipal hospital. The index patient developed a diffuse, pruritic erythematous maculopapular rash on his trunk and extremities. Dermanyssus gallinae, a nonburrowing, blood-sucking avian mite was identified on the patient and his bedding. A second patient who complained of scalp pruritus had mites present on her pillow and bed linen. The intern taking care of both patients, and two nurses who had contact with these patients, had mite infestation. Pigeons roosting on the air conditioners and near the doors connecting the patients' rooms to a sunporch were the source of the mites. The outbreak abated after control measures were instituted that prevented pigeons from roosting on the porch. This outbreak illustrates an unusual cause of nosocomial pruritic dermatitis that may be misdiagnosed as scabies or pediculosis. physicians and health care personnel working in metropolitan areas are alerted to mites as a cause of pruritic dermatitis that may be chronic, recurrent, or unresponsive to ectoparasiticides.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/13. head and neck manifestations of dermatomyositis-polymyositis.dermatomyositis and polymyositis are rare disorders of connective tissue that manifest themselves primarily as muscular weakness. Fifty-five percent of 45 patients with this diagnosis at Thomas Jefferson University Hospital had symptoms referable to the head and neck. While dysphagia and the cutaneous manifestation predominate, such symptoms as facial swelling and oral mucosal disorders may require the treating physician to seek the advice of an otolaryngologist before the patient suffers any muscular changes. A thorough knowledge of this disease entity is essential to specialists in head and neck diseases.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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