1/8. Elephantiasic pretibial myxedema: a novel treatment for an uncommon disorder.Pretibial myxedema is a known manifestation of Graves' disease. Much less common is the elephantiasis nostras variant, which is often refractory to treatment. We therefore elected to try a new therapy, often used for the management of chronic lymphedema, called complete decongestive physiotherapy. After 6 weeks of intensive treatment, our patient lost 37 pounds and had reduced her edema volume by 47%. Her skin softened with decreased lymph seepage and she became mobile for the first time in years. At a 2-year follow-up visit, she exhibited sustained improvement. This case demonstrates that complete decongestive physiotherapy can provide effective, long-term control of this disease process. We suggest that complete decongestive physiotherapy be considered in patients with severe forms of pretibial myxedema, as well as those with refractory lymphedema.- - - - - - - - - - ranking = 1keywords = elephantiasis (Clic here for more details about this article) |
2/8. elephantiasis Nostras Verrucosa: a rare thyroid dermopathy in Graves' disease.elephantiasis Nostras Verrucosa (ENV) is a rare form of pretibial myxedema, which is nearly always associated with Graves' disease. A case is presented here of Graves' disease who had elephantiasis variety of pre-tibial myxedema (PTM).- - - - - - - - - - ranking = 1keywords = elephantiasis (Clic here for more details about this article) |
3/8. Mossy leg--an unusual therapeutic success.elephantiasis verrucosa nostrum occurs when lymphatic obstruction of sufficient magnitude causes back pressure in the lymphatic channels forceful enough to produce superficial vessel dilation which has a "pebbly" or cobble-stone appearance. Unchecked this can progress to a marked verrucous or mossy appearance, frequently complicated by infection, with swelling and gross deformity. The patient presented here was both post-phlebitic and post-lymphatic with significant deformity. He showed dramatic improvement on a regimen of antibiotics and elevation followed by decompression and routine use of pressure-gradient support garments. This has not recurred and he has remained under control since 1979.- - - - - - - - - - ranking = 0.00012037928375387keywords = lymphatic (Clic here for more details about this article) |
4/8. erysipelas.erysipelas is a superficial cellulitis that affects the skin and subcutaneous tissues. There is also prominent lymphatic involvement. Group A streptococci are the usual cause of this painful infection, but the responsible organisms cannot always be cultured from the fiery red, edematous, sometimes vesicular rash. A fulminating case developed in the left leg of a man whose veins had been harvested four months earlier for coronary artery bypass surgery.- - - - - - - - - - ranking = 4.0126427917956E-5keywords = lymphatic (Clic here for more details about this article) |
5/8. Cancer-associated fasciitis panniculitis.BACKGROUND. Eosinophilic fasciitis and the related fasciitis panniculitis syndrome (FPS) are the clinical and morphologic expression of a variety of disorders, of which chronic inflammation and fibrous thickening of the subcutaneous septa, fascia, and perimysium are common. FPS in patients with cancer has been reported sporadically. methods. In the course of our studies of FPS we have encountered three patients who had an associated neoplasia. Nine reports of patients have been taken from the literature. The clinical and histologic data of FPS in the 12 patients were analyzed in the search of distinctive features from FPS in patients with no evidence of malignancy. RESULTS. Among patients with cancer-associated FPS there was a female predominance (8 patients), predilection for hematolymphatic malignancies (9 patients), precedence of the FPS to cancer diagnosis (10 patients) by a median lag time of 1 year, and unresponsiveness to prednisone therapy in most patients (7 of 8 patients). CONCLUSIONS. Cancer-associated FPS has several characteristics of a paraneoplastic syndrome: it occurs at a distance from the tumor, certain types of tumors are overrepresented among patients with FPS, it evolves in concert with the neoplasia, and it sometimes remits after successful cancer surgery. In contrast to idiopathic FPS, cancer-associated FPS shows a female predominance, and it usually fails to respond to corticotherapy.- - - - - - - - - - ranking = 4.0126427917956E-5keywords = lymphatic (Clic here for more details about this article) |
6/8. A reticulate vascular abnormality in patients with lymphoedema: observations in eight patients.We describe eight patients with lymphoedema who had prominent compressible ridges of tissue in a reticulate pattern, situated predominantly on the upper part of the lower leg. In five patients the lymphoedema was primary, two patients had circumferential venous ulceration, and one had marked venous disease with a small ulcer. One patient had a squamous cell carcinoma of the medial thigh and dysplastic keratoses in the distribution of the reticulate ridges. In three of the four cases in whom histological examination of the ridges was performed, the skin at these areas was demonstrated to contain grossly dilated angular vessels in the mid-dermis, many with valves visible. The vessel walls had a single layer of endothelial cells (anti-factor viii-related antigen positive) and a basement membrane containing type IV collagen. Abnormal elastic tissue in these biopsies was similar to that in erythema ab igne. Indirect lymphography in one case did not demonstrate dilated lymphatic vessels. The body site distribution and clinical pattern of the abnormality appeared to be similar to erythema ab igne but associated with an underlying abnormality of lymphatic rather than blood vasculature. We propose that our cases may represent 'lymphoedema ag igne'.- - - - - - - - - - ranking = 8.0252855835911E-5keywords = lymphatic (Clic here for more details about this article) |
7/8. Proliferative fasciitis. Report of a case with histopathologic and immunohistochemical studies.We present a case of proliferative fasciitis arising adjacent to an operative scar of the right lower leg of a patient with chronic lymphatic leukemia, diabetes mellitus, and multiple subcutaneous angiolipomas. A 61-year old man had a hard mass in his right lower leg that had rapidly increased in size in the past 10 days. The mass was microscopically composed of a dense proliferation of spindle cells forming interlacing fascicles admixed with an inflammatory infiltrate of lymphocytes and eosionphils, focal hemorrhage, and myxomatous change as typically seen in nodular fasciitis as well as many characteristic ganglion cell-like giant cells. Immunohistochemically, most of the spindle-shaped cells were positive for vimentin and alpha-actin, whereas the ganglion cell-like giant cells were positive for vimentin and negative for alpha-actin and lysozyme. We suggest that the main component cells of proliferative fasciitis are fibroblastic in nature, many of which are myofibroblasts in large part, whereas the ganglion cell-like giant cells are related more closely to fibroblasts rather than histiocytes or pericytes. Additionally, proliferating cell nuclear antigen (PCNA) stain revealed that many of the fibroblastic cells showed high proliferative activity, especially in the hypercellular areas, although there was no significant difference in PCNA staining between the focus traumatized by the needle biopsy and the nontraumatized areas.- - - - - - - - - - ranking = 4.0126427917956E-5keywords = lymphatic (Clic here for more details about this article) |
8/8. elephantiasis nostras verrucosa.elephantiasis nostras verrucosa is a rare, chronic, deforming disorder characterized by hyperkeratosis and papillomatosis of the epidermis with underlying woody fibrosis of the dermis and subcutaneous tissue. Chronic lymphedema, either congenital or secondary to infection, surgery, radiation, neoplastic obstruction, obesity, portal hypertension, or chronic congestive heart failure, plays a pivotal role in the pathogenesis. Without appropriate intervention, the slowly progressive cutaneous changes will culminate in massive and grotesque enlargement of the affected body region. In the following case report, the natural history and the management of elephantiasis nostras are discussed.- - - - - - - - - - ranking = 1keywords = elephantiasis (Clic here for more details about this article) |