1/9. Suppurative granulomatous eosinophilic panniculitis: case report.A case of 12 year-old Nigerian male is presented. He had an unusual variant of Weber-Christian disease and manifested massive subcutaneous indurations and nodules limited to the cheeks, lips, left pectoral, infraclavicular and supraclavicular areas. A wedge biopsy revealed suppurative granulomatous eosinophilic panniculitis. Despite exhaustive investigations, no obvious trigger of the panniculitis could be identified. Response to corticosteroids and to empirical trials with other drugs was poor, and the outcome was fatal. We believe this is the first report from nigeria of this rare variant of Weber-Christian panniculitis in the paediatric age, and draw attention to the life-threatening nature of this disorder.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/9. leukemia: the dentist's role in diagnosis.patients with leukemia frequently have oral signs and symptoms that may lead to the early diagnosis of this condition. Hematologic laboratory tests that would be of value include a white blood cell count and a platelet count. The dental practitioner should be aware of those diagnostic signs and the possibilities of oral complications associated with the disease. The nature of leukemia and its complications require a regular and thorough oral examination as part of the routine treatment of these patients.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/9. Management problems associated with carcinoma of the cervix diagnosed in the second trimester of pregnancy.A 29-year-old women presented in the second trimester of pregnancy with a stage IIB squamous carcinoma of the cervix. Fundal hysterotomy was performed with a view to radical radiotherapy the following week. The patient developed a pyometra in the postoperative period due to the position and nature of the tumor. Management strategies for dealing with similar cases are outlined.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/9. Recurrent knee pyarthrosis with intact hyaline cartilage. A case report.A 20-year-old patient with hyperimmunoglobulin E and abnormal leukocyte chemotaxis was treated by synovectomy for chronic and recurrent staphylococcal knee pyarthrosis. The articular cartilage was noted to be preserved despite the severity of synovial involvement and the chronic nature of this case of septic arthritis. Polymorphonuclear leukocytes were few, despite florid staphylococcus aureus growth. This observation lends support to the role of lysozomal enzyme activity from leukocytes in hyaline cartilage damage in pyarthrosis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/9. Surgical management of massive perianal hidradenitis suppurativa.hidradenitis suppurativa of the perineum and buttocks is a devastating disease often causing patients years of pain, discomfort, and eventual social isolation. The chronic form of the disease results from a lack of aggressive surgical intervention when the patient is first seen. It is characterized by a malodorous drainage from multiple sinus tracts encased in marked scarred and fibrotic tissue. In contrast to axillary involvement, the perianal form of hidradenitis suppurativa is associated with an increased frequency of anemia, fistulous communications with bowel and urinary tract, and the development of carcinomas. Several cases illustrating the debilitating nature of the disease and its optimal management are presented. This report illustrates that (1) a well-planned preoperative and postoperative bowel regimen can eliminate the need for a diverting colostomy, even in the most extensive forms of perianal disease, (2) radical excision is expedited and blood loss is minimized by the use of a Shaw hot knife (Oximetrix, Mountain View, CA), (3) the quilted application of meshed split-thickness skin grafts as a primary procedure provides rapid closure of the surgical defect and minimizes patient discomfort, and (4) aggressive surgical intervention in severe cases provides a chance for a rapid recovery from this crippling disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/9. Surgical management of chronic hidradenitis suppurativa of the perineum.Two cases of chronic hidradenitis suppurativa of the perineum are presented. Both patients suffered through many years of discomfort and social isolation, undergoing multiple temporizing procedures. The treatment course pursued is described in detail. It is hoped that a greater appreciation of the disabling nature of this disease will lead to earlier, definitive therapy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/9. A new autosomal dominant disorder of pyogenic sterile arthritis, pyoderma gangrenosum, and acne: PAPA syndrome.OBJECTIVE: To describe a multigenerational family with transmission of an autosomal dominant disorder characterized by pyogenic arthritis, pyoderma gangrenosum, and severe cystic acne. MATERIAL AND methods: We present a detailed case report of a 39-year-old man with arthritic changes in several joints, pyoderma gangrenosum, and cystic acne. Several relatives from three generations of his family underwent clinical and genetic investigations. The findings in this kindred are reported. RESULTS: Ten affected family members in three generations manifested variable expression of a pauciarticular, nonaxial, destructive, corticosteroid-responsive arthritis that began in childhood; pyoderma gangrenosum; and severe cystic acne in adolescence and beyond. Other less commonly associated features included adult-onset insulin-dependent diabetes mellitus, proteinuria, abscess formation at the site of parenteral injections, and cytopenias attributable to sulfonamide medications. Laboratory evaluation was nondiagnostic. Genetic studies excluded linkage to the major histocompatibility locus. CONCLUSION: The acronym of PAPA syndrome (pyogenic sterile arthritis, pyoderma gangrenosum, and acne) is suggested for this newly recognized pleiotropic autosomal dominant disorder. The nature of the genetic alteration in PAPA syndrome is unknown.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/9. Octogenarian with a congenital bronchoesophageal fistula.Bronchoesophageal fistula are commonly caused by a lung or esophageal malignancy eroding into the neighboring structure. Benign forms of bronchoesophageal fistula are less common and may have a congenital nature. Congenital bronchoesophageal fistula usually present in adult life with chronic symptoms of lung suppuration. We present a case of congenital bronchoesophageal fistula in an octogenarian and review the literature on this subject. We also suggest an extrapleural approach to the fistula to lessen the possibility of postoperative empyema.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/9. pyomyositis.A case of non-tropical pyomyositis (PM), in a 63-year-old female patient, affecting gluteus and intrapelvic muscles is presented. delayed diagnosis and treatment led to long-standing morbidity. magnetic resonance imaging (MRI) of the pelvis provided valuable information on the nature and extent of the disease and helped to plan surgical management. MRI of the pelvis should be undertaken at an early-stage. Prompt examination of material obtained by aspiration or debridement would then permit an accurate diagnosis and appropriate management.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |