1/3. Striae and acne following cardiac surgery in a child.We report a 13-year-old girl with extensive striae and an acneiform eruption following surgery for complex congenital heart disease. These findings were associated with elevated serum and urinary cortisol levels with loss of diurnal rhythm. The resolution of the eruption and the fading of her striae coincided in time with normalization of her blood parameters on day 72 postoperatively. We conclude that the cause of steroid excess in our patient was stress induced by the cardiac surgery and a complicated and protracted postoperative course. To our knowledge, this is the first report in the English language literature of skin changes due to endogenous hypercortisolaemia caused by intense physical and emotional stress.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/3. Colloid milium of the upper eyelid margins: a rare presentation.AIM: To report a rare presentation of colloid milium occurring only on the upper eyelid margins. DESIGN: Interventional case report. methods: (1) Slit-lamp examination of eyelids and eyes and clinical examination including the face and a general physical examination; (2) photography of the lesions on the lids; and (3) excision biopsy and histopathologic examination. MAIN OUTCOME MEASURES: Histologic examination confirmed the clinical diagnosis. RESULTS: Clinical examination and histopathologic findings revealed the cysts to be colloid milium. CONCLUSIONS: Colloid milium can involve upper eyelids in isolation, sparing the lower eyelids and facial skin. Such rare presentations should be kept in mind while examining similar lesions.- - - - - - - - - - ranking = 15.45419435788keywords = physical examination, physical (Clic here for more details about this article) |
3/3. Grouped papules in Hurler-Scheie syndrome.In a patient with Hurler-Scheie syndrome, a type of mucopolysaccharidosis (I H/S), an initial presentation was grouped papules on the extensor surfaces on the upper portions of the arms and legs. Other physical findings included progressive flexion contractures and mild developmental delay. The patient had deficient alpha-L-induronidase activity, and electron microscopy showed large cytoplasmic vacuoles and lysosomes, consistent with Hurler-Scheie syndrome. Findings of grouped papules have not been previously reported in patients with this syndrome.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |