1/8. Gingival telangiectases: an underappreciated physical sign of juvenile dermatomyositis.BACKGROUND: medline searches (1966-June 1969) failed to identify references that give detailed descriptions of the oral manifestations of dermatomyositis (DM). However, several reports predating medline provided more complete descriptions of oral lesions associated with DM. OBSERVATIONS: We describe 5 cases of juvenile DM with oral manifestations, primarily in the form of gingival telangiectases. These findings are compared with those descriptions found in earlier reports. CONCLUSIONS: Oral lesions in juvenile DM have rarely been reported. mucous membrane involvement associated with DM may include telangiectases, edema, erosions, ulcers, and leukoplakia-like areas. In cases of DM, gingival telangiectases likely represent an underappreciated diagnostic finding analogous to nail-fold telangiectases.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/8. Leber's miliary aneurysms associated with telangiectasia of the nasal mucosa.A 20-year-old woman, treated with cryopexy and xenon- and argon-laser photocoagulation for Leber's miliary aneurysms in her right eye, suffered from repeated epistaxis. She underwent an endoscopy that showed an unusual number of telangiectatic veins. Laboratory results and routine physical and neurologic examinations showed normal values. Dematologic examination revealed no signs of hereditary hemorrhagic telangiectasis (Osler's disease). Nevertheless, it seems reasonable to assume that the combination of microvascular disturbances in one eye and in the nasal mucous membrane is not a coincidental finding.- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |
3/8. Telangiectatic erythematous cutaneous reaction to an implantable cardioverter defibrillator.A 76-year-old man developed progressive blanchable reticulate erythema at the implantation site of his third implantable cardioverter defibrillator (ICD). Despite reports of allergic contact dermatitis to implantable devices, extensive routine patch testing in our patient failed to identify a responsible allergen. The clinical presentation and pathologic evidence were consistent with reticular telangiectatic erythema that has been reported overlying pacemakers and, in the English literature recently, overlying ICDs in two patients. Reticular telangiectatic erythema is a benign reactive condition that is possibly due to a combination of aberrant local circulatory and physical forces such as heat, electric fields, or magnetic fields.- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |
4/8. X-linked mental retardation and characteristic physical features in two brothers with duplication Xp22-Xpter.Two brothers are reported who share mental retardation, conjunctival teleangectasias (mainly equatorial) and characteristic flat face with small mouth and thin prolabia. At the neuropsychological examination, the older brother at 14 years showed a full scale IQ of 40 (WISC), with verbal IQ 45 and performance IQ 44. The younger brother at 7 years showed a full scale IQ of 58 (WPPSI), with verbal IQ 67 and performance IQ 55. Chromosome studies showed a duplication Xp22-Xpter in both brothers and in the inactivated X of their mother. The anomaly was not present in a 3rd healthy brother and in other healthy relatives. The mother has normal intelligence and did not present any of the physical features of her affected sons.- - - - - - - - - - ranking = 1.25keywords = physical (Clic here for more details about this article) |
5/8. Large vessel occlusive disease associated with crest syndrome and scleroderma.OBJECTIVES--To report the cases of three patients with crest syndrome and one patient with diffuse scleroderma who had severe macrovascular disease and only minimal vascular risk factors. methods--The medical histories, physical examinations, and results of clinical investigations were reviewed in four patients. RESULTS--These four patients had severe morbidity from macrovascular disease of the arms and legs in the presence of minimal underlying vascular risk factors. These patients represent 11% of the women with scleroderma seen at our hospital since 1974. This is a greater than threefold increase above the expected proportion of symptomatic vascular disease seen in population studies. In the patients with crest syndrome, large vessel disease was first seen more than 10 years after the onset of Raynaud's phenomenon, which was the first manifestation of the disease. A pathological specimen of the ulnar artery from one patient showed severe luminal narrowing by an acellular material with no evidence of atheroma. CONCLUSIONS--These cases suggest an association of both the crest syndrome and scleroderma with macrovascular disease.- - - - - - - - - - ranking = 1.8200880098865keywords = physical examination, physical (Clic here for more details about this article) |
6/8. Brain abscesses: the lung connection.Pulmonary arteriovenous fistulas are uncommon abnormalities of capillary development which cause right to left shunting and, if not treated, may lead to severe neurological complications, including meningitis and brain abscess. Pulmonary arteriovenous fistulas are commonly a result of hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber disease) and both conditions may be readily diagnosed by careful history taking and physical examination. Two cases of brain abscess associated with hereditary haemorrhagic telangiectasia, which remained unrecognized for many years, are reported. These cases emphasize the importance of early diagnosis and treatment of pulmonary arteriovenous fistula in preventing central nervous system infections.- - - - - - - - - - ranking = 1.8200880098865keywords = physical examination, physical (Clic here for more details about this article) |
7/8. Cervical neuroma presenting as a subarachnoid hemorrhage: case report.OBJECTIVE AND IMPORTANCE: The association of subarachnoid hemorrhage (SAH) with spinal lesions is well known, but hemorrhage from a cervical schwannoma is exceedingly rare. The histopathology and the mechanism of bleeding are discussed. CLINICAL PRESENTATION: We report a healthy 37-year-old man presenting with SAH after intense physical stress caused by bleeding of a cervical neuroma. INTERVENTION: A C6-T1 laminectomy disclosed an ovoid lesion, 4 cm in diameter; extremely dilated veins originated from the tumor. Removal of the spinal lesion resulted in immediate decongestion of the related venous network. The histopathological examination confirmed that the lesion was a telangiectatic schwannoma. The mechanism of bleeding of the intraforaminal cervical schwannoma is discussed. CONCLUSION: Telangiectatic neuromas may be a cause of occult SAH. The importance of magnetic resonance imaging of the cervical spine is emphasized to explain SAH with negative findings on four-vessel angiography in patients whose SAH may have a surgically correctable cause distant from the intracranial compartment.- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |
8/8. Cutis marmorata telangiectatica congenita: report of one case.Cutis marmorata telangiectatica congenita is an uncommon, congenital cutaneous lesion. It is usually present at birth, and is characterized by persistent fixed, flat, blue-violet cutaneous marmorata, telangiectasia, and phlebectasia. Frequently, there is associated skin atrophy and ulceration. There is an association with other abnormalities in at least 50% of the patients with cutis marmorata telangiectatica congenita. Thus, obtaining a thorough history and detailed physical examination are needed. We present a 38-day-old female infant with cutis marmorata telangiectatica congenita, with uneven growth of bilateral lower limbs, and review the literature on this rare lesion.- - - - - - - - - - ranking = 1.8200880098865keywords = physical examination, physical (Clic here for more details about this article) |