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At least 433 records · Page 24Linked to original sources

Neoplastic erythema nodosum.

We performed immunohistologic studies on a 75-year-old white woman with erythema nodosum (EN) and a systemic lymphoma. A skin biopsy specimen from an EN lesion showed lobular and septal pannicular infiltration by atypical lymphocytes. The cutaneous lymphocytic infiltrate was composed of a monoclonal population of B cells with lambda light chains. Atypical lymphocytes were also seen in the peripheral blood, and flow cytometry showed a predominance of the same phenotype of B cells with lambda light chains. Chemotherapy for systemic B-cell lymphoma resulted in the simultaneous resolution of EN and the lymphoma. This is the first documentation of EN representing direct cutaneous invasion by a B-cell lymphoma.

Aged↗

Bullous pemphigoid: a case report.

A case of bullous pemphigoid which presented initially in the mouth is described in an 82 year old male. Differential diagnosis is discussed.

Aged↗

[Deep granuloma annulare in children].

BACKGROUND: The granuloma annulare is a common benign disorder in childhood which may be difficult to recognize in its atypical forms, like deep granuloma annulare. CASES REPORT: Case 1: A 5-year-old girl suffered from subcutaneous nodules occurring on her soles. Open biopsy at the age of 6 years showed typical features of granuloma annulare. These nodules were still present one year later. Case 2: A 2-year-old girl suffered from nodular lesions on the anterior aspect of the lower legs similar to erythema nodosum with spontaneous outbreaks over 6 months. Histological examination showed typical features of granuloma annulare. CONCLUSIONS: Diagnosis of the deep granuloma annulare is often difficult. Its relation with rheumatic nodules which have similar histological patterns is discussed.

Child↗

Pneumococcal septicaemia with Purpura fulminans in an 11-month-old child.

Purpura fulminans (PF) is a syndrome characterised by acute onset of rapidly progressive haemorrhagic necrosis of the skin due to dermal vascular thrombosis, mainly occurring during meningococcal sepsis. It occurs rarely in the course of infection with Streptococcus pneumoniae and most cases report Meningococcus as the causing agent. This is a case report of successful conservative limb-preserving management of PF and sepsis caused by Streptococcus pneumoniae in an 11-month-old girl.

Bacteremia↗

Bacteraemic necrotizing fasciitis with compartment syndrome caused by non-O1 Vibrio cholerae.

Non-O1 Vibrio cholerae are gram-negative rods that can cause sporadic gastroenteritis, bacteraemia, and extraintestinal infections, primarily following the consumption of raw seafood or exposure of damaged skin to contaminated saltwater during the summer months. Bacteraemic necrotizing fasciitis caused by non-O1 V. cholerae has rarely been reported. Liver cirrhosis, haemochromatosis, and immunosuppression are important factors contributing to the severity of the infections and outcome. This report describes a case of liver cirrhosis in which right lower leg compartment syndrome and acute renal failure presented as the initial symptoms of bacteraemic necrotizing fasciitis. The organisms growing in the wound and blood cultures were identified as non-O1 V. cholerae. After antibiotic therapy, fasciotomy, right above-knee amputation, repeat debridement of the left lower leg and split-thickness skin grafts, the patient was eventually discharged in a stable condition.

Acute Kidney Injury↗

Laser treatment for an unusual reactive vascular proliferation.

An unusual case of severe vascular proliferation presenting in the form of haemorrhaging cutaneous lesions on the leg is reported. The similarity between these benign lesions and various malignancies is outlined. The patient healed well when the lesions were excised using a laser under local anaesthetic.

Aged↗

Graves' disease.

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Affective Symptoms↗

MR imaging of the diabetic foot.

Diabetes is a common disease with potentially devastating complications affecting the foot and ankle. Ischemia and infarction, neuropathic osteoarthropathy, callus, ulceration, and infection result from the underlying neurologic and vascular disease. The MR imaging appearance of these complications is discussed. Recognition of these MR imaging patterns is important for formulation of an appropriate treatment plan.

Amputation, Surgical↗

Vitiligo patterns simulating autoimmune and rheumatic diseases.

Several variants of generalised vitiligo can be recognised by their cutaneous distribution. In some, certain anatomical regions--e.g., hands--are predominantly affected while the cutaneous depigmentation in other variants shows a similar anatomical distribution to that of the internal structures affected in some of the autoimmune and rheumatic diseases. Five patients have been seen, and three described by others, with vitiligo affecting skin of eyelids and lower front of neck, reminiscent of the anatomical distribution of lesions in thyrotoxicosis with exophthalmos: two of these patients have thyrotoxicosis. Another variant of vitiligo mimicks the anatomical distribution of lesions in ankylosing spondylitis, Reiter's syndrome, and ulcerative colitis and there are cases simulating lupus erythematosus, rheumatoid arthritis, and psoriasis. It is suggested that the parts of the body affected in each vitiligo variant and its corresponding internal disease constitute a set os mosiac patches with distinctive shared characters. These may have morphogenetic functions during embryonic development and be potentially autoantigenic later in life.

Adolescent↗

Rapid diagnosis of Bacteroides infections by indirect immunofluorescence assay of clinical specimens.

43 specimens from a variety of sites were directly examined by indirect immunofluorescence assay (I.F.A.) with specific antisera against the capsular polysaccharide of Bacteroides fragilis and pooled antisera against a number of serotypes of Bacteroides sp. (all of the former B. fragilis subspecies). The findings were compared with those of routine anaerobic bacteriology and gas liquid chromatography for short chain fatty acids. Examination by I.F.A. was a sensitive (100%) and specific (90.3%) means of identifying B. fragilis. Use of the pooled serum was sensitive (100%) but less specific (64.3%) than the capsular antiserum (90.3%) although it had the advantage of detecting Bacteroides species other than B. fragilis. The capsular serum I.F.A. gave 9.7% false positives and no false negatives. The predictive value of a positive identification of B. fragilis in a clinical specimen using this anticapsular serum I.F.A. test was 80%; with the pooled Bacteroides group-serum it was 60%. The predictive value of a negative test was 100% for both sera, indicating that a negative I.F.A. test is a reliable index of the absence of Bacteroides from the culture I.F.A. of clinical material provides a rapid (less than 2 h) specific and sensitive means for the diagnosis of B. fragilis infections and would be of use in a clinical laboratory.

Abdomen↗