ABSTRACT
Background@#Facial herpes zoster can be accompanied by several complications. In particular, postherpetic neuralgia (PHN) and ocular complications (OCs) are relatively common. Both PHN and OC are of interest because they can lower the quality of life. @*Objective@#This study aimed to evaluate the clinical features of facial herpes zoster and to assess the risk factors of OCs and PHN. @*Methods@#We analyzed the medical records of 146 patients with facial herpes zoster from January 2014 to May 2019. We assessed the proportion of OCs and PHN in patients with facial herpes zoster according to several clinical factors, including age, sex, dermatomal distribution, delayed time to treatment, and associated systemic conditions. OCs were divided into mild and severe ocular complications (SOC) by ophthalmologic diagnosis. @*Results@#The incidence rate of OCs (83.8%) and SOC (37.8%) were highest in patients in their 70s. Herpes zoster involving the ophthalmic and maxillary branches of the trigeminal nerves showed a significantly higher incidence rate of OCs and SOC than those involving only the ophthalmic branch (p=0.031, p=0.025). Patients who received antiviral treatment within 4 days showed lower rates of OCs and SOC than patients who received treatment after 5 days (p＜0.001, p=0.003). The incidence of PHN was significantly higher in those over 60 years old, when both the ophthalmic and maxillary branches were involved, and for those treated more than 4 days after the onset. @*Conclusion@#To decrease the risk of OCs and PHN in facial herpes zoster, it is important to provide early antiviral treatment and appropriate ophthalmologic consultation.
ABSTRACT
Metastatic skin cancers are a relatively uncommon malignant tumor. Visceral tumors such as breast, lung, and colon cancers are commonly found to be the primary origin. Cutaneous metastasis with esophageal cancer is exceedingly rare, accounting for less than one percent of all skin metastasis. Here, we report a case of cutaneous metastatic squamous cell carcinoma that originated from esophageal carcinoma. The patient was a 48-year-old male who complained of a 2-cm-sized non-tender, skin-colored nodule on his left lower back. Positron emission tomography-computed tomography (PET-CT) showed focal fluorodeoxyglucose (FDG) uptake in the lesion. In the histopathological examination, the tumor cells stained positive for epithelial membrane antigen (EMA) and cytokeratin 5/6 (CK5/6), which was consistent with squamous cell carcinoma. This case suggests that patients who have been treated for primary esophageal carcinoma should undergo a skin biopsy to rule out metastatic skin cancer if the tumor appears to be suspicious.
ABSTRACT
Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made.
ABSTRACT
Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made.
ABSTRACT
Leprosy is a chronic infectious and granulomatous disease caused by Mycobacterium leprae. It is treated with a multidrug therapy (MDT), which is consisted of dapsone, rifampicin, and clofazimine. However, there were relapsed leprosy associated with various predisposing factors; persisting organism, multiple involved skin lesions and nerves, HIV infection, monotherapy, inadequate and irregular therapy. Early or late relapses were observed in leprosy. Early onset relapses may occur due to insufficient treatment, and late relapses are probably with persistent bacilli and drug resistant organisms. Herein, we report on an interesting case of a 78-year-old man presented with relapsed leprosy associated with ulcerative skin lesions. The patient was diagnosed with lepromatous leprosy about 40 years ago, and he was treated with dapsone monotherapy and MDT. Our case is thought to have occurred due to persistent bacilli related to irregular therapy.