Subcutaneous sweet's syndrome associated with progressive bilateral sensory neural hearing loss: a case report and review of literature

Sweet's syndrome is an autoimmune inflammatory condition, characterized by erythematous plaques infiltrated by neutrophils limited to the dermis. If the infiltrate just present in or extend to the subcutaneous tissue, then it will be labeled as subcutaneous Sweet's syndrome. Due to the rarity of this condition, its association with other medical conditions is inconclusive. Herein, we present a male patient who underwent cochlear implant after having progressive bilateral sensory neural hearing loss. Two months after the implant, he developed cutaneous lesions consistent with subcutaneous Sweet's syndrome, which were well controlled with systemic steroids and cyclosporine. Four previous cases of Sweet's syndrome followed by progressive bilateral sensory neural hearing loss were reported in the literature. Twenty-one cases of subcutaneous Sweet's syndrome associated with different medical conditions were reported so far. The present case is the first, up to our knowledge, of progressive bilateral sensory neural hearing loss that was followed by subcutaneous Sweet's syndrome

Erythema toxicum neonatorum: a retrospective review

To describe clinical manifestations, differential diagnosis, and treatment outcome of Erythema Toxicum Neonatorum in healthy newborns at King Hussein Medical Center and Queen Rania Children's Hospital. The medical records review was conducted for patients with clinical diagnosis of Erythema Toxicum Neonatorum who were treated at King Hussein Medical Center and Queen Rania Children's Hospital dermatology clinics between February 2008 and September 2012. Extracted data include duration of pregnancy, type of delivery, age, sex, cutaneous rash characteristics, associated clinical conditions, laboratory investigations, skin biopsy, and treatment. Simple statistical analyses [mean, frequency, and percentage] were used to describe the study variables. The study included 152 patients, 88 males and 64 females with a male to female ratio of 1.4:1. The age at onset of the rash ranged from one to 11 days [mean age was 4 days]. All subjects were products of hospital-based deliveries. The erythematous and papular type was the commonest [73.7%]. History of drug intake during pregnancy was found in about two thirds of cases [66%]. Four subjects [2.64%] had lymphadenopathy and five [3.22%] had moderate fever. Tzanck smear was done in 17 subjects with severe skin rash. Skin biopsy was done in four patients. About half cases received oral antihistamine treatment and the rashes disappeared over 24 to 36 hours. Follow up was done for four weeks. Erythema Toxicum Neonatorum is a self-limiting disease and without long term sequalae. More efforts are needed to raise awareness of this condition amongst health care professionals to avoid unnecessary investigations and treatment as it is sometimes misdiagnosed as bacterial infection

Orf infection: a clinical study at the royal medical services hospitals

To describe the demographics, clinical features, course, therapeutic interventions, and outcomes of patients with Orf infection seen at the Royal Medical Services Hospitals. We describe 64 patients with Orf infection who presented to dermatology clinics at different Royal Medical Services Hospitals during a five year period from March 2002 to February 2007. Their clinical presentations, complications and treatment were reported through regular follow-up at weekly intervals. Sixty four cases [42 males and 22 females] were studied. Their ages ranged from 8-67 years. History of exposure to sheep or lambs was documented in 57 cases [89%]. The mean incubation period was seven days [ranged 4-15 days]. The incidence peaked after the feast of sacrifice each year. Thirty-six patients [56%] were not aware about the infection before they had been examined by the dermatologist. Misdiagnosis by physicians unacquainted with the disease led to incision of the lesion in 21 patients [33%]. The most common sites were fingers, dorsum of hand, and palms. Diagnosis was made by history, appearance and location of the lesion and clinical course. In three cases, histopathological examination was made. The average resolution time of the lesions was 32 days without significant scarring. Complications were reported in 21 patients [33%]. In all cases, symptomatic treatment and local wound care were applied. Additionally, systemic antibiotics were used in 13 cases and cryotherapy in 11 cases. Orf is an endemic infection in Jordan. Although it is a self-limiting disease, prompt diagnosis is of paramount importance in order to alleviate the anxiety of patients because the lesions could resemble other more serious infections, and to avoid inappropriate treatments and possible complications. A national emphasis on the cognizance of the infection, public awareness and preventive measures is highly recommended

Furosemide induced linear IgA bullous dermatosis

A case of linear IgA bullous dermatosis in a 59-year-old female patient is reported. She developed generalized erythema and bullous eruption few months after starting furosemide treatment for arterial hypertension. Histopathology revealed a subepidermal blister, and direct immunofluorescence disclosed linear IgA deposits along the epidermal basement membrane. To the best of our knowledge, this is the first report of this disease from Jordan

Cryotherapy for the management of genital warts in pregnancy: a five-year observational study

This observational study aims to review our experience in using cryotherapy for the management of genital warts during pregnancy over a five-year period. Fifty-three pregnant women with established genital warts were managed during the period from January 2000 to April 2005. There were 23 patients in the first trimester, 22 in the second, and 8 in the third trimester. Base line laboratory investigations were performed to establish any abnormalities and any other concurrent sexually transmitted diseases before starting treatment in each patient. Sexual abstinence or the use of protective barriers was advised to all patients. Cryotherapy was performed for the treatment of all genital warts. The treatment was on an out-patient basis, and the women were followed up every two weeks throughout pregnancy, and every month afterwards until nine months post delivery. Infants were also examined at birth and at nine months of age. There was dramatic response to local cryotherapy during pregnancy against genital warts, with 84.9% clearance of lesions prior to delivery. There were no cases of premature labour or premature rupture of membranes directly related to treatment, and there were no cases of neonatal genital or laryngeal involvement. Although no recurrences of lesions were observed before delivery, there was an overall recurrence rate of 45.3% at nine months post delivery. Cryotherapy is an effective and safe method for the treatment of genital warts throughout pregnancy

potential relation between telogen effluvium and iron deficiency in adult females

To examine the association between chronic telogen effluvium and iron deficiency in adult females. Seventy-two adult menstruating women with chronic telogen effluvium and 30 healthy adult females were enrolled into the study. All women were interviewed and clinically examined. The hair pull test was additionally utilized as part of the physical examination for the assessment of hair growth. Laboratory tests included measurements of hematocrit, serum ferritin levels, liver function tests, renal function tests, thyroid hormones, serum testosterone, and dehydropiandrosterone. The results of hematocrit values and serum ferritin levels in patients and controls were analyzed and statistically compared. Patients with chronic telogen effluvium and low serum ferritin levels were given oral iron treatment in the form of ferrous sulphate 600 mg daily for 4 months. At the end of the study period improvement in their hair growth and serum ferritin levels re-assessed. The mean age of patients was 26 years and for controls was 32 years. Hematocrit measurement were similar in both groups, but there was a statistically significant difference in the mean serum ferritin levels [p<0.05] between patients and controls [18.7 and 47.6ng/mL, respectively]. All patients treated with iron had elevation in their serum ferritin levels, and most of them experienced improvement in their hair growth. There was a significant association between low serum ferritin levels and chronic telogen effluvium, therefore, serum levels may be of value in the evaluation of adult menstruating women with chronic diffuse hair loss