Nailfold capillaroscopy alterations in androgenetic alopecia: A cross-sectional study

Background: Androgenetic alopecia is considered to be an independent predictor of mortality from diabetes mellitus and heart disease. However, whether androgenetic alopecia causes changes in microcirculation is unknown. Objective: The objective of the study was to investigate whether alterations in nailfold capillaries occur in androgenetic alopecia patients. Methods: The nailfold capillaroscopy images of androgenetic alopecia patients and matched controls were collected and analyzed. Results: The frequencies of avascular areas, dilated, bushy and bizarre capillaries and capillary disorganization, nailfold capillaroscopy scores of 2 or scores both 2 and 3 were significantly higher in the androgenetic alopecia group than in the healthy controls (9.0% vs. 0%, 57.7% vs. 19.2%, 3.8% vs. 0%, 2.8% vs. 1.3%, 3.8% vs. 0%, 38.5% vs. 12.8% and 39.7% vs. 12.8%, respectively). Limitations: The results of this study may be biased on account of the limited sample size or the presence of an undiagnosed disease in participants which could alter the nailfold capillaries. Conclusion: Bushy, bizarre and dilated capillaries, capillary disorganization, avascular areas and nailfold capillaroscopy scores of 2 or 2 and 3 were more common in androgenetic alopecia patients than in healthy controls. These findings indicate that abnormalities in microcirculation may be involved in androgenetic alopecia

Video-dermoscopic Assessment of Capillaroscopic Pattern in Hansen's Disease

Leprosy is a chronic granulomatous infectious disease with a proven role of Mycobacterium leprae invasion into endothelial cells. Animal studies have shown evidence of involvement of vasa nervorum in the process of nerve invasion. Capillaries act as the mirror image of vascular involvement in any rheumatic disorder and holds good for leprosy also. Nailfold capillaroscopy (NFC) is a non-invasive, easily reproducible technique to study proximal nailfold capillaries. The aim of this study is to investigate morphological nailfold capillaroscopic alterations in patients with leprosy in its various forms and comparison with the normal individual. Total 20 Leprosy patients and 20 normal age and sex matched individuals recruited for nailfold capillaroscopic examination using video dermoscopye. Among 20 normal individuals, 3(15%) individuals showed tortuous capillaries and microhemorrhages each, 2(10%) showed meandering vessels, 1(5%) each showed megacapillaries, dilated/ectatic capillaries and bizarre vessels. Out of 20 leprosy patients, 11 (55%) patients showed bizarre and meandering capillaries, 10(50%) showed dilated vessels and avascular areas, 9(45%) showed capillary dropouts and neovascularisation, 8(40%) showed tortuous vessels, 6(30%) haemorrhages and 4 (20%) showed megacapillaries. Findings like avascular areas, capillary dropouts, haemorrhages were more noticed in lepromatous and borderline lepromatous leprosy, whereas early capillary abnormalities like dilated, meandering, bizarre vessels and neoangiogenesis were noticed more in borderline tuberculoid leprosy. However, statistical significant difference between clinical and dermoscopic observations was not seen in this study. Further studies with a large sample size are required to find out the same. Morphological changes may denote micro-vascular invasion by Mycobacterium leprae and may act as warning signs of fore- coming complications like loss of sensation and trophic ulcers. Follow-up studies are required to understand such correlation, if any.

Habitando a noite nas trevas dos sentidos / Dwelling the night in the darkness of the senses / Viviendo la noche en la oscuridad de los sentidos / Vivre la nuit dans l'obscurité des sens

O presente trabalho expõe as ideias de Bion sobre transformações em alucinose, sustentadas por uma experiência clínica. Também trabalha as ideias de capacidade negativa, reverie e continente-contido. Traz considerações sobre a construção de significados pela dupla analista-analisando, tendo como pano de fundo manifestações de dor e terror que são experimentadas no campo analítico. A pergunta que o trabalho suscita (mas que não ousa responder) é: Como o analista poderá alcançar um instrumento auxiliar a fim de permitir que a sessão aconteça com atenção relaxada e atitude aberta, contribuindo para a sobrevivência do vínculo analítico, considerando a ocorrência de fatos não digeridos, objetos bizarros, identificação projetiva excessiva, alucinose, inveja e destrutividade?

The present work exposes Bion's ideas about transformations in hallucinosis, supported by a clinical experience. It also works on the ideas of negative capacity, reverie and continent-contained. It brings considerations about the construction of meanings by the analyst-patient duo, against the background of pain and terror manifestations that are experienced in the analytical field. The question that the work raises (but which it does not dare to answer) is: How can the analyst be able to reach an auxiliary instrument in order to allow the session to take place with relaxed attention and an open attitude, contributing to the survival of the analytic bond, considering the occurrence of undigested facts, bizarre objects, excessive projective identification, hallucinosis, envy, and destructiveness?

El presente trabajo expone las ideas de Bion sobre las transformaciones en la alucinosis, respaldadas por una experiencia clínica. También trabaja sobre las ideas de capacidad negativa, ensueño y continente-contenido. Aporta consideraciones sobre la construcción de significados por parte del dúo analista-paciente, en el contexto de las manifestaciones de dolor y terror que se experimentan en el campo analítico. La pregunta que plantea el trabajo (pero que no se atreve a contestar) es: ¿Cómo puede el analista llegar a un instrumento auxiliar para permitir que la sesión se desarrolle con una atención relajada y una actitud abierta, contribuyendo a la supervivencia del vínculo analítico, considerando la ocurrencia de hechos no digeridos, objetos extraños, identificación proyectiva excesiva, alucinosis, envidia y destructividad?

Le présent travail expose les idées de Bion sur les transformations dans l'hallucinose, soutenues par une expérience clinique. Il travaille également sur les idées de capacité négative, de rêverie et de contenu continental. Il apporte des réflexions sur la construction de sens par le duo analyste-analyseur, sur fond de manifestations de douleur et de terreur vécues dans le champ analytique. La question que pose le travail (mais à laquelle il n'ose pas répondre) est : Comment l'analyste peut-il accéder à un instrument auxiliaire afin de permettre à la séance de se dérouler avec une attention détendue et une attitude ouverte, contribuant à la survie de la lien, compte tenu de la survenue de faits non digérés, d'objets bizarres, d'une identification projective excessive, d'hallucinose, d'envie et de destructivité ?

Bizarre Leiomyoma of the Scrotum / 대한피부과학회지

No abstract available.

Leiomioma vaginal con núcleos atípicos. Informe de un caso / Vaginal leiomyoma with bizarre nuclei. A case report

Resumen ANTECEDENTES: Los tumores vaginales benignos son excepcionales: papilomas, hemangiomas, pólipos y leiomiomas. Estos últimos son los más raros (4-5% de todas las neoplasias vaginales) pues solo se han reportado alrededor de 300 casos. CASO CLÍNICO: Paciente de 47 años, acudió a la consulta ginecológica con una tumoración vaginal de dos meses de evolución, sin manifestaciones clínicas adicionales. En la exploración física se observó una tumoración elástica, en la cara posterolateral derecha de la vagina. La ecografía transvaginal no mostró la alteración. Después del tratamiento expectante inicial, en la siguiente revisión se comprobó el rápido crecimiento de la lesión y la manifestación de los síntomas vaginales. Se decidió la extirpación quirúrgica de la lesión. El estudio anatomopatológico reportó un leiomioma vaginal, con células con núcleos atípicos. Durante el seguimiento la paciente permaneció asintomática, sin signos de recidiva local. CONCLUSIÓN: Si bien los leiomiomas son los tumores benignos más frecuentes en mujeres en edad reproductiva, su manifestación vaginal es excepcional. El diagnóstico definitivo se establece en el estudio anatomopatológico y el tratamiento de elección es la extirpación quirúrgica completa. Los tumores con elevada celularidad, alta concentración de células atípicas y actividad mitótica incrementada pueden tener un comportamiento benigno. Las recidivas también son excepcionales.

Abstract BACKGROUND: Benign vaginal tumors are a very rare entity which includes papillomas, hemangiomas, polyps and leiomyomas. Leiomyomas are especially infrequent, constituting only 4-5% of all vaginal tumors. In literature, about 300 cases have been reported. CLINICAL CASE: 47-year-old patient, who attended a gynecological consultation with a vaginal tumor of two months evolution, without additional clinical manifestations. Physical examination refers to an elastic tumor on the right posterolateral aspect of the vagina. The transvaginal ultrasound did not show the alteration. After the initial expected treatment, in the following review the rapid growth of the lesion was observed, in addition to the manifestation of vaginal symptoms. Surgical removal of the lesion will be applied. The anatomopathological study reported a vaginal leiomyoma, and cells with bizarre nuclei. During the follow-up, the asymptomatic patient was observed, without signs of local recurrence. CONCLUSION: Although leiomyomas represent the most frequent benign tumors in women of reproductive age, their vaginal manifestation is exceptional. The gold treatment is complete surgical extirpation and the definitive diagnosis is established by anatomopathological study. Tumors with high cellularity, high concentration of bizarre cells and increased mitotic activity appear to have a benign behavior. Although it is rare, there are cases of recurrence.

Diagnosis and Treatment of Bizarre Parosteal Osteochondromatous Proliferation / 대한정형외과학회잡지

PURPOSE: There have been a few reports of bizarre parosteal osteochondromatous proliferation (BPOP) in Korea to date. The purpose of this study was to investigate the etiology, diagnosis, treatment, and prognosis of BPOP and to report the clinical outcomes from a single institution. MATERIALS AND METHODS: Between 1999 and 2016, six patients who were diagnosed and treated operatively at Yeungnam University Medical Center were reviewed retrospectively. The analysis was performed using medical records, simple radiographs, magnetic resonance imaging (MRI), and pathology results, based on clinical and oncological results. All patients underwent surgical treatment for complete resection. We also analyzed one patient who was initially diagnosed with BPOP, showing different clinical features during the follow-up period. RESULTS: The age of patients ranged from 17 to 60 years. All patients did not show a history of trauma. All patients showed localized edema on the tumor lesion, and three patients also showed tenderness. The tumor lesions were distributed to the femur, tibia, and humerus. All patients underwent marginal resection or wide resection. The mean follow-up period was 50.3 months. There was a malignant change in one patient, but no recurrence or metastasis. CONCLUSION: In this study, there was no difference in the incidence of BPOP in accordance with sex. Moreover, there was no significant relationship between trauma and onset of BPOP. Unlike previous reports, no recurrence occurred after complete resection. If BPOP is diagnosed, it is necessary to consider the possibility of malignant change and distinguish it from other malignant tumors.

Parosteal Lipoma Associated with Underlying Recurrent Bizarre Parosteal Osteochondromatous Proliferation (Nora's Lesion) of the Hand / 대한정형외과학회잡지

Parosteal lipoma is a benign tumor of the mature adipose tissue that contacts the periosteum of the underlying bone directly. The tumor commonly arises in the long bones, such as the femur, radius or tibia, and often exhibits underlying osseous changes, such as a cortical hyperostosis or erosion. Parosteal lipoma arising in a finger is rare. Furthermore, there are no reports of parosteal lipoma associated with underlying bizarre parosteal osteochondromatous proliferation. The authors present a rare case of parosteal lipoma of the proximal phalanx of the little finger accompanied by recurrent bizarre paroteal osteochondromatous proliferation in a 64-year-old male patient who had previously undergone an excisional biopsy at the same location 8 years earlier.

Pathologic diagnosis and differential diagnosis of bizarre parosteal osteochondromatous proliferation / 肿瘤研究与临床

Objective To study the clinicopathological features and differential diagnosis of bizarre parosteal osteochondromatous proliferation (BPOP). Methods The clinicopathological features of 3 patients with BPOP were analyzed , and related literature was reviewed. Results 3 patients included 2 males and 1 female with an average age 40 years old (24-53 years old). The lesions in three patients were located in the left side of the distal radius, the left side of the little finger inside and the right side of ulna coracoid, respectively. Histologically, characterized by unusual mineralized cartilaginous matrix (`blue bone'), the lesion was composed of a heterogeneous mixture of bone, cartilage and fibrous tissue. Conclusion BPOP is a rare benign surface osteocartilaginous lesion, and its diagnosis and differential diagnosis mainly depend on radiographic and histopathologic features.

Bizarre parosteal osteochondromatous proliferation and other similar lesions on humerus: a comparative analysis of clinicopathologic and imageologic characteristics / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic and imageologic characteristics of bizarre parosteal osteochondromatous proliferation (BPOP),osteochondroma and chondrosarcoma.Methods One case of BPOP on right humerus,one case of osteochondroma on left humerus,and one case of chondrosarcoma on right humerus were analyzed and compared on their clinical,pathologic and imaging manifestations and followup.Results The patients of BPOP and osteochondroma did not feel pain,but patient with chondrosarcoma felt severe pain.Microscopically,it was composed of different amounts cartilage,bone,and spindle cells with a poorly organized distribution.It appeared bizarre chondrocyte and characterized " blue bone".The mass was arising from the surface of the bone and the lesion was not cortical erosion and continuity with medullary cavity in the imaging findings.BPOP,osteochondroma and chondrosarcoma could be distinguished by the above characteristics.Conclusion BPOP is a rare and benign osteochondroma-like lesion,which may be confused with osteochondroma and chondrosarcoma.BPOP can be diagnosed definitely by combining histology with medical imageology.

A bizarre case report of self-harm by ingested lock trapped in oropharynx.

The present case report deals with a highly and yet unreported case of self-harm in which a medium sized lock was ingested with convulsive movements of the face and neck which ultimately got trapped in oropharyngeal region. The lock managed to „sink‟ and settled down in that region so that the patient did not feel any gross pain once it was swallowed. There was history of mental illness reported by the attendants of the patient that remained unverified since no treatment card or the name of drug(s) was shown to the treating team of doctors. Therefore, it remained speculative whether the attempt to swallow lock was as a result of psychiatric illness or was supplemented by other social factor notable the influence of “Tantrik”. Tantriks are special breed of spiritual healers who resorted to unscientific method of healing. At times they use unethical practices. There are reports in which tantrik have provoked their unsuspecting victims to highly complex maneuvers leading to self-harm. The present case, it is believed falls in this category.

Bizarre Parosteal Osteochondromatous Proliferation in the First Metatarsal Bone: A Case Report / 대한골관절종양학회지

Bizarre parosteal osteochondromatous proliferation (Nora's lesion) is a rare benign tumor and known to be primarily occur in the small tubular bone of the hands and feet. However, it is very unusual to be reported that it occurs in metatarsal bone in Korea. Thus, we report this tumor of metatarsal bone including the literature review because we have experienced this example.

Coexistence of atypical adenoma, adenoma with bizarre nuclei and follicular variant of papillary carcinoma of the thyroid.

Coexistence of atypical adenoma, adenoma with bizarre nuclei and follicular variant of papillary carcinoma is described in the same thyroid, with study of p53 expression. A 72-year-old woman presented to the endocrinology outpatient unit for a routine follow-up visit. Patient underwent a total thyroidectomy. Histological examination revealed a solid nodular neoplasm with the longest diameter of 0.8 cm in the upper pole of the left lobe. The neoplasm showed the histological features of follicular variant of papillary carcinoma with moderate diffuse immunoreactivity for p53. The lower pole of the right lobe showed two adjacent nodules with histological features respectively of atypical adenoma and adenoma with bizarre nuclei, with strong diffuse immunoreactivity for p53.

Bizarre Parosteal Osteochondromatous Proliferation (Nora's lesion) of the Big Toe. (A Report of Two Cases and Review) / 대한족부족관절학회지

Bizarre parosteal osteochondromatous proliferation (BPOP) is an rare benign tumor which involve mostly tubular bones of feet and hand. BPOP has clinical, radiographic, and histologic similarities with osteochondroma.Radiologically, BPOP has not central continuity with underlying osseous medulla. Histologically, the lesion has marked proliferative activity, and enlarged, bizzare, and binucleated chondrocytes.Despite the high risk of recurrence, treatment of choice is surgical resection. This report presents two cases of BPOP of the big toe with reviews of clinical, radiographic, and histological characteristics.

Leiomioma atípico / Atypical leiomyoma

Os autores relatam o caso de um leiomioma atípico ocasionalmente identificado em uma mulher de 45 anos submetida a histerectomia por sangramento uterino anormal. O leiomioma atípico, também conhecido como leiomioma bizarro ou simplástico, é um tumor pouco comum, sendo responsável por 0,5% a 1,0% das neoplasias mesenquimais uterinas. É caracterizado pela presença de células gigantes com múltiplos núcleos pleomórficos e cromatina grumosa. O seu comportamento biológico depende do seu índex mitótico e da presença de necrose tumoral. Paralelamente ao relato do caso, são discutidos os achados histopatológicos e clínicos do leiomioma atípico e a importância do seu diagnóstico diferencial com neoplasias malignas uterinas como o leiomiossarcoma.

The authors report a case of atypical leiomyoma occasionally identified in a woman of 45 who underwent hysterectomy for abnormal uterine bleeding. Atypical leiomyoma, also known as symplastic or bizarre leiomyoma, is an uncommon tumor accounting for 0.5-1.0% of uterine mesenchymal neoplasms. It is characterized by the presence of giant cells with multiple pleomorphic nuclei and granular chromatin. Its biological behavior depends on their mitotic index and the presence of tumor necrosis. Parallel to the case report we discuss the clinical and histopathological findings of atypical leiomyoma and the importance of its differential diagnosis with malignant uterine neoplasms such as leiomyosarcoma.

A Case of Subungual Bizarre Parosteal Osteochondromatous Proliferation of the Toe / 대한피부과학회지

Bizarre parosteal osteochondromatous proliferation (Nora's lesion) is a rare lesion with a tendency to recur. It is usually a solitary lesion that most often develops on the hands and feet. We now present a case of bizarre parosteal osteochondromatous proliferation initially misdiagnosed as subungual exostosis on the left great toe of a 13-year-old boy. The diagnosis was confirmed by radiologic and histopathologic features, followed by complete excision of the lesion. He had a relapse after two months and was treated with re-excision. We suggest that bizarre parosteal osteochondromatous proliferation should be considered in the differential diagnosis of any digital mass.

Bizarre Parosteal Osteochondromatous Proliferation of Middle Phalanx: A Case Report

Although bizarre parosteal osteochondromatous proliferation does not frequently occur, this calcified, osteal, chondromatous tumor has relatively high recurrence rates and presents clinical, radiological, histological features that can be classified with other lesions. And it is a benign disease that until now, there were no death or metastasis reports because of this tumor. This proliferation is hard to distinguish between other benign tumors and non-neoplastic lesions if it is occurred in small bone of hand or foot. We experienced bizarre parosteal osteochondromatous proliferation of middle phalanx of the little finger, and report this case and the review of relevant literature.

Aberrant Chromosomal Alterations in Bizarre Parosteal Osteochondromatous Proliferation (Nora's Lesion) of Hand: A Case Report / 대한정형외과학회잡지

Bizarre parosteal osteochondromatous proliferation is a disease similar to an osteochondroma that usually involves the metatarsal, metacarpal, proximal and middle phalanx. The symptoms are normally caused by the bone mass, the condition has a benign clinical course but recurrence is common. Recently, it was reported that there is a translocation between chromosome 1 and 17. We report a case of BPOP in the middle phalanx of hand with translocations and duplication in cytogenetic karyotyping with a review of relevant literature.

Bizarre Parosteal Osteochondromatous Proliferation: A report of five cases

Bizarre parosteal osteochondromatous proliferation was first described in 1983, when Nora and his collegues reported 35 examples of a proliferative lesion involving bones of the hands and the feet. In 1993, Meneses reported 65 cases of this condition. A fourth of all the reported cases involved the long bones. It is important to identify the clinical, roentgenographic, and histologic characteristic to seperate it from other entities because it is a benign lesion with atypical microscopic features with a tendency to recur. Roentgenograms show a calcific mass attached to the underlying cortex having a broad base. Histologically, the lesion exhibites proliferative activity, irregular bony cartilaginous interfaces, and enlarged, bizarre, and binucleated chondrocytes. We reviewed the bone tumors, diagnosed in the KyungHee University Hospital, dated from 1984 to 1994. Five cases were revised to Nora's lesion, all of which were previously diagnosed as osteochondroma. The ages of the patients ranged from 12 to 57 years (median, 19 years), and all of them were males. Two cases involved the bones of hands and feet (metacarpal and talus), and 3 cases involved the long bones (humerus, fibula, and ulna). One lesion involving the humerus has a recurrence. No metastasis had been reported.

Bizarre Parosteal Osteochondromatous Proliferation: A Report of One Case / 대한정형외과학회잡지

In 1983, Nora et. al. reperted 35 cases of bizarre parosteal osteochodromatous proliferations of the hands and feet. All lesions occured on proximal phalanges, metatarsals, or metacarpals. The gross appearance was typically that of a small osteochondroma. Radiologically, the proliferations lacked both central continuity of the tumor with the underlying osseus medulla and flaring of the adjacent cortices. Histologically, the lesion exhibited marked proliferative activity, irregular bohy cartilaginous interface, and enlarged, bizarre, and binucleate chondrocyte. The authors experienced a case of bizarre parosteal osteochondromatous proliferation of the right foot in a 61 year-old female which arised from the proximal phalanges of second toe, hostologic and radiologic findings were consistent with the bizarre parosteal osteochondromatous proliferation. The mass was treated by excision, and neither recurrence, nor malignant change was observed up to one year follow-up period.

A Case of Pleomorphic Xanthoastrocytoma

The pleomorphic xanthoastrocytoma has been known as a very rare type of glioma, which occurs mainly in the temporal lobe of the brain in young ages. It has distinctive characteristics regarding age, symptoms and signs, gross and microscopic features and relatively favorable prognosis despite of pleomorphism and bizarre giant cells in microscopic picture. The authors report a case of plemorphic xanthoastrocytoma presented with generalized seizure and review the past literatures.