Queratodermia acuagénica / Aquagenic keratoderma

Resumen Introducción: La queratodermia acuagénica se desencadena tras el contacto de las palmas de las manos y las plantas de los pies con el agua. Se caracteriza por la aparición de pápulas translúcidas que forman placas de aspecto macerado. Puede asociarse con el consumo de ciertos medicamentos y con afecciones como la fibrosis quística, la atopia y la desnutrición, o ser idiopática. Caso clínico: Se describe el caso de una paciente de 17 años con dolor abdominal crónico funcional. Presentó una dermatosis de 2 meses de evolución que afectaba las palmas con «arrugamiento¼ después del contacto con el agua. Tras el estímulo con el agua, se observaron hiperlinealidad palmar y pápulas blanquecinas y translúcidas que formaban placas de aspecto macerado con una depresión central. Dermatoscópicamente se observaron estructuras blanquecinas anfractuosas de apariencia coraliforme y microgotas de agua. En el estudio histológico se observaron hiperqueratosis continua y dilatación del acrosiringio desde la dermis media hasta el estrato córneo. Con el cuadro clínico y los hallazgos histológicos, se confirmó el diagnóstico de queratodermia acuagénica y se inició el tratamiento, con el que se observó una mejoría parcial. Conclusiones: La queratodermia acuagénica es una afección subdiagnosticada y poco reportada. A pesar de cursar de forma indolente, puede considerarse como un marcador de enfermedad sistémica como la fibrosis quística. Ya que existe discusión sobre la nomenclatura de la enfermedad, consideramos ajustarnos a una nomenclatura descriptiva, como «placas blanquecinas y maceradas acuagénicas del acrosiringio¼. Es necesario continuar reportando estos casos para comprender mejor la enfermedad, ofrecer un manejo adecuado y dar seguimiento integral a los pacientes.

Abstract Background: Aquagenic keratoderma is triggered in the palms and soles after contact with water, and is characterized by the appearance of translucent papules forming macerated plaques. It may be associated with medications and diseases such as cystic fibrosis, atopy, and malnutrition, or be idiopathic. Case report: We describe the case of a 17-year-old female patient with chronic functional abdominal pain. She presented with a 2-month history of "wrinkling" of palms after contact with water. After stimulation with water, palmar hyperlinearity and whitish, translucent papules forming macerated-looking plaques with a central depression were observed. Dermoscopically, we observed whitish and anfractive structures with coral appearance and microdroplets of water. In the histological study, we observed continuous hyperkeratosis and acrosyringium dilation from the middle dermis to the stratum corneum. With the clinical presentation and histological findings, aquagenic keratoderma was diagnosed, and treatment was started with partial improvement. Conclusions: Aquagenic keratoderma is an underdiagnosed entity. Despite its indolent course, it could be considered as a marker of a systemic disease such as cystic fibrosis. Since the discussion about the terminology of the disease has arisen, we considered adjusting to a descriptive nomenclature, proposing the term whitish macerated aquagenic plaques of the acrosyringium. It is necessary to continue reporting these cases to understand the disease better and offer adequate management and comprehensive follow-up to the patients.

Polyarticular charcot: A rare case report and a literature review in Indian context

Charcot or neuropathic arthropathies are a progressive form of destructive, erosive and generally painless arthropathies.Prevalence of neuropathic joints has decreased globally with reduction in the cases of leprosy and syphilis. However,syringomyelia and diabetes mellitus have emerged as the major causes for upper limb and lower limb Charcot jointsrespectively. Literature evidence shows lack of India data pertaining to these arthropathies. The present study describesa case of polyarticular Charcot in a patient with syrinx and Chiari malformation. The patient history revealed a provisionaldiagnosis of rheumatoid arthritis and Koch’s elbow, and was treated with anti-tubercular treatment (ATT) and diseasemodifying anti-rheumatic drugs (DMARDS). Nervous system examination would have easily led to the diagnosis ofsyringomyelia. The present study also provides a review of Indian literature on neuropathic joints from 2001 to 2019.Diabetes mellitus, syringomyelia, leprosy and syphilis are major etiologies for Charcot joints.

Missed Diagnosis of Syrinx

STUDY DESIGN: Prospective, randomized, controlled human study. PURPOSE: We checked the proportion of missed syrinx diagnoses among the examinees of the Korean military conscription. OVERVIEW OF LITERATURE: A syrinx is a fluid-filled cavity within the spinal cord or brain stem and causes various neurological symptoms. A syrinx could easily be diagnosed by magnetic resonance image (MRI), but missed diagnoses seldom occur. METHODS: In this study, we reviewed 103 cases using cervical images, cervical MRI, or whole spine sagittal MRI, and syrinxes was observed in 18 of these cases. A review of medical certificates or interviews was conducted, and the proportion of syrinx diagnoses was calculated. RESULTS: The proportion of syrinx diagnoses was about 66.7% (12 cases among 18). Missed diagnoses were not the result of the length of the syrinx, but due to the type of image used for the initial diagnosis. CONCLUSIONS: The missed diagnosis proportion of the syrinx is relatively high, therefore, a more careful imaging review is recommended.

Descripción anatómica del esqueleto de los tractos respiratorios superiores del periquito australiano (Melopsittacus undulatus) / Anatomical description of upper respiratory tracts skeleton of budgerigar (Melopsittacus undulatus)

Se describe detalladamente los elementos esqueléticos de los tractos respiratorios superiores de 10 periquitos australianos (Melopsittacus undulatus), dicha descripción permitió encontrar claras diferencias en su anatomía no referidas con anterioridad, debido posiblemente al interés por estudiar la siringe y no los tractos respiratorios completos, el objetivo principal fue describir la morfología y osificación de los tractos respiratorios superiores del periquito australiano, a través de la técnica de transparentación con doble tinción (rojo de alizarina "S" y azul de alciano), que permite observar la osificación de los tractos respiratorios; obteniendo como resultado dos diferencias óseas importantes: (1) la lengua exhibe dos pequeños huesos paraglosales asociados con la movilidad de la misma y (2) una importante osificación desde la lengua hasta los elementos "A" siringeales. En cuanto al patrón del esqueleto traqueal y siríngeo, no se observan grandes diferencias con respecto a otros psittaciformes. Se propone el estudio del esqueleto lingual para determinar su importancia en el establecimiento de relaciones de parentesco y su valor taxonómico, y de esta forma, abrir una puerta para nuevos estudios de morfología comparativa.

In this work describes in detail skeletical elements of upper respiratory tracts of 10 budgerigars (Melopsittacus undulatus), the description obtains evident differences in its anatomy doesn't relate before, this should to be possible at interest to study syrinx and not full respiratory tracts the objective was to describer morphology and ossification of full upper respiratory tracts of budgerigar, this obtained utilizing clearing technique's with stain double (alizarin red "S" and alcian blue) it allows to observe ossification of respiratory tracts, it obtained like result two principal evident differences: (1) the lingual shows two small paragloss bones associates with its mobility and (2) a important ossification from the lingual to "A" syrinx elements. Respectful at patron tracheal and syrinx skeletical doesn't show evident differences in comparation with other psittacidae. It proposes a study of lingual skeletical to determination of importance for to establish relationship and its taxonomic value and this form meets a door for new studies of comparative morphology.

Dimorfismo sexual da traquéia e siringe de periquito (Touist sp. ) / Sexual dimorphism of the parakeet (Touist sp. ) trachea and syrinx

Investigaram-se as diferenças morfológicas da siringe do periquito Touist sp, cinco machos e cinco fêmeas. A traquéia e a siringe foram dissecadas com o auxílio de uma lupa estereoscópia e avaliaram-se o número de anéis, o comprimento da traquéia e da siringe e o comprimento e espessura do músculo traqueolateral. A traquéia do macho apresentou maior número de anéis e maior comprimento que a das fêmeas. O músculo traqueolateral dos machos é mais vigoroso e origina-se no 43º anel traqueal enquanto o das fêmeas origina-se no 30º anel traqueal e se insere no primeiro anel bronquial. A siringe do piriquito é constituída por anéis craniais, cinco nos machos e três nas fêmeas, anéis intermediários, com formato semelhante a uma bolha sulcada ventralmente, anéis caudais, quatro em ambos os sexos, e pessulo. O dimorfismo sexual está presente na morfometria da musculatura e das cartilagens, o que reflete no canto mais vigoroso dos machos

The morphologic differences of the trachea and syrinx of five male and five female Touist sp. parakeets were studied. Trachea and syrinx were dissected with the aid of a stereoscopic magnifying glass and the number of rings, the length of trachea and syrinx were evaluated, as well as the length and thickness of the tracheolateral muscle. Trachea of male parakeets had larger amount of rings and was lengther than the female. Tracheolateral muscle of the males was more vigorous and arised in the 43rd tracheal ring while in the females it originated in the 30th tracheal and inserted in first bronchi ring. The syrinx was constituted by cranial rings (five in males and three in females), intermediate rings (resembly a bubble furrowed ventrally), caudal rings (four in both sexes) and the pessule. Sexual dimorphism directly influenced on the syrinx, concerning the morfometry of the musculature and cartilages, making males sound more vigorously

Comparative anatomy of the syrinx in the tribe arini (Aves psittacidae)

The syrinx is the organ responsible for producing the vast majority of bird sounds. Because its anatomyvaries greatly among bird taxa, prior knowledge of variations is extremely important to studies of functionalanatomy and phylogenetic systematics. With the aim of accessing and describing morphological variationin birds of the tribe Arini, this paper presents the findings of a comparative analysis of the syrinxes of 156specimens belonging to 47 species in 22 genera of the tribe. A number of hitherto unknown variationsare highlighted and confronted with the knowledge produced to date on the morphology of the syrinx inPsittaciformes. Some of the variations detected occurred in structures probably involved in sound productionand this should be taken into consideration in future studies of functional anatomy. Several characterssuggest the presence of a phylogenetic signal, given the congruence between their distribution among taxaand the hypotheses regarding monophyletic groupings proposed in the literature. Some of the variationsfound, including those suggesting a phylogenetic signal, are intraspecifically polymorphic, which reinforcesthe importance of using series of specimens in studies of syrinx anatomy.

Should syrinx be treated in patients with scoliosis complicated by syringomyelia without neurologic symptom / 中国矫形外科杂志

[Objective]To investigate whether syrinx should by treated before correction in patients with scoliosis complicated by syringomyelia without neurologic impairment. [Method]Thirty-five cases were divided into experimental group(group A,without preoperative surgical intervention to syrinx,15 cases)and control group(group B,with preoperative surgical intervention,20 cases) randomly. The coronal plane Cobb's angle,the length of syrinx,the position of syrinx,the biggest diameter of syrinx and S/C ratio were measured and compared between 2 groups.[Result]There was no significant difference in the correction rate and loss rate between two groups.The postoperative syrinx index(biggest diameter of syrinx,syrinx length and S/C ratio) was significantly smaller than that of preoperation(P

Caracterização Morfológica de Três Espécies de Broca-da-Haste em Chuchuzeiro (Coleoptera: Cerambycidae, Lamiinae) / Morphological Characterization of Three Species of Stem Borer (Coleoptera: Cerambycidae, Lamiinae) in Chayote

The simultaneous occurrence of Adetus analis (Haldeman), Adetus fuscoapicalis Breuning and Plerodia syrinx (Bates) (Coleoptera: Cerambycidae, Lamiinae) is reported boring the stems of chayote, Sechium edule. A. analis is the same species as Adetus muticus (Thomson) been wich was referred before by several authors in Brazil. A. analis and A. fuscoapicalis are similar in morphologic and ethologic aspects. This paper presents a detailed description and illustrations of both species in order to help in the identification of these species. P. syrinx, which shows the same attacking behavior of these species of Adetus, also had its morphological characters described, in pupal and adult stages.

A ocorrência simultânea de Adetus analis (Haldeman), Adetus fuscoapicalis Breuning e Plerodia syrinx (Bates) (Coleoptera: Cerambycidae, Lamiinae), broqueando ramos de chuchuzeiro Sechium edule (Jaqc.) Sw., é relatada. A. analis é sinônima de A. muticus (Thomson), que foi referida por diversos autores no Brasil. A. analis e A. fuscoapicalis são muito semelhantes quanto aos aspectos morfológicos e etológicos. Assim foi realizada uma descrição detalhada e ilustrações de ambas espécies a fim de promover uma identificação segura. P. syrinx, que apresenta comportamento de ataque semelhante ao das espécies de Adetus, também foi descrita em seus caracteres morfológicos nas fases de pupa e adulto.

Pathologic Findings of Experimental Post-traumatic Syringomyelia

An experimental model was devised to elucidate the role of spinal blockade in post-traumatic syringomyelia. 38 White adult rabbits were divided into four groups:in Group 1, eight animals received traumatic injury only to the midthoracic area via the weight-drop method but no further treatment;in Group 2, 12 animals received a traumatic injury following injection of 100mg kaolin suspended in 1cc normal saline into subarachnoid space at the midthoracic trauma level;in Group 3, nine animals received traumatic injury following injection of 200mg kaolin in 1cc of normal saline into subarachnoid space;in Group 4, nine animals without injury received an injection of 00mg kaolin in 1cc normal saline solution into subarachnoid space at the midthoracic level. The subjective criteria for syrinx formation were the presence of a definite round cyst having a smooth margin and an upper or lower extension of more than 2cm from the injured site. Syrinx formation was seen in 12.5% in Group 1, 41.7% in Group 2, 55.5% in Group 3 , and 0% in Group 4(p<0.05). In subarachnoid space, the specimen of trauma and kaolin groups showed neutrophils infiltration and obstruction of subarachnoid space on acute stage. The pathologic changes in subarachnoid space on chronic stage were infiltration of kaolin-laden macrophages and chronic arachnoiditis. In parenchyma, hemorrhagic necrosis of the cord, edema, microinfarcts and liquefaction of hematoma were found on acute stage, and multiple cysts in white mater, cell-debris-laden macrophages in the cyst, formation of foam cells, microcysts, and large yst were shown. In Group 4, the same findings as other groups were shown in the subarachnoid space, but in the parenchyma there was no cyst formation. The results suggest that subarachnoid block secondary to adhesive arachnoidities is important in initiating the extension of the syringomyelia cavity that have already formed at the time of initial injury.