RESUMO
Pneumococcus is the most frequently encountered causative pathogen in community-acquired pneumonia in elderly patients. The pneumococcal polysaccharide vaccine (PPV23) is widely used for preventing pneumococcal diseases in adults. PPV23 is relatively safe; however, some cutaneous adverse reactions, including localized mild inflammation associated with erythema, a sensation of heat, and tenderness, have been reported. Systemic reactions such as myalgia, arthralgia, and headache have also been reported, though severe adverse reactions are rare. In the Korean literature, a case of localized toxic reaction near the injection site after pneumococcal conjugate vaccine (PCV13) administration was previously reported. However, there are no published reports of a generalized skin rash after PPV23. Herein, we report a case of PPV23-induced generalized skin rash on the face, neck, upper trunk, and both arms with a local adverse reaction at the injection site after vaccination.
Assuntos
Adulto , Idoso , Humanos , Braço , Artralgia , Toxidermias , Eritema , Exantema , Cefaleia , Temperatura Alta , Inflamação , Mialgia , Pescoço , Vacinas Pneumocócicas , Pneumonia , Sensação , Pele , Streptococcus pneumoniae , VacinaçãoRESUMO
No abstract available.
Assuntos
Histiocitose , Histiocitose de Células não Langerhans , Estômago , XantomatoseRESUMO
Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare cutaneous T-cell lymphoma. Most cases are composed of large anaplastic cells. However, it presents a wide spectrum of histologic patterns. In the small cell variant, a small-sized pleomorphic cell morphology can be seen. A 74-year-old woman presented with an 8-month history of asymptomatic ulcerative plaque and satellite nodule on the right calf. Her past medical history was not specific. The histologic findings on punch biopsy specimens showed a malignant small round cell tumor on both lesions. The tumor cells had large pleomorphic nuclei with multinucleation and some eosinophilic cytoplasm. We performed immunohistochemical staining to rule out neuroectodermal tumor, neuroendocrine tumor, melanoma, lymphoma, and so on. However, the staining results were negative for pancytokeratin, CD3, CD20, CD99, chromogranin A, synaptophysin, CD56, ALK, HMB45, desmin, kappa, lambda, myoglobin, and S-100 protein. CT, MRI, and PET-CT were negative for extracutaneous involvement. Total excision was done, and additional immunohistochemical staining was performed to confirm the origin of the tumor. Staining results for vimentin, LCA, CD4, and CD30 were positive. We concluded that these findings were consistent with the small cell variant CD30+ PCALCL, which occurs rarely.
Assuntos
Idoso , Feminino , Humanos , Biópsia , Cromogranina A , Citoplasma , Desmina , Eosinófilos , Linfoma , Linfoma Anaplásico de Células Grandes , Linfoma Anaplásico Cutâneo Primário de Células Grandes , Linfoma Cutâneo de Células T , Imageamento por Ressonância Magnética , Melanoma , Mioglobina , Tumores Neuroectodérmicos , Tumores Neuroendócrinos , Proteínas S100 , Sinaptofisina , Úlcera , VimentinaRESUMO
Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare cutaneous T-cell lymphoma. Most cases are composed of large anaplastic cells. However, it presents a wide spectrum of histologic patterns. In the small cell variant, a small-sized pleomorphic cell morphology can be seen. A 74-year-old woman presented with an 8-month history of asymptomatic ulcerative plaque and satellite nodule on the right calf. Her past medical history was not specific. The histologic findings on punch biopsy specimens showed a malignant small round cell tumor on both lesions. The tumor cells had large pleomorphic nuclei with multinucleation and some eosinophilic cytoplasm. We performed immunohistochemical staining to rule out neuroectodermal tumor, neuroendocrine tumor, melanoma, lymphoma, and so on. However, the staining results were negative for pancytokeratin, CD3, CD20, CD99, chromogranin A, synaptophysin, CD56, ALK, HMB45, desmin, kappa, lambda, myoglobin, and S-100 protein. CT, MRI, and PET-CT were negative for extracutaneous involvement. Total excision was done, and additional immunohistochemical staining was performed to confirm the origin of the tumor. Staining results for vimentin, LCA, CD4, and CD30 were positive. We concluded that these findings were consistent with the small cell variant CD30+ PCALCL, which occurs rarely.
Assuntos
Idoso , Feminino , Humanos , Biópsia , Cromogranina A , Citoplasma , Desmina , Eosinófilos , Linfoma , Linfoma Anaplásico de Células Grandes , Linfoma Anaplásico Cutâneo Primário de Células Grandes , Linfoma Cutâneo de Células T , Imageamento por Ressonância Magnética , Melanoma , Mioglobina , Tumores Neuroectodérmicos , Tumores Neuroendócrinos , Proteínas S100 , Sinaptofisina , Úlcera , VimentinaRESUMO
BACKGROUND: Many patients seeking treatment for skin disorders have an underlying psychiatric problem that either causes or exacerbates a skin condition; thus, the demand for dermatologists' expert opinions on such cases is increasing. OBJECTIVE: The purpose of this study was to analyze and quantify the pattern of dermatologic consultations referred by the department of neuropsychiatry in a tertiary hospital. METHODS: We retrospectively studied data from 337 inpatients referred by the department of neuropsychiatry for dermatologic consultation during an 8.5-year period in a tertiary hospital. RESULTS: The percentage of department of neuropsychiatry patients who were referred to the department of dermatology for consultation was 15.3%. The most prevalent age group for referrals was 30~39 years (26.4%), and the male-to-female ratio was 1:1.6. Bipolar disorder was the most common underlying neuropsychiatric problem (31.1%), and eczema (36.5%) was the most common dermatoses, followed by infectious disease (27.6%). The main reasons for dermatologic consultations were dermatologic disease (71.5%) and treatment-related dermatoses (10.1%). Thirty-five cases were discordant as to the reason for consultation between psychiatrists and dermatologists. Neuropsychiatric medication-related adverse reactions were reported in 9.8% of referred patients. CONCLUSION: This study revealed the distribution of skin disorders in patients referred by department of neuropsychiatry for dermatologic consultation. We believe its findings could be helpful as educational material to encourage cooperation between the specialties of dermatology and neuropsychiatry.
Assuntos
Humanos , Transtorno Bipolar , Doenças Transmissíveis , Dermatologia , Eczema , Prova Pericial , Pacientes Internados , Neuropsiquiatria , Psiquiatria , Encaminhamento e Consulta , Estudos Retrospectivos , Pele , Dermatopatias , Centros de Atenção TerciáriaRESUMO
No abstract available.