Porocarcinoma ecrino pigmentado en cuero cabelludo: a propósito de un caso / Pigmented eccrine porocarcinoma of scalp: a case report

El poroeorcinoma ecrino es un tumor cutáneo maligno infrecuente que deriva de las glándulas sudoríparas ecrinas y que afecta fundamentalmente a personas de edad avanzada. Se localiza con mayor frecuencia en extremidades inferiores, cara y cuero cabelludo y son potencialmente agresivos, tanto localmente como a distancia. Reportamos el caso de una paciente con diagnóstico de Porocarcinoma Ecrino Pigmentado en cuero cabelludo, que fue tratado con extirpación total de la lesión.

Eccrine porocorcinoma is a rare malignant skin tumor derived from eccrine sweat glands. It affects primarily older people and is found more frequently in lower extremities, face and scalp, and is potentially aggressive, both locally and through methastasis. We describe o patient diagnosed with pigmented eccrine porocarcinoma of the scalp, and treated with total excision of the lesion.

Aripiprazole overdose causing neuroleptic malignant syndrome: A clinical report and brief review.

A student on aripiprazole (an atypical second generation antipsychotic drug) was admitted with deliberate overdose of the drug, and in the course of her hospital stay developed a clinical picture of mild neuroleptic malignant syndrome (NMS). She survived after supportive care. A brief review is included on the incidence of NMS secondary to aripiprazole overdose, and reveals an increasing incidence

Pulmonary arteriovenous malformations.

Pulmonary arteriovenous malformations rarely present in childhood. Two cases are presented in this report. Both the cases presented clinically with cyanosis and clubbing without a cardiac murmur. The second case had cerebral abscess in addition. Both the cases underwent a contrast-enhanced echocardiography which suggested the presence of pulmonary arteriovenous malformations. The first case also underwent 99mTc radionuclide scan and pulmonary angiography. The cases are being reported for their characteristic clinical features and for emphasizing the role of non-invasive modalities like contrast-enhanced echocardiography and radionuclide scan in reaching the diagnosis.

Glanzmann's thrombasthenia.

Glanzmann's thrombasthenia (GT) is an uncommon cause of bleeding in children. We diagnosed two siblings as having GT on the basis of flow cytometric studies. Both had cutaneous bleedings and epistaxis since early childhood. Hematological investigations revealed prolonged bleeding time and a normal platelet count. Both the patients had absence of aggregation of platelets with the agonist adenosine diphosphate. Absence of the GPIIb/IIIa receptor was confirmed by flow cytometry. A short review of the disorder is presented.

Study of Takayasu's arteritis in children: clinical profile and management.

AIMS: To study clinical features, pattern of involvement and treatment modalities of Takayasu's arteritis (TA) in children. MATERIAL AND METHODS: Retrospective analysis of hospital records of children admitted over a period of 4.5 years. RESULTS: 17 patients in the age group of 5 to 11 years (M: F = 1.1: 1) were diagnosed to have TA on the basis of Ishikawa's criteria. One child was diagnosed post-mortem. The commonest presenting features were hypertension (64. 7%), congestive cardiac failure (47%), weak or absent peripheral pulses, cardiomyopathy (41.1% each) and cardiac valvular affection (35.2%). Retinopathy, hypertensive encephalopathy and abdominal bruits were uncommon. None presented in the prepulseless phase. No patient had an active tuberculous lesion, although Mantoux or BCG test was positive in 6 (35.2%). The predominant pattern of angiographic affection was Type II (52.9%). Nephrotic syndrome and portal cavernoma seen in one patient each were incidental associations. Anti-hypertensive drugs, oral steroids and drugs to control congestive heart failure were the mainstays of medical management. Antitubercular therapy was started in six patients. Angioplasty was attempted in 15 cases and proved to be partially beneficial in six. Three patients who failed to respond to medical management had to undergo surgical procedures, either bypass, nephrectomy or both. In-hospital mortality was 11.7%. CONCLUSIONS: Patients of TA in this study presented acutely in the pulseless phase, with hypertension and its complications. Type II involvement was the commonest pattern. Anti-hypertensive agents and steroids along with angioplasty were partially successful in controlling symptoms in 35.2%. Surgical procedures were reserved for a minority with poor response to drugs and angioplasty.

Chloroquine induced parkinsonism.

A case of parkinsonism is reported in a 5-years-old male child following prolonged use of chloroquine. The patient presented with reduced spontaneous movements and speech with an expressionless face and a parkinsonian gait but no tremors. His investigations including CT scan brain, CSF study and serum ceruloplasmin were normal. Chloroquine was discontinued and the patient was started on oral trihexyphenidyl. The patient showed gradual recovery and the drug was successfully withdrawn. The toxic manifestations were only transient and reversible.