Subject(s)
Erythema , Skin Diseases, Genetic , Middle Aged , Female , Humans , Erythema/diagnosis , Erythema/etiology , ExtremitiesSubject(s)
Onychomycosis , Aged , Humans , United States , Onychomycosis/drug therapy , Medicare , PrescriptionsABSTRACT
Aplasia cutis congenita (ACC) was diagnosed in a newborn with dysmorphic facial features, oligodactyly of the bilateral feet, and hip instability. The neonate's clinical abnormalities in addition to genetic testing confirmed a diagnosis of trichorhinophalangeal syndrome (TRPS) type II. The possibility of concurrent Adams-Oliver syndrome (AOS) is raised.
Subject(s)
Ectodermal Dysplasia , Langer-Giedion Syndrome , Limb Deformities, Congenital , Scalp Dermatoses , Ectodermal Dysplasia/complications , Ectodermal Dysplasia/diagnosis , Ectodermal Dysplasia/genetics , Humans , Infant, Newborn , Langer-Giedion Syndrome/complications , Langer-Giedion Syndrome/diagnosis , Langer-Giedion Syndrome/genetics , Limb Deformities, Congenital/diagnosis , Scalp , Scalp Dermatoses/diagnosisSubject(s)
Antibodies, Monoclonal, Humanized/adverse effects , Candida glabrata , Candidiasis, Invasive/etiology , Dermatologic Agents/adverse effects , Diabetes Mellitus, Type 2/drug therapy , Psoriasis/drug therapy , Pyelonephritis/etiology , Sepsis/etiology , Sodium-Glucose Transporter 2 Inhibitors/adverse effects , Benzhydryl Compounds/adverse effects , Candidiasis, Invasive/microbiology , Diabetes Mellitus, Type 2/complications , Female , Glucosides/adverse effects , Humans , Hypoglycemic Agents/therapeutic use , Insulin Detemir/therapeutic use , Liraglutide/therapeutic use , Middle Aged , Psoriasis/complications , Pyelonephritis/microbiology , Recurrence , Sepsis/microbiology , Urinary Tract Infections/etiology , Urinary Tract Infections/microbiologyABSTRACT
BACKGROUND: Psoriasis impairs the quality of life of approximately 7.5 million Americans and is associated with serious comorbidities. Because of chronic vascular access and epidermal dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater risk for infection, and psoriasis treatment could affect this risk. METHODS: A retrospective cohort analysis was performed using the United States Renal Data System from 2004-2011 to investigate the association of psoriasis with infections common to ESRD patients, as well as the effect of psoriasis treatment on infection risk as well as mortality. RESULTS: A total of 8,911 psoriasis patients were identified. Psoriasis was associated with a significantly increased risk for all queried infections, especially cellulitis (adjusted relative riskâ¯=â¯1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis treatment (systemic, local, and light) was associated with a significantly decreased risk of some infections. Psoriasis treatment was also correlated with a significantly decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants) showing the greatest reduction (adjusted hazard ratioâ¯=â¯0.55). CONCLUSIONS: These results suggest that psoriasis-ESRD patients may have an increased risk of infection and treatment of psoriasis is associated with a reduced risk of some infections and improved survival.
Subject(s)
Kidney Failure, Chronic/drug therapy , Kidney Failure, Chronic/mortality , Psoriasis/drug therapy , Psoriasis/mortality , Skin Diseases, Infectious/drug therapy , Skin Diseases, Infectious/mortality , Adrenal Cortex Hormones/administration & dosage , Aged , Cohort Studies , Databases, Factual/trends , Dermatologic Agents/administration & dosage , Female , Humans , Male , Middle Aged , Mortality/trends , Retrospective StudiesABSTRACT
Valsalva maneuvers have the potential to cause dermal capillary rupture manifesting as purpura and petechiae. We present a unique case of Valsalva purpura occurring in a 12-year-old girl after blowing up multiple balloons at a birthday party. Obtaining a detailed history proved essential to the diagnosis and curtailed any unnecessary workup or concern.
ABSTRACT
BACKGROUND: Dermal filler injection in the vicinity of the terminal facial artery (FA) can lead to vascular compromise with devastating consequences, including tissue necrosis, blindness, and stroke. OBJECTIVE: The purpose of this study was to examine lumen diameter and other anatomical features of the terminal FA relevant to dermal filler injection. MATERIALS AND METHODS: Eighteen embalmed adult cadavers were dissected along the distribution of the terminal FA. Gross and microscopic measurements were taken at predetermined points in its course. RESULTS: Mean lumen diameter was largest at the midpoint between the oral commissure and the lateral supra-alar crease (0.81 ± 0.36 mm; point P1) and smallest at the midpoint between the lateral supra-alar crease and the medial canthus (0.43 ± 0.23 mm; point P3). Mean cutaneous depth was deepest at the lateral supra-alar crease (5.06 ± 1.84 mm; point P2) and most superficial at the midpoint between the lateral supra-alar crease and the medial canthus (3.13 ± 2.07 mm; point P3). CONCLUSION: The large-caliber lumen diameter of the terminal FA creates the potential for intra-arterial injection with commonly used filler needles and blunt-tipped cannulas at all points in its course in the nasolabial fold and midface.
Subject(s)
Arteries/anatomy & histology , Cosmetic Techniques/adverse effects , Dermal Fillers/adverse effects , Lip/blood supply , Nasolabial Fold/blood supply , Aged , Aged, 80 and over , Arteries/injuries , Cadaver , Dermal Fillers/administration & dosage , Female , Humans , Injections, Subcutaneous/adverse effects , Injections, Subcutaneous/methods , Male , Middle AgedABSTRACT
Spinal muscular atrophy (SMA) type 0 is the most severe phenotype of SMA and is characterized by hypotonia, muscle weakness, and respiratory distress. Cutaneous necrosis, first described in an SMA mouse model, can occur in patients with severe disease; the use of targeted treatment versus supportive measures in the setting of skin necrosis is debated. We present a male infant with SMA type 0 with cutaneous necrosis of proximal and distal limbs who improved with supportive care. The seven previously reported cases of SMA skin necrosis are reviewed.
