Diaphragmatic Endometriosis Presenting as Recurrent Catamenial Pneumothorax: A Case Report.

Catamenial pneumothorax is one of the most common extra-pelvic presentations of endometriosis, with the gastrointestinal tract being the most common location. Catamenial pneumothorax is defined as spontaneous recurrent pneumothorax occurring in women of reproductive age in a temporal relationship with menses. Symptoms include dyspnea, sharp chest pain, and hypoxemia. A much rarer presentation is the involvement of endometriosis with the diaphragm. In this case, we present a 31-year-old female who presented with signs of pneumothorax. She has had multiple episodes leading to suspicion of catamenial pneumothorax. However, it wasn't until her surgery that the extent of diaphragmatic involvement, characterized by numerous holes secondary to endometriosis, was discovered. She was surgically treated, which led to a drastic improvement in symptoms and a reduction in subsequent episodes. We hope that this case can add to the current limited literature on diaphragmatic endometriosis cases. Since this patient presented with mainly catamenial pneumothorax symptoms, we urge clinicians to still consider diaphragmatic involvement as a primary cause in patients with recurrent episodes of pneumothorax.

Basal Cell Carcinoma of Hand Presenting With Severe Sepsis.

Basal cell carcinoma (BCC) is one of the most common skin malignancies in the United States. It commonly presents in the neck and head as a papulo-nodular lesion that is slow-growing with rare metastasis. BCC has a high curative rate often with Mohs surgery or excision of the lesion. In this case, we present an 80-year-old male who presented to the emergency department with a necrotizing wound on his left hand and met sepsis criteria. His necrotizing wound was identified as severe BCC of his hands which he has a 10-year history diagnosis of. He received appropriate sepsis measures with fluids, antibiotics, and blood transfusions but denied any further care for his BCC. Our case is unique because hands are an extremely uncommon presentation location of BCC. It is also unique because he presented as an extremely aggressive case while most cases of BCC are relatively innocuous. Early management of BCC is important, especially with a multidisciplinary approach as it can significantly reduce mortality risk.

The Association Between Pica and Iron-Deficiency Anemia: A Scoping Review.

There are many presentations of iron-deficiency anemia associated with pica in adults, but there is a lack of literature summarizing its different presentations. In this scoping review, we sought to identify the various presentations and if treatment of iron-deficiency anemia resolved the presenting symptoms of pica. This review was conducted by completing the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) checklist. The following electronic databases were searched for potentially eligible articles: PubMed, ProQuest, and Bielefeld Academic Search Engine (BASE). Study screening procedures were completed with a narrative synthesis. The data is synthesized and interpreted by sifting, charting, and sorting based on organ systems. Twenty articles met the inclusion criteria and were included in the scoping review. Regardless of other clinical presentations, the identification of pica symptoms allowed treatment for iron deficiency and led to the resolution of all symptoms in all 20 articles. Therefore, it is imperative to map the available evidence to inform clinicians and allow for better patient care.