ABSTRACT
Rosaceous lymphedema is considered to be a rare and disfiguring variant of acne rosacea. Cases remain difficult to treat and can challenge afflicted patients both cosmetically and psychologically. We describe an unusual presentation of rosaceous lymphedema and review the differential diagnosis of persistent facial edema.
Subject(s)
Face , Lymphedema/etiology , Lymphedema/pathology , Rosacea/complications , Biopsy, Needle , Diagnosis, Differential , Humans , Lymphedema/diagnosis , Male , Middle Aged , Rosacea/diagnosis , Skin Diseases/diagnosisABSTRACT
A case is presented of a woman who had an occlusive stroke at age 29. She was seen in a rehabilitation medicine clinic for central nervous system-mediated pain that had developed soon after a cerebrovascular event. After an extensive workup to find the cause of her cerebrovascular occlusion, it was discovered that she had a markedly elevated fasting plasma homocysteine level of 59 micromol/L. A discussion of premature vascular disease in the rehabilitation patient is followed by a short review of the clinical detection of, and potential therapy for, hyperhomocysteinemia.
Subject(s)
Cerebrovascular Disorders/etiology , Homocysteine/blood , Adult , Age of Onset , Cerebrovascular Disorders/blood , Female , Humans , Pain, Intractable/etiologyABSTRACT
OBJECTIVE: To determine the efficacy of clonidine in the management of gustatory facial sweating (GFS) ipsilateral to an upper thoracic sympathectomy. DESIGN: Placebo-controlled N-of-1 trial. SETTING: Tertiary care referral center. INTERVENTION: Clonidine patch that delivers 0.2mg/d. OUTCOME MEASURE: Daily episodes of GFS are recorded. The severity of GFS is graded as mild, moderate, or severe, and a daily GFS score is calculated. RESULTS: Clonidine was shown to significantly decrease (p < .05) the incidence and frequency of gustatory facial sweating.
Subject(s)
Adrenergic alpha-Agonists/therapeutic use , Clonidine/therapeutic use , Ganglia, Sympathetic/surgery , Ganglionectomy/adverse effects , Sweating, Gustatory/drug therapy , Administration, Cutaneous , Adult , Humans , Male , Sweating, Gustatory/etiologyABSTRACT
BACKGROUND: A new technique, electroporation, enhances the antitumor effects of a variety of chemotherapeutic agents. When used in combination with conventional chemotherapy, the procedure is termed electrochemotherapy. Exposure of cancerous tissues to pulses of electricity during electrochemotherapy appears to increase cell membrane permeability and thus intracellular access to cytotoxic drugs. Electrochemotherapy has been shown to have potent antitumor activity in a variety of in vitro studies, animal tumor models, as well as in clinical trials with squamous cell carcinomas of the head and neck. OBJECTIVE: The purpose of the study was to determine the effects of bleomycin-mediated electrochemotherapy on several basal cell carcinomas (BCCs) in two patients with nevoid BCC syndrome. METHODS: Electrical pulses were delivered to tumor nodules by means of caliper electrodes after systemic doses of bleomycin were administered. Vital signs were closely monitored during application of the electrical pulses. RESULTS: Partial responses were observed in tumors from both of the patients treated with electrochemotherapy; three partial responses were observed in one patient, and one partial response was observed in the other patient. Complete responses were seen in two lesions. Only minimal local or systemic side effects were noted in response to the therapy. CONCLUSION: To our knowledge, this is the first study that documents the effects of bleomycin-mediated electrochemotherapy on BCC. Studies are ongoing with intralesional bleomycin during electrochemotherapy to see whether additional antitumour effects can be produced in patients with BCC by this route of administration.
Subject(s)
Antibiotics, Antineoplastic/administration & dosage , Bleomycin/administration & dosage , Carcinoma, Basal Cell/drug therapy , Electroporation , Skin Neoplasms/drug therapy , Adult , Carcinoma, Basal Cell/pathology , Electric Stimulation Therapy , Humans , Male , Middle Aged , Skin Neoplasms/pathologyABSTRACT
BACKGROUND: Several years ago, the razor blade was introduced as an alternative device for performing the shave removal and/or biopsy of skin lesions. Though inexpensive and readily available, the razor blade is somewhat cumbersome to use and poses a risk for accidental injury to the practitioner. OBJECTIVE: We describe a modification of the razor blade shave biopsy procedure utilizing an innovative adaptor design. METHODS: A comparison of the adaptor-designed shave biopsy instrument to the standard razor blade device is made. RESULTS: The modifications implemented in the adaptor design serve to enhance the comfort of performing biopsies, minimize accidental injury, help save time, and provide for a more professional appearing way in which to obtain skin specimens. CONCLUSION: The new adaptor design helps to facilitate the safe and effective use of the razor blade in dermatologic practice.
Subject(s)
Biopsy/instrumentation , Skin/pathology , Biopsy/methods , HumansABSTRACT
Gustatory facial sweating has been described as a consequence of upper thoracic sympathectomy. Patients may also develop compensatory hyperhidrosis, sensory deficits, nipple hypersensitivity, and Horner's syndrome. In this article, we have reviewed three patients with reflex sympathetic dystrophy who developed gustatory facial sweating subsequent to endoscopic T2 and T3 ganglionectomy. This article also discusses the possible mechanisms of gustatory facial sweating.
