ABSTRACT
INTRODUCTION: Shingles is the cutaneous expression of the reactivation of latent varicella zoster virus infection in sensory ganglia. It presents as vesicles in the corresponding dermatome. The condition is called disseminated herpes zoster (DHZ) when more than 2 contiguous dermatomes are affected, more than 20 vesicles are observed outside the initial dermatome, or involvement is systemic. DHZ is rare and most frequently occurs in immunocompromised patients. OBJECTIVES: To describe the epidemiology, predisposing factors, clinical presentation, laboratory findings, and clinical course of patients with DHZ, and to compare the findings in immunocompromised and immunocompetent patients. METHODOLOGY: We analyzed a retrospective case series of adults hospitalized between February 2010 and October 2015. RESULTS: Forty-one patients with virologically confirmed manifestations of DHZ were included. Stress as a trigger factor was detected in 39% and immunodepression in 58.5%. Immunocompromised patients were younger than the immunocompetent patients (mean ages, 60.5 vs 82 years, P<.01). The 8 immunocompetent patients with no detectable trigger factors were older (mean age, 85 years). In 95% of cases, DHZ was initially limited to a single dermatome and then spread to other dermatomes or became disseminated. Thrombocytopenia was detected in 56% of cases. Complication rates were similar in immunocompromised and immunocompetent patients (54% vs 59%, P>.01). Six patients died; there was no difference in mortality between the 2 groups. CONCLUSION: This study provides evidence on the relationship between DHZ, the presence of underlying immunodepression, and complications. Immunosenescence may play an important role in the onset of this disease in older immunocompetent patients.
Subject(s)
Herpes Zoster/epidemiology , Acyclovir/therapeutic use , Aged , Aged, 80 and over , Anemia/etiology , Antiviral Agents/therapeutic use , Female , Herpes Zoster/complications , Herpes Zoster/immunology , Herpes Zoster/pathology , Humans , Immunocompetence , Leukopenia/etiology , Male , Middle Aged , Neuralgia, Postherpetic/epidemiology , Retrospective Studies , Risk Factors , Spain/epidemiology , Stress, Psychological/complications , Superinfection/epidemiology , Treatment OutcomeABSTRACT
Polish Laryngectomy Association Division in Bialystok is initiating and organising 5 rehabilitation sessions (3 in Lithuania and 2 in Poland) for people after total laryngectomy caused by cancer. 99 people took part in the above mentioned sessions. This report presents the program and affects of rehabilitation.
Subject(s)
Laryngectomy/rehabilitation , Physical Therapy Modalities , Psychotherapy , Speech Disorders/rehabilitation , Voice Disorders/rehabilitation , Female , Humans , Laryngeal Neoplasms/psychology , Laryngeal Neoplasms/rehabilitation , Laryngeal Neoplasms/surgery , Laryngectomy/adverse effects , Laryngectomy/psychology , Lithuania , Male , Physical Therapy Modalities/organization & administration , Poland , Psychotherapy/organization & administration , Societies, Medical , Speech Disorders/etiology , Speech Disorders/psychology , Treatment Outcome , Voice Disorders/etiology , Voice Disorders/psychologyABSTRACT
Ten patients with benign familial chronic pemphigus (BFCP) (Hailey-Hailey disease) were evaluated; semiologic and localization differences were described, and special attention was given to solitary or atypical forms. In all the cases, the diagnosis was confirmed by histopathology; some histopathologic differences and the results achieved by direct immunofluorescence of skin are discussed. Most of the patients responded to the treatment with corticosteroids and antibiotics.
Subject(s)
Pemphigus/genetics , Adult , Betamethasone/analogs & derivatives , Betamethasone/therapeutic use , Chronic Disease , Diagnosis, Differential , Drug Therapy, Combination , Female , Fluorescent Antibody Technique , Gentamicins/therapeutic use , Humans , Male , Middle Aged , Pemphigus/diagnosis , Pemphigus/drug therapy , Prednisone/therapeutic use , Seasons , Skin/pathologyABSTRACT
We present the case of a patient thirty seven years old who has angiolymphoid hyperplasia with eosinophilia, diagnosis confirmed by histopathological examination, localized in ear's pavilion, ear's outer duct and beyond the ear. She has received intralesional injections of corticoid (because of a possible misdiagnosis). This provoked the appearance of a pyogenous process with a profuse, purulent and fetid secretion (Staphylococcus aureus) resistant to many antibiotics which was finally controlled with trimethoprim-sulfamethoxazole. We controlled the disease with radiotherapy applications and afterwards partial cryosurgery.
Subject(s)
Angiolymphoid Hyperplasia with Eosinophilia/pathology , Adult , Angiolymphoid Hyperplasia with Eosinophilia/drug therapy , Angiolymphoid Hyperplasia with Eosinophilia/radiotherapy , Biopsy , Combined Modality Therapy , Ear, External/pathology , Female , HumansABSTRACT
Se presenta un caso de fibromas perifoliculares multiples localizados en hemicara proponiendose la denominacion de fibromas perifoliculares multiples unilaterales, nueva forma clinica de este cuadro. Se efectua el diagnostico diferencial histologico con cuadros vecinos como el foliculoma, fibrofoliculoma y el tricodiscoma. Se describe la histogenesis de estos tumores y la clasificacion de los fibromas perifoliculares. Se senala el exito de la electrofulguracion como terapeutica
Subject(s)
Adult , Humans , Male , Fibroma , Skin NeoplasmsABSTRACT
Se presenta una nina de dos anos, con tumores fibromatosos, sobreelevados, firmes, indoloros, localizados en region dorsolateral de los dedos medio y anular de mano derecha. Aparecidos al mes de edad. Se comenta la clasificacion de fibromatosis juveniles dentro de las cuales se incluye la fibromatosis digital infantil y se realizan diagnosticos diferenciales. Se destaca el buen resultado terapeutico con criocirugia
Subject(s)
Child, Preschool , Humans , Female , Cryosurgery , Fingers , FibromaABSTRACT
Se presenta un caso de fibromas perifoliculares multiples localizados en hemicara proponiendose la denominacion de fibromas perifoliculares multiples unilaterales, nueva forma clinica de este cuadro. Se efectua el diagnostico diferencial histologico con cuadros vecinos como el foliculoma, fibrofoliculoma y el tricodiscoma. Se describe la histogenesis de estos tumores y la clasificacion de los fibromas perifoliculares. Se senala el exito de la electrofulguracion como terapeutica
Subject(s)
Adult , Humans , Male , Fibroma , Skin NeoplasmsABSTRACT
Se presenta una nina de dos anos, con tumores fibromatosos, sobreelevados, firmes, indoloros, localizados en region dorsolateral de los dedos medio y anular de mano derecha. Aparecidos al mes de edad. Se comenta la clasificacion de fibromatosis juveniles dentro de las cuales se incluye la fibromatosis digital infantil y se realizan diagnosticos diferenciales. Se destaca el buen resultado terapeutico con criocirugia
