ABSTRACT
Infectious diseases in the form of 'typhus' (74.2%) and 'fevers' (17.2%) were the commonest conditions accounting for entry to the Wakefield Workhouse Infirmary between 1826 and 1857, as recorded in the admissions book. Skin diseases were noted for 3.2% of admissions, principally scarlet fever (1.5%) and smallpox (0.8%). The mean age for primary dermatological admissions was 20â years (compared with 24â years for patients overall), with a mortality rate of 0.3%. The low number of smallpox cases may be the result of successful vaccination campaigns. The absence of admissions because of scabies (then known as 'the itch') might be as a result of exclusion of such patients from entry because of the known extreme infectivity of the condition. Workhouses played an important role in medical care in 19th century Britain but, in this example, skin diseases did not feature highly as causes of admission.
Subject(s)
Skin Diseases , Smallpox , Humans , History, 19th Century , Young Adult , Adult , Workhouses , Hospitalization , PruritusABSTRACT
The epidermal growth factor receptor (EGFR) is a transmembrane protein with tyrosine kinase signaling activity regulating many essential cellular functions, and loss of function mutations in EGFR result in a life-threatening neonatal syndrome. We present the case of a preterm boy born with intrauterine growth restriction who developed multisystem disease due to a homozygous mutation in the EGFR gene. He experienced a tumultuous and complex clinical course with recurrent skin infections and sepsis, nephrocalcinosis, failure to thrive, severe electrolyte imbalances, rectal perforation, and thrombus formation, and died after 11 months due to renal failure. This case report builds on work recently published in 2020 describing a case series of 18 similar patients and adds to the growing literature describing the severe phenotype and multisystem disease associated with loss of EGFR mutation in the Roma population.
