Solitary Endobronchial Papilloma: A Rare Entity.

Solitary papillomas of the lower airways are uncommon clinical entities that present a diagnostic challenge because they are not usually considered among the differential diagnoses. Reliable clinical data about their presentation and treatment remain scarce. We describe a case of an elderly male who presented to us with cough and hemoptysis. He had been a smoker for 50 years. Chest radiograph revealed hyperinflated lungs and slight hilar enlargement on the right side. Bronchoscopy revealed a polypoid mass at the origin of the right upper lobe bronchus. Biopsy showed it to be a papillomatous growth composed of squamous epithelial cells. No malignant cells were detected microscopically. Patient declined surgical removal of this papilloma. He was fine on followup visits during the subsequent months. In patients with hemoptysis, solitary endobronchial papilloma should also be considered in the differential diagnosis.

Bullous scabies: a case report and review of the literature.

BACKGROUND: Scabies is a common parasitic infection caused by the mite Sarcoptes Scabiei. About 300 million cases of scabies are reported annually. Scabies usually presents clinically with an erythematous excoriated papulovesicular rash, burrows, nodules and hyperkeratotic lesions in specific body areas. A rare presentation of scabies is the bullous pemphigoid-like bullous scabies. So far, to the best of our knowledge, only 32 cases of bullous scabies have been reported in medical literature, of which only 11 were under 60 years of age at the time of initial presentation. This is the first case of bullous scabies being reported from Pakistan. CASE PRESENTATION: Herein we discuss, with reference to the existing literature, the case of a 23-year-old Punjabi male who presented with a 3 day history of a tense, non-erythematous, non-tender bulla measuring approximately 0.5 cm x 0.8 cm on the right foot near the interdigital cleft. He was diagnosed to have bullous scabies. CONCLUSION: The diagnosis of scabies should be considered in all patients who present with tense bullous lesions accompanied by pruritus and a maculopapular rash. This is particularly relevant if these lesions do not resolve with steroid treatment. In such patients, in order to prevent a misdiagnosis of bullous pemphigoid, scrapings for Sarcoptes Scabiei mites and eggs should be taken.