ABSTRACT
The authors report a case of pyoderma gangrenosum in a 37-year-old woman that occurred at surgical sites after reduction mammoplasty. The diagnosis was delayed, but treatment with intralesional triamcinolone resulted in complete resolution o the condition. Pyoderma gangrenosum in this setting can mimic infectious causes of wound necrosis. Early recognition of its characteristics features may prevent unnecessary and ineffective treatment, thereby avoiding frustration for both patient and physician.
Subject(s)
Breast Diseases/etiology , Breast/surgery , Postoperative Complications , Pyoderma/etiology , Skin Ulcer/etiology , Surgery, Plastic , Adult , Breast Diseases/diagnosis , Breast Diseases/drug therapy , Diagnosis, Differential , Female , Humans , Postoperative Complications/diagnosis , Postoperative Complications/drug therapy , Pyoderma/diagnosis , Pyoderma/drug therapy , Skin Ulcer/diagnosis , Skin Ulcer/drug therapy , Surgical Wound Infection/diagnosis , Triamcinolone/therapeutic useSubject(s)
Arthritis/etiology , Blind Loop Syndrome/complications , Dermatitis/etiology , Postgastrectomy Syndromes/complications , Blind Loop Syndrome/drug therapy , Calcium/therapeutic use , Female , Humans , Middle Aged , Tissue Adhesions/complications , Tissue Adhesions/surgery , Vitamin D/therapeutic useABSTRACT
Of the 31 patients who developed polyarthritis following jejunoileal bypass for obesity, 24 had cutaneous vasculitis (urticarial, pustular, and nodular), 11 paresthesias, 10 Raynaud's phenomenon, and 1 pericarditis. Blind loop symptoms (14 of 26 patients), cryoglobulinemia (10 of 28), and immune deposits in biopsied skin lesions (5 of 7) support the theory of a relationship between bowel bacteria and immune complexes. Treating the blind loop with antibiotics and sphincteroplasty to prevent bacterial reflux into the blind loop helped 5 of 10 and 6 of 9 patients, respectively. A comparison is made to other bowel associated arthritides.
Subject(s)
Arthritis/etiology , Blind Loop Syndrome/etiology , Dermatitis/etiology , Ileum/surgery , Jejunum/surgery , Obesity/therapy , Anti-Bacterial Agents/therapeutic use , Antigen-Antibody Complex/immunology , Blind Loop Syndrome/drug therapy , Blind Loop Syndrome/surgery , Complement C3/analysis , Complement C4/analysis , Cryoglobulins/analysis , Dermatitis/immunology , Dermatitis/pathology , Humans , Paresthesia/etiology , Postoperative Complications , Raynaud Disease/etiology , Syndrome , Vasculitis, Leukocytoclastic, Cutaneous/etiologyABSTRACT
Four patients are reported with concomitant erythrasma and trichophyton rubrum dermatophytosis of the groin. The recognition and diagnosis of these associated infections is emphasized.
Subject(s)
Corynebacterium Infections/complications , Erythrasma/complications , Inguinal Canal , Skin Diseases, Infectious/complications , Tinea/complications , Adolescent , Adult , Erythrasma/pathology , Female , Humans , Male , Microscopy, Electron , Microscopy, Fluorescence , Skin/pathology , Skin/ultrastructure , Skin Diseases, Infectious/pathology , Tinea/pathologyABSTRACT
Electronmicroscopic studies confirmed that melanoacanthoma is a non-nevoid elevated epithelial tumor composed of keratinocytes of both basaloid and spinous differentiation and of large dentritic melanocytes. The block in transfer of pigment from melanocytes to keratinocytes was found not to be complete. Langerhans cells, present in the malpighian layers were normal in morphology. Immunofluorescent studies and an immunoprecipitin assay also showed our patient's melanoacanthoma not to be related to malignant melanoma.
