ABSTRACT
This article presents the case of a 25-year-old Moroccan male who contracted Orf disease (Ecthyma contagiosum), a common zoonotic viral infection in sheep and goats. The disease, caused by a parapoxvirus, can be transmitted to humans through contact with infected animals. The patient developed painful lesions on his fingers after interacting with a sheep during the Feast of Sacrifice. Diagnosis was clinically established considering exposure history and lesion characteristics. Treatment involved local antiseptics and 2% fusidic acid cream. The lesions resolved spontaneously over a few weeks without functional impairment.
Subject(s)
Pain , Viral Zoonoses , Adult , Animals , Humans , Male , Pain/etiology , Sheep , Viral Zoonoses/diagnosisABSTRACT
BACKGROUND: AS is a malignant tumor that originates from vascular endothelial cells and is known for a high rate of local recurrence and metastasis. CASE REPORT: A 48-year-old male presented with cutaneous epithelioid AS. Cutaneous AS of the foot is quite rare, especially in the absence of predisposing factors, and in this patient it was previously misdiagnosed as a DFU. CONCLUSION: Physicians should be aware of this rare presentation of cutaneous AS. The authors of the current report advise regular clinical reassessment of chronic ulcers and biopsies of nonhealing wounds, even when adequate wound treatment has been administered, with the goal of identifying ulcerated skin malignancies and preventing delay in providing appropriate treatment.
Subject(s)
Diabetes Mellitus , Diabetic Foot , Foot Ulcer , Hemangiosarcoma , Skin Neoplasms , Male , Humans , Middle Aged , Diabetic Foot/pathology , Hemangiosarcoma/diagnosis , Endothelial Cells/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Diagnostic Errors , Foot Ulcer/diagnosisSubject(s)
Leukemia , Skin Neoplasms , Humans , Leukemia/complications , Leukemia/diagnosis , Skin , Acute DiseaseSubject(s)
Eczema, Dyshidrotic , Humans , Eczema, Dyshidrotic/diagnosis , Skin , Diagnosis, DifferentialSubject(s)
Herpes Zoster , Child , Humans , Herpes Zoster/drug therapy , Antiviral Agents/therapeutic use , FaceSubject(s)
Exanthema , Kaposi Varicelliform Eruption , Humans , Exanthema/diagnosis , Exanthema/etiologyABSTRACT
Summary: Cushing's disease or pituitary adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome is considered a rare condition. It is caused by hypersecretion of the ACTH by a pituitary adenoma that ultimately induces endogenous hypercortisolism by stimulating the adrenal glands. It is responsible for significant morbidity and mortality. The clinical signs and symptoms of hypercortisolism are usually common and non-specific including obesity, moon face, hypertension, hirsutism and facial plethora. The association between Cushing's disease and calcinosis cutis which is defined as dystrophic calcium deposition in the skin and subcutaneous tissues is extremely rare. To the best of our knowledge, it has never been described previously in humans, probably like a symptom or complication of chronic and severe hypercortisolism. In this paper, we report a case of a 30-year-old female diagnosed with Cushing's disease and presented bilateral leg's calcinosis cutis complicated with ulceration. The evolution was favorable and the complete cicatrization was obtained 12 months following the suppression of systemic glucocorticoid excess. Learning points: Calcinosis cutis is common in autoimmune connective diseases. However, to our knowledge, it has never been reported in humans with Cushing's disease. Given the rarity of this association, the diagnostic approach to calcinosis cutis must exclude the other etiologies. Calcinosis cutis is challenging to treat with no gold standard therapy. In our case, the use of the combination of colchicine and bisphosphonates does not significantly improve the patient's outcomes. In fact, we suppose that without treating the endogenous hypercortisolism, the calcinosis cutis will not resolve.
