RESUMO
INTRODUCTION: The association psoriasis and osteomalacia is very rare. EXEGESIS: We report the case of a young girl, aged 17, who was consulting for ostealgia and erythematic and squamous cutaneous lesions. She had a staturo-ponderal delay, ostealgia and a bending of the general state. The osteo-articular examination showed a sternal protrusion with painful limitation of the movements of all joints. The dermatologic examination noted a dry erythrodermis to hick squamous with scalp's crush. The biological (hypocalcaemia, diminished urinary calcium) and radiological (demineralized bone with Looser-Milkmann fractures) results suggest an osteomalacia, diagnostic confirmed by the bone histological study that found out osteoid lines. The cutaneous biopsy was compatible with psoriasis diagnosis. A vitamino-calcic treatment associated to local nursing was undertaken. The evolution was favorable, noted by a cutaneous bleaching with a return back of the articular function. The present receding is of nine years. CONCLUSION: Different studies underlined that outside of its action on the phosphocalcic metabolism, the vitamin D acts on the skin, especially on the proliferation of the keratinocytes that allowed its indication in the treatment of the psoriasis.
Assuntos
Osteomalacia/complicações , Psoríase/complicações , Adolescente , Feminino , HumanosRESUMO
We report the case of a 22-year-old woman who was admitted for inflammatory right-sided sciatica with a decline in general health. Laboratory tests showed severe inflammation. Ultrasonography and computed tomography of the buttock and pelvis demonstrated a large tumor in the deep muscles of the right buttock, with an intrapelvic component that displaced the pelvic organs without invading them. Histologic examination of a biopsy specimen taken via the buttock established the diagnosis of leiomyosarcoma. Surgery by a pelvic approach allowed partial resection of the tumor, which was seen to invade the sciatic nerve. Radiation therapy was given. Six months later the residual tumor was considerably larger and the patient's general health had deteriorated further. Leiomyosarcomas are rare tumors whose diagnosis rests on histologic examination of biopsy or surgical specimens. The treatment is surgical. Recurrences are seen in 40 to 60% of cases, and metastases in 27 to 60%. The place of radiation therapy and chemotherapy in the treatment of leiomyosarcoma remains unclear.
Assuntos
Nádegas , Leiomiossarcoma/complicações , Neoplasias Pélvicas/complicações , Ciática/etiologia , Neoplasias de Tecidos Moles/complicações , Adulto , Feminino , Humanos , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/patologia , Invasividade Neoplásica , Neoplasias Pélvicas/diagnóstico por imagem , Neoplasias Pélvicas/patologia , Nervo Isquiático/patologia , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/patologia , Tomografia Computadorizada por Raios XRESUMO
CMV-induced neurological manifestations are uncommon, especially in immunocompetent subjects. We report a case of CMV-induced myeloradiculopathy with a favorable outcome in an immunocompetent patient who presented with diffuse myalgia and inflammatory polyarthralgia. Presence of both peripheral and central neurological abnormalities with monocytosis and positive serological tests in the blood and cerebrospinal fluid established the diagnosis. Mixed neurological involvement is rare during CMV infection and usually occurs in association with a deficiency in immunological responses.