SAGE Open Medical Case Reports最新文献

Paraspinal hematomas are common complications following spine surgery. In general, these hematomas are asymptomatic and resolve without issue. Unfortunately, there is a paucity of literature that describes the recurrence of these hematomas in a chronic setting. This case report describes a patient with a chronic recurrent calcified paraspinal hematoma that first developed over 4 years and then reoccurred 11 years later at the same site. The case features a 53-year-old female presented with severe lumbar back pain and right lower extremity radiculopathy in which she underwent a lumbar decompression posterior spinal fusion from L3 to L5 in 2008. Postoperatively, she developed a lumbar paraspinal hematoma which was treated with aspiration followed by conservative management. Four years later, the patient had a large paraspinal mass removed from a similar location in an outside medical facility. The procedure required the assistance of plastic surgery for flap closure and a pathologic review of the mass revealed a calcified hematoma. Ten years later, the patient sought treatment from her index surgeon for a recurrence of the lumbar mass with new onset radicular symptoms. Magnetic resonance imaging of the lumbar spine confirmed the presence of a large paraspinal mass. The patient proceeded with the removal of hardware, revision of laminectomy, revision of posterior instrumentation from L2 to L5, and removal of the lumbar mass. The pathology report classified the mass as a chronic calcified hematoma. The patient remains symptom-free for 1 year following the revision procedure. This case demonstrates an extremely rare presentation, ill-described in the existing literature, of a recurrent symptomatic calcified lumbar paraspinal hematoma requiring repeat operative intervention.

Radicular cysts are rarely present in the primary dentition because of the distinct biological cycle of primary teeth. Cyst formation in children may cause bony expansion and resorption, malposition, delayed eruption, enamel defects, or damage to the developing permanent successors. Various treatment modalities for the management of radicular cysts have been reported in the literature. In this case, the preferred treatment approach is window decompression surgery (WDS) combined with gap retainers. Long-term follow-up revealed good healing of the bony lesion. The present case involved an abnormally large radicular cyst in a 7-year-old girl. After surgery, WDS was performed, and a gap retainer was provided. At the 9-month follow-up, the radicular cyst had healed and the impacted tooth had erupted. The aim of this study was to explore the clinical effectiveness of WDS for impacted teeth within root radicular cysts.

Cutaneous pseudolymphoma refers to a group of skin conditions that simulate lymphoma either clinically and/or histologically. Cutaneous pseudolymphoma is a benign disorder that can often be misdiagnosed and has a wide range of treatment modalities. Currently, there is no gold standard of treatment, and the literature would benefit from more reports on successful and unsuccessful treatments of cutaneous pseudolymphoma. In this case, we present a 24-year-old female with cutaneous pseudolymphoma successfully treated with intralesional triamcinolone acetonide after misdiagnosis and several failures with other treatments.

Ponatinib, a tyrosine kinase inhibitor used for chronic myeloid leukemia and acute lymphoblastic leukemia, can cause rare cutaneous side effects. In this case, a 63-year-old woman developed a pityriasis rubra pilaris-like eruption 1 month after starting the drug. The skin reaction improved with dose reduction and recurred more mildly at a lower dose. Symptomatic relief was achieved with topical tretinoin, triamcinolone, and emollients. This case underscores the importance of managing dose-dependent skin reactions while maintaining cancer therapy.

This case report emphasizes the complexities involved in dental implant placement within the anterior esthetic zone, focusing on the integration of advanced surgical techniques and meticulous prosthetic design for optimal esthetic and functional results. A 28-year-old male presented with the absence of the upper left central incisor, which had been extracted 5 years prior due to fracture. Clinical and radiographic assessments indicated normal alveolar bone levels; however, the esthetic demands required a specialized approach. The surgical procedure included a papilla preservation flap, immediate implant placement, and bone grafting to prevent peri-implant resorption and achieve an optimal emergence profile. An Osstem implant and resorbable Xenograft were utilized to address the thin labial bone. Over 4 months, successful osseointegration occurred, followed by the placement of a permanent crown. This case illustrates that dental implant restoration in the anterior esthetic zone can effectively address functional and esthetic challenges, leading to high patient satisfaction with the final restoration's natural appearance.

Porokeratosis is a condition characterized by abnormal epidermal keratinization with a unique morphology of papules or plaques surrounded by a thread-like border of scale corresponding to the cornoid lamella on histology. Many established subtypes have been described; however, genitogluteal porokeratosis is a rare entity. We present the case of a 58-year-old male with pruritic reddish lesions affecting the genitals and thighs, diagnosed with genital porokeratosis. This case highlights features of this rare and diagnostically challenging subtype of porokeratosis.

Atopic dermatitis is a chronic inflammatory skin disease associated with immune dysregulation, particularly overexpression of T helper 2 cytokines. Cytotoxic T lymphocyte-associated antigen 4 deficiency, a primary immune disorder, can exacerbate atopic dermatitis. Dupilumab, an IL-4 and IL-13 receptor antagonist, has demonstrated efficacy in controlling severe, recalcitrant atopic dermatitis by mitigating T helper 2-driven inflammation. We present a case of a 24-year-old male with cytotoxic T lymphocyte-associated antigen 4 haploinsufficiency and severe atopic dermatitis successfully managed with Dupilumab. The patient showed marked improvement in eczema severity scores, including a sixfold reduction in the Eczema Area and Severity Index and a threefold reduction in the Dermatology Life Quality Index over 6 months, highlighting Dupilumab's potential role in cytotoxic T lymphocyte-associated antigen 4-deficient patients experiencing atopic dermatitis.

Acute barium poisoning is a rare but life-threatening method of suicide attempt, and it is a challenging disease in the emergency department. We report a case of barium carbonate poisoning in a 21-year-old man who ingested a large dose to attempt suicide and presented with gastrointestinal symptoms, gradual muscular weakness, and severe hypokalemia (K⁺1.63 mmol/L). He was promptly managed with gastric lavage, respiratory support, and large doses of oral and intravenous potassium supplementation. In addition, intravenous sodium thiosulfate and continuous venovenous hemodiafiltration were administered to reduce the serum concentration of barium ions. Following comprehensive treatment, the patient recovered within 5 days and discharged home for 12 days. Clinicians should be vigilant when a patient presents gastrointestinal symptoms and limb weakness, associated with severe hypokalemia and cardiac arrhythmia over a short disease course as these may indicate potential barium poisoning. Furthermore, we advocate for paying more attention to the management of toxic substances and the mental health education of young adults.

Cyclosporine A (CsA) is a commonly used immunosuppressant, but its association with thrombotic microangiopathy (TMA) is rarely reported. In recent years, CsA has been used in pregnant women with autoimmune diseases or previous immune-related adverse pregnancies. Our case involves a 34-year-old female who developed typical laboratory indicators of TMA while using CsA to improve pregnancy outcomes. After discontinuing CsA, the TMA markers gradually normalized. To our knowledge, this is the first report of CsA-induced TMA during pregnancy. We also reviewed previous case reports of CsA-induced TMA and summarized the possible mechanisms, characteristics, and risk factors, as well as methods to identify this rare adverse effect of CsA in pregnant women.

Discoid lupus erythematosus is a chronic, recurring, autoimmune skin disease causing annular, scarring plaques on the head and neck. Deucravacitinib, a tyrosine kinase 2 inhibitor in the Janus kinase inhibitor family, represents an emerging treatment option in systemic lupus erythematosus with potential applicability to discoid lupus erythematosus. We describe a 48-year-old woman with multiple treatment-refractory scalp plaques and associated alopecia treated with deucravacitinib. She demonstrated resolution of symptoms and 1-2 cm hair regrowth at a 3-month follow-up, with significant hair regrowth and reduction in plaque size at a 6-month follow-up. The patient tolerated the medication well with no side effects. This case highlights the potential of deucravacitinib as an effective therapy for refractory discoid lupus erythematosus.