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Saddled by the Saddle Nose: A Case of Wegener's Granulomatosis 鞍鼻:韦格纳肉芽肿病的一个病例
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_22_21
K. Shilpa, Heera Ramesh, S. Somashekhar, B. Leelavathy
Wegener's Granulomatosis with polyangiitis (GPA) is a systemic disease of unknown etiology characterized by necrotizing granulomatous inflammation, tissue necrosis, and variable degrees of vasculitis in small- and medium-sized blood vessels. The classical clinical triad consists of involvement of the upper airways, lungs, and kidneys. Saddle-nose deformity is a well-recognized complication of GPA but more commonly occurs due to leprosy, trauma, cocaine abuse, and sarcoidosis. Since this entity is not commonly encountered in our country, we present a unique case of a middle-aged woman presenting with saddle-nose deformity and the diagnostic dilemmas faced by us. This case is being reported due to its rarity in Indian literature.
韦格纳肉芽肿伴多血管炎(GPA)是一种病因不明的全身性疾病,以坏死性肉芽肿炎症、组织坏死和不同程度的中小血管炎为特征。典型的临床三联征包括上呼吸道、肺部和肾脏受累。鞍鼻畸形是一种公认的 GPA 并发症,但更常见于麻风病、创伤、可卡因滥用和肉样瘤病。由于这种病症在我国并不常见,我们在此介绍一例独特的中年女性鞍鼻畸形病例,以及我们所面临的诊断难题。由于该病例在印度文献中十分罕见,我们特此报告。
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引用次数: 0
Zero Leprosy Strategic Plans: Global and National Level: A Short Communication 零麻风病战略计划:全球和国家层面:简短交流
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_118_23
K. Geetha
Since the launch of multidrug therapy in 1982, the global leprosy situation has undergone significant changes, with the prevalence falling from over 5 million cases in the mid-1980s to <200,000 by the end of 2016. In India, the program reduced the prevalence rate from 57.8/10,000 in 1983 to <1/10,000 by the end of 2005, marking the achievement of the World Health Organizations (WHOs) target of eliminating leprosy as a public health issue. The WHO has recently introduced a new global leprosy plan called “Towards Zero Leprosy” as part of the disease-specific strategies outlined in the WHO's roadmap for neglected tropical diseases (NTDs) 2021–2030. This strategy aims to achieve interruption of leprosy transmission by 2030 and provides a framework for direction, objectives, challenges, and strategic pillars at a global level. In India, a committee of over 80 experts in the field of leprosy developed the National Strategic Plan and Roadmap for Leprosy 2023–2027, which was published on January 30, 2023. This policy is aligned with the WHO's NTDs roadmap 2021–2030 and the Global Leprosy Strategy 2021–2030, both of which aim to interrupt leprosy transmission by 2030. In this article, we have discussed the strategic plans of both the National leprosy eradication programme (NLEP) and the WHO.
自1982年启动多种药物疗法以来,全球麻风病形势发生了重大变化,患病率从20世纪80年代中期的500多万例下降到2016年底的小于20万例。在印度,该计划将麻风病患病率从1983年的57.8/10,000降至2005年底的<1/10,000,标志着世界卫生组织(WHO)实现了消除麻风病这一公共卫生问题的目标。世卫组织最近推出了一项名为 "实现零麻风病 "的新全球麻风病计划,作为世卫组织 2021-2030 年被忽视热带疾病(NTDs)路线图中概述的特定疾病战略的一部分。该战略旨在到 2030 年实现阻断麻风病的传播,并为全球层面的方向、目标、挑战和战略支柱提供了一个框架。在印度,一个由 80 多名麻风病领域专家组成的委员会制定了《2023-2027 年麻风病国家战略计划和路线图》,并于 2023 年 1 月 30 日发布。这项政策与世界卫生组织的《2021-2030 年非传染性疾病路线图》和《2021-2030 年全球麻风病战略》相一致,这两项战略的目标都是到 2030 年阻断麻风病的传播。在本文中,我们讨论了国家根除麻风病计划(NLEP)和世界卫生组织的战略计划。
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引用次数: 0
Trichoscopic Features in Female Pattern Hair Loss: 1-Year Hospital-Based Cross-sectional Study 女性型脱发的三镜特征:为期一年的医院横断面研究
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_123_21
Chintan Ramesh Kothari, Shivakumar Patil
Female pattern hair loss (FPHL) a nonscarring alopecia, is a common cause of hair loss in women. FPHL shows miniaturization of the hair follicles with thinning of hair. Scalp biopsy is diagnostic of FPHL but usually not needed. Trichoscopy a noninvasive higher magnification method (vs. scalp biopsy) for diagnosis of hair loss allows measurement of anisotrichosis characteristic of FPHL. A total of 110 patients with clinically diagnosed FPHL of all grades were subjected to clinical and trichoscopic examination, and findings were looked for and compared with the occipital region serving as control. Trichoscopic features apart from yellow dots and 2–3 hairs per unit follicle (HU) were statistically significant like hair diameter diversity, brown and white peripilar sign, one hair per follicular unit, white dots (WD), fine scaling, and honey-comb pigmentation (HCP). Focal atrichia, 2–3 hairs/HU, WD, HCP correlated with the grade of hair loss. Trichoscopy could be excellent tool for diagnosing FPHL in early stages and may aid in differentiating it from other conditions like chronic telogen effluvium and obviating the need of painful procedures like scalp biopsy. The study lacks histo-pathological and hormonal investigations however past studies done have already established correlation of trichoscopic and histo-pathological changes.
女性脱发(FPHL)是一种非瘢痕性脱发,是女性脱发的常见原因。FPHL 表现为毛囊变小,头发变细。头皮活检可诊断 FPHL,但通常不需要。三镜检查是诊断脱发的一种无创、放大率较高的方法(与头皮活检相比),可测量 FPHL 特征性的毛囊异形。 共有 110 名临床诊断为各种等级 FPHL 的患者接受了临床和三镜检查,检查结果与作为对照的枕部进行了比较。 除黄点和每单位毛囊 2-3 根毛发(HU)外,三镜检查的其他特征也具有统计学意义,如毛发直径多样性、棕白色毛周征、每毛囊单位一根毛发、白点(WD)、细小鳞屑和蜂蜜梳状色素沉着(HCP)。局灶性富集、2-3 根头发/HU、WD、HCP 与脱发等级相关。 三腔镜检查是早期诊断 FPHL 的绝佳工具,有助于将 FPHL 与慢性毛囊性脱发等其他疾病区分开来,并避免了头皮活检等痛苦的手术。这项研究缺乏组织病理学和激素调查,但过去的研究已经证实了三镜检查与组织病理学变化之间的相关性。
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引用次数: 0
A Knee Pain Referred to a Dermatologist 膝关节疼痛转诊至皮肤科医生
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_83_23
Aravind Suprakasan, Nayak U. K. Sudhir, Ranjini Kudva
A painful lesion on the skin can arise from any of the cutaneous structures. A 51-year-old man presented with left knee pain of 1-year duration that got aggravated by contact with clothing or light touch. His symptoms failed to improve despite multiple visits to orthopedics and neurologists. On examination, a 1 cm × 2 cm tender nodular lesion was present on the left knee with surface scaling. Dermoscopy showed peripheral scaling with a rich vascular network interlaced with structureless white areas. The lesion was excised, and histopathology showed fibrocollagenous tissue along with a well-circumscribed encapsulated tumor composed of islands and nests of monomorphic cells with round centrally placed nuclei, reported as a glomus tumor. Post excision, the patient was asymptomatic, and no recurrence was observed. Glomus tumors are classically described to arise from fingertips or extremities. Atypical sites can also be involved, with very few cases reported in the literature.
皮肤上的疼痛病变可能来自任何皮肤结构。一名 51 岁的男子因左膝疼痛就诊,病程长达 1 年,与衣物接触或轻触时疼痛加剧。他曾多次到骨科和神经科就诊,但症状仍不见好转。经检查,左膝上有一个 1 厘米×2 厘米的触痛性结节病变,表面有脱屑。皮肤镜检查显示,周围脱屑,有丰富的血管网与无结构的白色区域交错。病变被切除,组织病理学显示为纤维胶原组织,以及一个由单形细胞组成的岛状和巢状、核圆形居中的包膜瘤,报告为腺瘤。切除术后,患者没有任何症状,也没有发现复发。据经典描述,腺泡瘤多发于指尖或四肢。非典型部位也有可能受累,但文献报道的病例很少。
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引用次数: 0
Ramrod Penis with Unilateral Inguinal Bubo 带有单侧腹股沟泡的拉杆阴茎
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_109_22
Yogindher Singh
Lymphogranuloma venereum (LGV) is a sexually transmitted disease caused by Chlamydia trachomatis. Classically, LGV is characterized by the development of a transient genital ulcer or papule, followed by the appearance of tender femoral and/or inguinal lymphadenopathy. Esthiomene, a rare late manifestation of, LGV is a primary infection affecting the lymphatics of the penis, scrotum, or vulva. The male genitalia are affected less commonly by esthiomene. Here, we report a male patient who presented with a Ramrod penis along with an enlargement of inguinal lymph nodes.
淋巴肉芽肿(LGV)是一种由沙眼衣原体引起的性传播疾病。通常,淋巴肉芽肿性病的特征是出现一过性生殖器溃疡或丘疹,随后出现股部和/或腹股沟淋巴结肿大。阴茎淋巴结炎是一种罕见的晚期表现,它是一种影响阴茎、阴囊或外阴淋巴管的原发性感染。男性生殖器较少受到淋巴结肿大的影响。在此,我们报告了一名男性患者,他的阴茎呈 "拉姆罗德 "状,同时腹股沟淋巴结肿大。
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引用次数: 0
Cutaneous Malignancies: A Prospective Study of Demographic Patterns, Risk Factors, and Clinical Spectrum at a Tertiary Care Center in South India 皮肤恶性肿瘤:印度南部一家三级医疗中心的人口统计模式、风险因素和临床谱系前瞻性研究
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_95_22
Shilpa Kanathur, Supriya Rajesh, A. Shanmukhappa, E. Loganathan, Shwetha Suryanarayan
The incidence of skin cancer is increasing worldwide and is causing a massive burden to the health-care system. It arises as a result of interplay between various predisposing factors. We intend to study the various clinical presentations of cutaneous malignancies and the demographic pattern and risk factors associated with them. The study was done over a period of 7 years, 181 patients were diagnosed with cutaneous malignancy in the department of dermatology of our tertiary care hospital. A diagnosis was done based on history, clinical and histopathological examination. Of 181 patients, majority of the patients belonged to 7th decade (n = 56, 31%) with the mean age being 55 years. The study group had 105 males (58%) and 76 (42%) females. The most common site was the head-and-neck region (n = 105, 58%). The most important associated condition/predisposing factor was ultraviolet (UV) radiation exposure (n = 79, 44%). Keratinocytic tumors formed the largest group (n = 131, 72%) in which basal cell carcinoma (BCC) was the most common (n = 75, 41%). Surgical excision was the main modality of treatment and was done in 111 (61%) patients. BCC was the most common skin cancer with head-and-neck region being the most common location in our study. Important risk factors were increasing age, male sex, and prolonged exposure to UV radiation. Early diagnosis helps in planning effective management strategies.
皮肤癌的发病率在全球范围内不断上升,给医疗系统造成了巨大负担。皮肤癌是各种诱发因素相互作用的结果。我们打算研究皮肤恶性肿瘤的各种临床表现以及与之相关的人口统计学模式和风险因素。 这项研究历时 7 年,我们所在的三级医院皮肤科共诊断出 181 名皮肤恶性肿瘤患者。诊断基于病史、临床和组织病理学检查。 在 181 名患者中,大多数属于第七个十年(56 人,31%),平均年龄为 55 岁。研究组中有 105 名男性(58%)和 76 名女性(42%)。最常见的发病部位是头颈部(105 人,58%)。最重要的相关条件/诱发因素是紫外线(UV)照射(79人,占44%)。角化细胞肿瘤是最大的群体(n = 131,72%),其中基底细胞癌(BCC)最常见(n = 75,41%)。手术切除是主要的治疗方式,有 111 名患者(61%)接受了手术切除。 在我们的研究中,BCC是最常见的皮肤癌,头颈部是最常见的发病部位。年龄增长、男性和长期暴露于紫外线辐射是重要的风险因素。早期诊断有助于制定有效的治疗策略。
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引用次数: 0
Dowling-Degos Disease with Reticulate Acropigmentation of Kitamura: Two Facets of a Single Disease Complex 道林-德戈斯病与北村网状色素沉着症:一种疾病复合体的两个方面
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_4_23
K. Maheshwari, Amandeep Saluja, Kalpana Gupta
{"title":"Dowling-Degos Disease with Reticulate Acropigmentation of Kitamura: Two Facets of a Single Disease Complex","authors":"K. Maheshwari, Amandeep Saluja, Kalpana Gupta","doi":"10.4103/cdr.cdr_4_23","DOIUrl":"https://doi.org/10.4103/cdr.cdr_4_23","url":null,"abstract":"","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Kaposi’s Varicelliform Eruption in a Patient with Darier’s Disease: A Rare Case Report 一名达里尔病患者的卡波西静脉曲张溃疡:罕见病例报告
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_45_23
Shirahatti Trishala, H. Bangaru
Darier's disease is a rare autosomal dominant disorder, characterized clinically by the appearance of multiple, pruritic, discrete, and scaly papules affecting seborrheic areas coupled with palmar pits, nail changes, and mucosal involvement. Histologically, the lesions show supra-basal clefts with acantholytic and dyskeratotic cells. Kaposi's varicelliform eruption (KVE) is the dissemination of the herpes simplex virus in the setting of preexisting skin disease, presenting with disseminated vesico-pustules. Darier's disease presenting as KVE is a rare occurrence. If misdiagnosed or left untreated can increase the rate of mortality. Here, we report the case of a 25-year-old male patient who presented with multiple vesicles and crusted lesions over the face, neck, chest, and upper back. After thorough cutaneous examination, he was found to have multiple hyperkeratotic, dirty-warty papules over seborrheic areas, present since childhood. With detailed clinical and laboratory evaluation, we arrived at the diagnosis of KVE with underlying Darier disease.
达里尔病是一种罕见的常染色体显性遗传疾病,临床特征是在脂溢区出现多发性、瘙痒性、离散性和鳞屑性丘疹,同时伴有手掌凹陷、指甲变化和粘膜受累。组织学上,病变表现为基底上裂隙,伴有棘层细胞溶解和角化不良细胞。卡波西静脉曲张样疹子(KVE)是单纯疱疹病毒在原有皮肤病的基础上的传播,表现为播散性水疱。达里尔病表现为 KVE 的情况非常罕见。如果误诊或不及时治疗,会增加死亡率。在此,我们报告了一例 25 岁男性患者的病例,他的面部、颈部、胸部和上背部出现多发性水泡和结痂性病变。经过全面的皮肤检查,发现他自童年起就在脂溢部位出现多发性角化过度、脏疣状丘疹。经过详细的临床和实验室评估,我们诊断他患有KVE,并伴有潜在的达里尔病。
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引用次数: 0
A Rare Case Report of Lipoid Proteinosis with Distichiasis and Trichomegaly: An Interesting Entity 伴有肛瘘和毛细血管扩张的类脂样蛋白病的罕见病例报告:一个有趣的实体
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_106_21
H. Bangaru, S. Shankar, N. Lingaiah, SR Shivani, BY Praveen, Tejaswini Acharya
Lipoid proteinosis (LP) is a rare autosomal recessive disorder characterized by infiltration of periodic acid schiff (PAS)-positive diastase-resistant hyaline material in the skin, oral cavity, and larynx caused by a mutation in the extracellular matrix 1 gene. Clinically characterized by beaded eyelid papules, waxy papules, nodules, plaques, and acneiform pock-like scars over the face and body. We report a case of LP, with involvement of the skin, eyes, brain, oral mucosa, and larynx, histopathologically confirmed by PAS-positive and diastase-resistant deposition in the dermis. The patient showed good response in skin lesions and quality of speech with 6-month of therapy of acitretin 0.5 mg/kg/day and followed up for 1 year without recurrences. As there is no curative and specific therapy for LP, acitretin is a very useful drug in improving quality of life, speech, and cosmetic appearance.
类脂样蛋白病(Lipoid proteinosis,LP)是一种罕见的常染色体隐性遗传疾病,其特征是由于细胞外基质 1 基因突变而导致皮肤、口腔和喉咙中浸润了周期性酸性希氏(PAS)阳性的耐弹性蛋白酶透明物质。临床特征为面部和全身出现串珠状眼睑丘疹、蜡样丘疹、结节、斑块和痤疮样痘疤。我们报告了一例累及皮肤、眼睛、大脑、口腔粘膜和喉部的 LP 病例,组织病理学证实其真皮层有 PAS 阳性和抗 diastase 沉积。患者使用阿曲汀 0.5 毫克/千克/天治疗 6 个月后,皮损和语言质量均有良好反应,随访 1 年未再复发。由于目前尚无根治 LP 的特效疗法,阿曲汀是一种非常有用的药物,可改善患者的生活质量、语言能力和外观。
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引用次数: 0
Cutaneous Vascular Anomalies: A Cross-Sectional Study in a Tertiary Care Hospital 皮肤血管异常:一家三级医院的横断面研究
Pub Date : 2024-04-01 DOI: 10.4103/cdr.cdr_64_22
S. Somashekhar, E. Loganathan, Heera Ramesh
Vascular anomalies are a group of disorders that are divided into two categories: tumors and malformations. Given the vast diversity of clinical presentations with overlapping signs and symptoms, diagnosis can be difficult. We conducted a cross-sectional study to evaluate the common cutaneous vascular anomalies encountered in our outpatient department. A total of 28 patients suspected to be having cutaneous vascular anomalies were screened and subjected to biopsy. The diagnosis was based on clinicopathological correlation. In our study, pyogenic granuloma was the most common vascular anomaly seen in 25% of patients; majority of these patients gave a history of trauma and spontaneous bleeding. It was followed by angiokeratoma (17.8%), infantile hemangioma, port-wine stain, and verrucous hemangioma which was seen in 10.7% of patients. Other common vascular anomalies included are glomus tumor and tufted angioma. Vascular anomalies comprise a spectrum of diseases, diagnosis of which is often challenging. Accurate diagnosis is critical to generate a management plan for the patient. Our study highlights the varied clinical spectrum of vascular tumors that we come across in clinical practice and it will increase familiarity of the various clinical presentations, thereby enabling clinicians to better identify and manage these challenging entities.
血管畸形是一组疾病,分为肿瘤和畸形两大类。由于临床表现多种多样,且症状和体征相互重叠,因此诊断非常困难。 我们进行了一项横断面研究,以评估我们门诊部常见的皮肤血管畸形。 共有 28 名疑似皮肤血管异常的患者接受了筛查和活组织切片检查。诊断依据是临床病理学相关性。 在我们的研究中,化脓性肉芽肿是最常见的血管畸形,占 25% 的患者;这些患者大多有外伤和自发性出血史。其次是血管角化瘤(17.8%)、婴儿血管瘤、葡萄酒色斑和疣状血管瘤(10.7%)。其他常见的血管畸形包括胶质瘤和簇状血管瘤。 血管畸形包括多种疾病,其诊断往往具有挑战性。准确的诊断对于为患者制定治疗方案至关重要。我们的研究强调了我们在临床实践中遇到的血管肿瘤的各种临床表现,它将提高人们对各种临床表现的熟悉程度,从而使临床医生能够更好地识别和管理这些具有挑战性的实体。
{"title":"Cutaneous Vascular Anomalies: A Cross-Sectional Study in a Tertiary Care Hospital","authors":"S. Somashekhar, E. Loganathan, Heera Ramesh","doi":"10.4103/cdr.cdr_64_22","DOIUrl":"https://doi.org/10.4103/cdr.cdr_64_22","url":null,"abstract":"\u0000 \u0000 Vascular anomalies are a group of disorders that are divided into two categories: tumors and malformations. Given the vast diversity of clinical presentations with overlapping signs and symptoms, diagnosis can be difficult.\u0000 \u0000 \u0000 \u0000 We conducted a cross-sectional study to evaluate the common cutaneous vascular anomalies encountered in our outpatient department.\u0000 \u0000 \u0000 \u0000 A total of 28 patients suspected to be having cutaneous vascular anomalies were screened and subjected to biopsy. The diagnosis was based on clinicopathological correlation.\u0000 \u0000 \u0000 \u0000 In our study, pyogenic granuloma was the most common vascular anomaly seen in 25% of patients; majority of these patients gave a history of trauma and spontaneous bleeding. It was followed by angiokeratoma (17.8%), infantile hemangioma, port-wine stain, and verrucous hemangioma which was seen in 10.7% of patients. Other common vascular anomalies included are glomus tumor and tufted angioma.\u0000 \u0000 \u0000 \u0000 Vascular anomalies comprise a spectrum of diseases, diagnosis of which is often challenging. Accurate diagnosis is critical to generate a management plan for the patient. Our study highlights the varied clinical spectrum of vascular tumors that we come across in clinical practice and it will increase familiarity of the various clinical presentations, thereby enabling clinicians to better identify and manage these challenging entities.\u0000","PeriodicalId":34880,"journal":{"name":"Clinical Dermatology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinical Dermatology Review
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