Traumatic soft tissue injuries of the finger represent a frequent hand injury challenging hand surgeons. We report a case involving a 30-year-old man with a dorsal index finger soft tissue wound failing conservative treatment. The novel use of applied fibrin membranes and concentrated growth factors yielded complete resolution of the injury in 6 months without need for skin grafting.
Chemical peels are widely used minimally invasive procedures with both cosmetic and medical indications. Although known for their general safety and efficacy, peels can rarely result in significant complications.
Here we report the first case in the peer-reviewed literature of chemical burn from erroneous home use of 50% trichloroacetic acid.
A focused literature review was performed of complications relating to chemical peels.
Chemical burns from trichloroacetic acid peels are rare. To our knowledge, this is the first such case reported with supporting histopathological data.
Physicians must be aware of the potential complications of chemical peels, prevention strategies, and treatment modalities.
The fibrosarcomatous variant of dermatofibrosarcoma protuberans (DFSP) represents an uncommon form of DFSP which has a higher risk of local recurrence and distant metastases than ordinary DFSP.
The aim of our study is to investigate clinicopathologic characteristics, treatment modalities and prognostic factors of nine cases of transformed DFSP admitted in Salah Azaiez Institute between 2002 and 2009.
They were five men and four women. Median age at diagnosis was 52 years (35–87 years). The lesions were located on the abdominal wall (three cases), the upper limb (two cases), the back (two cases), the lower limb (one case) and the chest wall (one case). Tumor size ranged from 25 mm to 150 mm. After diagnosis, six patients were treated by wide local excision with margins ⩾2 cm, two patients had local excision without defined margins and one patient had incomplete local excision. Three patients underwent radiotherapy because of either cramped or unknown limits. Local recurrence was diagnosed in 5 cases and distant metastasis occurred in one patient.
Fibrosarcomatous DFSP exhibits more aggressive behavior than DFSP. Their similar clinical presentation requires histopathological differentiation for prognosis. Treatment is based on wide local excision, radiation and targeted therapy.
Nail-patella syndrome (NPS) which also known as hereditary osteo-onychodysplasia is a rare autosomal-dominant disorder characterized by a classic clinical tetrad of changes in the nails, knees, elbows and the presence of iliac horns.
Occasionally the central nervous system, the eyes and the renal system are affected.
NPS was reported worldwide, affecting males and females equally.
Infertility was not mentioned in this syndrome before.
Here we are reporting a case of NPS in a 38 year old Saudi male, in association with infertility, which was exceptional and could represent an additional manifestation to the syndrome.
This study was performed to determine the pattern of skin malignancies in Dammam Medical Complex, Dammam, Kingdom of Saudi Arabia and to compare these results with those from other parts of the world.
Histologically diagnosed skin cancers between June 2008 and May 2014 were reviewed and analyzed. Dammam Medical Complex is the main hospital in Dammam that receives most of the malignant cases in this area. Trends in incidence of skin cancers by their age, sex and anatomic location were examined.
Of the 27 cases of skin cancer majority (74%) were Saudis and males (59.2%). The most common malignant skin lesion was BCC followed by SCC, dermatofibrosarcoma protuberans (DFSP), skin secondaries from stomach, breast and lung, mycosis fungoides (MF), malignant melanoma (MM). The most common site was head and neck for BCC, trunk for SCC, and trunk for DFSP.
Low occurrence of malignant skin tumors is found in dermatology practice in Dammam. Nevertheless BCC, SCC and MM should be considered in the dermatology practice locally.
The most common skin cancers seen are BCC and SCC followed by DFSB and MF. The site of distribution of BCC and SCC in our study is similar to studies from various other regions of Saudi Arabia and other countries.
Psoriasis vulgaris is a common chronic dermatological disease that has a negative impact on the psychological status and the social interaction of the patient.
To correlate the quality of life and clinical severity of psoriasis vulgaris in patients using different types of treatment.
This is a prospective observational cross-sectional study that took place over a 4 month period, from January to April 2014, at the King Abdul Aziz Medical City, Jeddah, Saudi Arabia. All patients with psoriasis vulgaris attending the dermatology clinics during this period were included.
Of the total 41 Saudi patients, 25 were males and 16 were females. 21 were on combined (i.e. topical with either systemic or NB-UVB) and 20 were on topical treatments only. PASI score was moderate in the majority for both groups, that is, patients on topical (70%) and combined treatment (80%). DLQI score shows only a small effect on the patient’s quality of life for the majority (14/20) in the topical group and (16/21) for those on combined therapy.
There is no significant difference in terms of the effect of the type of treatment between the two groups.
Lipomas are common benign soft tissue, however intramuscular lipoma, is an often misdiagnosed clinical entity. The aim of this case is to present an atypical infiltrating lipoma and discuss its diagnostic and therapeutic features.
A 24 year-old patient presented to our consultation with a swelling of the right lower limb from childhood and gradually increasing in size. Clinical examination revealed a firm and extended swelling along the leg, thigh and foot giving an aspect of monomelic hypertrophy. There were no signs of vascular or nerve compression.
Pathological study showed a lipoma. Magnetic resonance imaging (MRI) of the right lower limb objectified a large infiltrating lipoma affecting muscles of the posterior compartment of the thigh and the right leg with no signs of malignancy. The diagnosis of intramuscular lipoma was done. The surgery was proposed but the patient refused.
This case report described an adult female patient with an unusually intramuscular lipoma where magnetic resonance imaging was playing an important role in the diagnostic. Indeed the intramuscular is a benign fatty tumor with characteristic appearance on MRI. Its management should be considered in multidisciplinary collaboration.
The aim of this work was to evaluate the efficacy and safety of intralesional injection of 5-fluorouracil and bleomycin in the treatment of keloids and hypertrophic scars. One hundred and twenty patients were divided into the following groups: group IA was injected intralesionally with 5-fluorouracil; group IB was injected intralesionally with a combination of triamcinolone acetonide and 5-fluorouracil; group II was injected intralesionally with bleomycin. Patients underwent follow up by photographing and Vancouver scar scale system. There was a significant improvement in the Vancouver scar scale in group II compared to group I after treatment. There was hyperpigmentation, pain and ulceration in all the studied groups. Pain was significantly decreased in group IB compared to that in group IA, ulceration was significantly decreased in group II than in group I while pain after injection was increased in group II than in group I. Relapse occurred in 12 patients of group IA, 14 patients of group IB and no relapse occurred in group II. So, intralesional injection of bleomycin was more effective and better in remission than intralesional 5-fluorouracil injection in the treatment of keloids and hypertrophic scars regardless of patient’s age, sex, disease duration or site of the lesion.
Scleredema, a medical problem first described by Buschke in 1902, is a rare scleromatosis of unknown aetiology, which is characterized by wooden, nonpitting induration of the skin. This skin disorder first affects the neck and face and may symmetrically spread to the shoulders, trunk, arms, and legs. We report a case of a 65 year-old hypertensive and diabetic male who presented with marked thickening of the upper back with obvious peau d’orange changes. Association with other complications of diabetes is not certain and treatment is difficult, though improvement is possible with optimal glycaemic control. Scleredema diabeticorum is rare and is a cause of significant morbidity in diabetes.
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