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Infectious disease
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Lepromatous leprosy: skin becomes thickened which may lead to a leonine facies appearance. Nerve damage leads to neuropathies. Repetitive trauma to anaesthetic digits can lead to damage and ultimately loss.
Skin diseases of the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
Sézary syndrome is the erythrodermic leukemia variant of CTCL. Other potentially erythrodermic endues such as drug eruptions, atopic dermatitis, psoriasis (Figure 31) and contact dermatitis may mimic this entity. Since the clinical picture is not pathognomonic, the diagnosis is made by a combination of clinical, histopathologic and immunologic studies (monoclonal antibodies and gene rearrangement studies). Peripheral blood exhibits a leukocytosis with more than 10% hyperconvoluted cerebriforme nuclei. The syndrome may develop de novo and may be complicated by mycosis fungoides. Clinically, Sézary syndrome is an erythrodermic pruritic scaling dermatitis accompanied by palmo-plantar keratoderma, alopecia, onychodystrophy, adenopathy and hepatosplenomegaly. The patients can develop a leonine facies.
Lepromatous leprosy
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
In this pole of leprosy, the host immunity toward lepra bacilli is very poor, and the disease is manifested throughout the body [5]. The earliest findings include nasal stuffiness and epistaxis. Cutaneous findings include bilateral symmetrically arranged macules, papules, nodules (Figure 57.1), and diffuse or ulcerative lesions. Sensory loss is usually absent, except for glove and stocking anesthesia. Nerves are symmetrically thickened, tender, and fibrotic. Diffuse infiltration of the skin of the forehead, chin, nose, and ears leads to development of “leonine facies” [6].
Atypical manifestations of sarcoidosis in a Hispanic male
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Bao Ho, Kristal S. Choi, William Ochoa, Karina D. Torralba, Vaneet K. Sandhu, Zahra Pakbaz
Physical exam was significant for diffuse joint tenderness without swelling or warmth, and multiple raised, blanchable, erythematous papules and plaques distributed on the back, arms, legs, and face, as well as leonine facies (Figures 1 and 2). Labs were significant for a serum white blood cell count (WBC) of 3,700/microL (normal 4,500–1100/microL), absolute lymphocytes 400/microL (1,000–4,000/microL), hemoglobin of 8.6 g/dL (normal 14.0–17.5 g/dL), corrected calcium of 14.4 mg/dL (normal 8.6–10.3 mg/dL), 1,25-dihydroxyvitamin D of 154 pg/mL (normal 18–72 pg/mL), 25-hydroxyvitamin D of 20 ng/mL (normal 30–100 ng/mL), PTH of 1 pg/mL (normal 14–64 pg/mL), PTH-related protein of 24 pg/mL (normal 14–27 pg/mL), creatinine of 3.23 mg/dL (unknown baseline, normal 1.13 and 0.93 mg/dL), and 24-h urine protein of 700 mg (normal < 100 mg).
Bilateral periorbital leukemia cutis presenting as suspected cellulitis
Published in Orbit, 2022
Lalita Gupta, Melissa A. Levoska, Timmie Sharma, Kord Honda, Mark A. Prendes
Most commonly associated with AML, leukemia cutis occurs when leukemic cells infiltrate the epidermis, dermis or subcutaneous tissue.4,5 Leukemia cutis commonly presents as single or multiple red-brown papulonodules on the legs, arms, or trunk.6 Other clinical variants include hemorrhagic papules, bullae, ulcers, erythema-nodosum-like lesions, subcutaneous nodules similar to panniculitis, and leonine facies.7,8