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Bacterial, Mycobacterial, and Spirochetal (Nonvenereal) Infections
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Clinical presentation: The cutaneous manifestations of leprosy vary depending on patient immunity and can include single or multiple lesions with various morphology (e.g., macules, papules, nodules) that can be hyper- or hypopigmented. Typically, the skin lesion shows a decreased sensation to pain and touch. Peripheral nerves can be thickened and become easily palpable, which can lead to muscle weakness and atrophy. Leprosy has traditionally been classified into two major types: tuberculoid and lepromatous leprosy. Patients with tuberculoid leprosy (TT; high resistance) have limited disease and few bacteria in the skin and nerves, while patients with lepromatous leprosy (LL; low resistance) have widespread disease and large numbers of bacteria (Figure 6.7).
Arthropod Bites or Stings
Published in Jerome Goddard, Public Health Entomology, 2022
The skin is a human’s first line of defense against invasion or external stimuli, and it may react in a variety of ways against all kinds of stimuli—physical or chemical—including arthropods and their emanations. Lesions may result from arthropod exposure, although not all lesions have the same pathological origin—some are due to mechanical trauma, some due to infectious disease processes, and some result from hypersensitization processes. Physicians and other healthcare providers are frequently confronted with patients claiming that their skin lesions are due to a mysterious arthropod bite or sting. Diagnosis in such cases is difficult, but may be aided by asking the patient key questions about the event and any recent activity leading to arthropod exposure. The following kind of questions may provide useful information: Did you see the thing that bit or stung you? Was it wormlike? Did it fly away? Most treatments for skin lesions are symptomatic only (except in cases of infectious diseases) and involve counteracting immune responses to venoms, salivary secretions, or body parts using various combinations of antihistamines and corticosteroids.
Suppression of itch and tinea capitis
Published in Dinesh Kumar Jain, Homeopathy, 2022
Regarding prognosis, “Children frequently grow out of the disease about puberty. Adults never lose the tendency to attack but may be free for years” (Warner, 1964, p. 214).Now we summarize total characteristic features of asthma.Paroxysmal episodic character.Free intervals of varying periods between attacks.Associated with skin lesions.Skin eruptions are present often alternating with paroxysms of asthma.Chances of spontaneous recovery.Children frequently grow out of the disease about puberty.
Mastocytosis and related entities: a practical roadmap
Published in Acta Clinica Belgica, 2023
Michiel Beyens, Jessy Elst, Marie-Line van der Poorten, Athina Van Gasse, Alessandro Toscano, Anke Verlinden, Katrien Vermeulen, Marie-Berthe Maes, J. N. G. Hanneke Oude Elberink, Didier Ebo, Vito Sabato
If a child presents with typical cutaneous lesions of mastocytosis one should obtain a thorough history and perform a complete physical examination. Laboratory tests include a complete blood count, serum electrolytes, transaminases and measurement of bST. Furthermore, an abdominal ultrasound should be performed. A bone densitometry is only recommended in selected cases (e.g. a child with unexplained bone pain). If a child with suspicious skin lesions presents with – (a) clinically significant abnormalities in cytology or biochemistry, (b) a bST >100 ng/mL or a rapidly rising bST or (c) obvious organomegaly – a BM biopsy should be obtained. The prevalence of SM in children with MIS is unclear, mostly because children undergo a bone marrow only when signs and symptoms suggest the presence of an advanced/progressive neoplasm. Detection of KIT (D816V) in peripheral blood and the morphology (e.g. monomorphic lesions) of skin lesions might be suggestive of systemic disease and might represent an indication for BM examination [17]. On the other hand, if no abnormalities are found, we suggest a watchful waiting approach in these patients, because of the invasive nature of a BM examination.
Clinical Features, Autoantibodies, and Outcome of Neonatal Lupus Erythematosus
Published in Fetal and Pediatric Pathology, 2022
Skin lesions of affected infants were treated with sun protection of all skin. One patient with a third-degree AV block was auto-discharged against advice without recovery with an average heart rate of 50 beats per minute. None of the other three CHB patients required a pacemaker at the time of hospitalization or after discharge. Intravenous immunoglobulin(IVIG) together with systemic corticosteroids were administered to three patients for thrombocytopenia and hepatobiliary injury (jaundice, a severe elevation of aminotransferases and/or gamma-GT), two patients for thrombocytopenia, one patient for hepatobiliary injury. Intravenous immunoglobulin without systemic corticosteroids was use in three patients for thrombocytopenia. Systemic corticosteroids without intravenous immunoglobulin were used in four patients for hepatobiliary injury, three patients for anemia, and one patient for thrombocytopenia.
Treatment of fibrous dysplasia: focus on denosumab
Published in Expert Opinion on Biological Therapy, 2022
Bogdan Huzum, Sabina Antoniu, Raluca Dragomir
In the other two adult cases of polyostotic FD, denosumab was also successfully used. The first case was a 44-year-old female with FD lesions at the skull, pelvis, and femoral levels detected with CT imaging during childhood. Characteristic skin lesions were also present. She had bone pain and increased levels of biomarkers of bone turnover, which remained constant during treatment with zoledronic acid. Therefore, she was started on denosumab (60 mg). She received three doses of denosumab. The interval between the first two doses was 9 months and interval between the second and the third doses was 6 months. At the one-month follow-up after the first denosumab dose, the severity of hip bone pain had decreased from a score of 7/10 to 4/10, and the levels of BTMs [serum amino-terminal collagen type I propeptide (PINP) or NTX and urinary deoxypyridinoline (uDPD)] decreased, reaching a peak decrease at week 31 from the first dose, with another peak decrease at 23 weeks after the second dose [33].