Infectious diseases
Giuseppe Micali, Francesco Lacarrubba in Dermatoscopy in Clinical Practice, 2018
Clinically, MC presents as an eruption of multiple papules. The morphology of an individual lesion is a dome-shaped, flesh colored, or pearly papule with an umbilicated center (Figures 10.1 –10.2). Lesions vary in size from 1–10 mm, although occasionally giant lesions are seen. The papules may be atypical in size, shape, and color, and signs of inflammation may occur spontaneously or after trauma. The lesions are often grouped in small areas but also may become widely disseminated. Any cutaneous surface may be involved, but favored sites include the axillae, the antecubital and popliteal fossae, and the crural folds in children. Autoinoculation is common. MC in adults affects the groin, genital area, thighs, and lower abdomen and is often acquired with sexual intercourse. Histologically, MC exhibits epidermal hyperplasia producing a crater filled with huge (up to 35 microns) eosinophilic to basophilic intracytoplasmatic inclusions that are called molluscum bodies or Henderson-Patterson bodies. MC is a self-limited disease, which if left untreated will eventually resolve in immunocompetent hosts but may persist in atopic and immunocompromised individuals.1–5
Cutaneous Manifestations of Sexually Transmitted Disease in the HIV-Positive Patient
Clay J. Cockerell, Antoanella Calame in Cutaneous Manifestations of HIV Disease, 2012
After a variable incubation period most likely in the neighborhood of 50 days,72 a single or multiple firm papules or subcutaneous nodules develop at the site of inoculation. In the most common type of donovanosis, the ulcerogranulomatous form, the primary lesions grow and ultimately ulcerate to form the classic painless ‘beefy red’ ulcers with clean, friable bases and distinctive raised, rolled edges (187).56 Without treatment, ulcers can enlarge, become confluent, and cause extensive local destruction. Autoinoculation is common leading to the classic ‘kissing’ lesions at sites of skin apposition.56 Less common alternative presentations include hypertrophic or verrucous ulcers, deep necrotic foul-smelling ulcers, or sclerotic lesions. Granuloma inguinale is usually limited to a localized infection and infected persons, therefore, do not often have constitutional symptoms.81 These local lesions occur in the genitalia in approximately 90% of cases, with the remainder of cases occurring in the inguinal area. Ulcers more commonly occur in uncircumcised men and are linked to poor hygiene. Extragenital cases comprise a small minority of cases but have been reported in the literature at anatomic sites largely contained within the oro- or nasopharynx.82 Disseminated donovanosis may rarely occur and is thought to be associated with pregnancy and cervical infection.
Bacterial Sexually Transmitted Diseases
Laurence R. Sands, Dana R. Sands in Ambulatory Colorectal Surgery, 2008
Chancroid is caused by the bacterium Haemophilus ducreyi. It is only transmitted by sexual contact, although autoinoculation into other body areas has been shown in patients with genital ulcers. It is endemic in many developing countries, but has only been seen in focal outbreaks in the United States in recent years (30–33). Studies have shown that the early papule stage affects men and women equally, but men progress to the pustule stage much more frequently (36). Uncircumcised men are three to four times more likely to have H. ducreyi infection. Ulcers are more commonly single and painful in men. Women with ulcers have an average of 4.5 around the introitus, but generally do not complain of pain (34). The “chancroid triad” of a moderate-to-severely painful ulcer with an undermined ulcer edge having a purulent dirty gray base is only present in less than half of men. Painful unilateral inguinal adenitis is present in up to 40%. Enlarged nodes may suppurate. Previously, aspiration of the suppurative adenitis has been recommended over incision and drainage but, more recently, drainage has proven to be superior with more rapid healing. Untreated disease leads to prolonged genital ulcers with incomplete healing.
Orbital cysticercosis: clinical features and management outcomes
Published in Orbit, 2021
Shebin Salim, Md Shahid Alam, Varsha Backiavathy, Nirav Dilip Raichura, Bipasha Mukherjee
Cysticercosis is a parasitic infestation caused by Cysticercus cellulosae; which is the larval form of Taenia solium. Human infection is caused by drinking contaminated water, eating uncooked vegetables infested with parasitic eggs, and by autoinoculation.1,2 Neurocysticercosis is the most common systemic manifestation.1 Intraocular cysticercosis especially involving the posterior segment is more common in western countries, while the orbital and adnexal form is more prevalent in the Indian subcontinent and it can occur in 13% to 46% of infected patients.3–5 Advances in the imaging modalities have made the diagnosis of orbital and adnexal cysticercosis easier and more accurate.6 The last study, one with a study population of more than 50 patients was published 10 years ago by Rath et al., and there is no recent study.7 There is also a lack of studies with an objective assessment of the management outcomes. We herewith present the clinical manifestations, radiological features, and treatment of a large case series of orbital cysticercosis presenting at a tertiary eye care center over 10 years with an objective analysis of the management outcome. The present study can provide further insight into the disease process and advances in the management over the past decade.
A Belgian student with black eschars
Published in Acta Clinica Belgica, 2023
Astrid Van Reempts, Liesbet De Meester, Koen Blot, Ann-Sophie Candaele, Hilde Beele, Jo Van Dorpe, Diana Huis in ‘t Veld
Lesions at multiple sites are mainly attributable to multiple primary inoculations or autoinoculation, and occasionally to lymphatic or viraemic spread [2]. In immunocompromised patients, cutaneous dissemination and even fatal cases have been reported [2,9,14]. Given the presence of multiple lesions in our patient, we conducted a screening for immunodeficiency that was negative. Therefore, we presume that the spreading of lesions is the result of autoinoculation.
Psychological effect of COVID-19 pandemic on healthcare professionals of Yemen and coping strategies
Published in Libyan Journal of Medicine, 2023
Nagd Mohammed Ahmed Mahmood, Sitaram Khadka, Mohammad Saleem, Maroa Ahmed Ali Mohammed Alkamel, Maged Mohammed Salem Saeed Khudhiere, Prem Prasad Panta, Muhammad Abdul Jabar Adnan, Gopal K Yadav
Because little is known about COVID-19, and subsequently, without proven therapy, many HCPs are unrehearsed to perform duties [8]. The fear of autoinoculation, social stigma, and the risk of transmitting the disease to family members and friends are adding extra burdens to them that definitely impact their mental health [8–10].
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