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  • Author: Simona Stolnicu x
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Knuckle Pads – Practical Diagnostic Issues

Abstract

Knuckle pads are thickening of the skin over the extensor surface of the proximal interphalangeal joints. Clinical picture, ultrasound imaging, and histopathological examination of the skin biopsy ascertain the diagnosis. In routine practice, two main differential diagnoses are important: knuckle pads vs. pseudo-knuckle pads and idiopathic vs. non-idiopathic forms of knuckle pads.

Open access
The Diagnostic Value of Ultrasonography in a Case of Unusual Pilomatrixoma

Abstract

Introduction: Pilomatrixoma or pilomatricoma is a benign appendageal growth, originating from hair cortex cells.

Case presentation: We present an unusual case of a 65-year-old female patient who has been diagnosed and treated for a presumed recurrent furunculosis localized on the abdominal area. Ultrasonography raised the suspicion of pilomatrixoma. A large excision was performed and histopathology confirmed the diagnosis.

Conclusions: Ultrasonography could be a simple and reliable diagnostic tool in daily practice.

Open access
Horse Shampoo for Human Hair?

Abstract

Introduction: Lately, a new idea has caught the attention of young people of both genders, being debated in consultation rooms, during classes, and especially on social media: is using horse shampoo for human hair wrong or not?

Material and methods: A simple questionnaire about horse shampoo and its use in humans was addressed to 85 students.

Results: Thirty-eight responders were aware of its existence, 27 have tried it and 3 were still using it as a weekly shampoo. All positive responders were young women who declared being completely satisfied by horse shampoo and none of them have reported side effects.

Conclusion: Although it has good reviews, horse shampoo is not available in human pharmacies. As dermatologists, we are still looking for an answer.

Open access
The Role of Pedobarography and Therapeutic Padding in the Management of Hyperkeratosis due to Mechanical Stress

Abstract

Hyperkeratotic lesions result from continuous mechanical action on the skin forming a callus or a corn. The accumulation of horny layers will increase pressure, creating a vicious cycle. We present a new approach based on relieving pressure or friction, strictly based on the results of pedography (pedobarography).

Open access
Generalized Severe Plaque Psoriasis in an HIV Positive Patient – a Challenging Treatment

Abstract

Psoriasis is a systemic chronic immune-mediated disorder, rarely reported in HIV-infected patients, in which the disease is more severe and debilitating. Response to treatment is modest, and skin diseases may profoundly affect the patients’ quality of life. Anti-psoriasis therapies have immunosuppressive effects and must be carefully recommended in HIV-infected patients. Moreover, the compliance of HIV patients diagnosed with psoriasis is low, and monitoring these patients is challenging. Herein we present a rare case of severe HIV-associated psoriasis with large plaques localized on the trunk, abdomen, limbs and plantar area in a non-compliant patient, with impaired renal and hepatic functions, dyslipidemia, and anemia, for whom the therapeutic approach was disappointing.

Open access
Trauma-induced Skin Lesions in Newborns – an Overlooked Problem

Abstract

Newborns are more likely to develop bruises due to mechanical trauma during birth. Establishing the correct diagnosis in newborns presenting with different skin lesions is not an easy task, and besides the well-known pathology, one must not forget simple posttraumatic injuries. We present three cases that raised questions before establishing that the lesions had been induced by simple mechanical trauma during birth. Trauma-induced skin lesions in newborns may represent an overlooked problem. The three cases presented here are meant to draw attention to the possibility of trauma-induced lesions in newborns, which require only close follow-up and surveillance instead of exhaustive clinical and laboratory investigations, which are inevitably accompanied by anxiety.

Open access
Erythroplasia of Queyrat Treated with 5% Imiquimod Cream — Case Report Emphasizing the Role of Human Papilloma Virus Testing in a Clinical Setting

Abstract

Background: Anogenital premalignancies and malignancies often affect females and males, and human papillomavirus infection plays a crucial role in their etiopathogenesis. These lesions are very important and represent an immense public health burden.

Case presentation: A 78-year-old Caucasian male presented to the Dermatology Unit for persistent, slowly progressing, well-demarcated, erythematous plaques on the glans penis, observed by the patient 18 months prior to the consultation. Variable topical treatments were applied, with no improvement and with the denial of a punch biopsy. A clinical diagnosis of erythroplasia of Queyrat was established and the test for HPV revealed an association with subtype 16 (which excluded other benign inflammatory conditions). Positive results were obtained after 4 weeks of topical application of 5% imiquimod cream, once daily, 5 times a week.

Conclusion: Erythroplasia of Queyrat should be diagnosed in a non-compliant patient based on the clinical picture and HPV testing even in the absence of a biopsy, and a non-surgical treatment should be initiated immediately.

Open access
Congenital Malalignment of the Nails

Abstract

Congenital malalignment of the toenail is characterized by the lateral (rarely medial) deviation of nail plates that affects mostly the great toes from one foot or both, but has also been described on other toes, even on the hands. This nail disease is still considered a rare entity, although it is not a rare clinical observation in daily practice. We present a few cases in children and adults, highlighting the diagnosis made by clinical observation, regardless of the different grades of severity of the nail disease. Conclusion: It is of great importance to clinically recognize this entity in young children and to make the correct recommendations.

Open access
Skin Lesions in a Daclizumab-treated Patient with Multiple Sclerosis

Abstract

Background: Daclizumab is a humanized monoclonal antibody against the D-subunit (CD25) of the high-affinity interleukin (IL)–2 receptor, used for the treatment of relapsing-remitting multiple sclerosis with a large spectrum of cutaneous adverse reactions. Case presentation: We present the case of a middle-aged man treated with daclizumab for multiple sclerosis, who developed skin reactions difficult to evaluate. A 4 mm punch-biopsy was taken from the plantar area. Histological examination of the biopsy revealed hyperkeratosis and acanthosis but no parakeratosis, while a discrete inflammatory infiltrate was noticed around vessels in the dermis. Treatment with fluconazole 50 mg/day for 10 days, moisturizers, and grade I topical steroids was followed by slight improvement of the clinical picture. Treatment with daclizumab was not discontinued. Conclusion: The clinical efficacy and side effects of daclizumab have to be reported and confirmed in clinical practice in the following years. Any clinical report can contribute to validate the efficacy and risk of the drug’s administration. Any type of adverse skin reaction must be reported for clarifying the diagnosis.

Open access
Cutaneous Manifestations of Cystic Fibrosis

Abstract

Cystic fibrosis (CF) is an autosomal recessive affliction triggered by genetic mutations in the cystic fibrosis transmembrane conductance regulator. The lung and pancreas are the most frequently affected organs in cystic fibrosis, cutaneous involvement is undervalued and underdiag-nosed. Skin lesions observed in patients diagnosed with cystic fibrosis are not well known and can create confusions with other dermatological diseases. The diagnosis of cutaneous lesions as signs of cystic fibrosis by pediatricians or dermatologists, despite their overlapping with different nutritional deficiencies, would allow earlier diagnosis and proper treatment and could improve quality of life and outcomes.

Open access