Anca Chiriac, Cristian Podoleanu and Simona Stolnicu
Alopecia areata represents an autoimmune process against an unidentified autoantigen in the follicle of the hair, which affects all ages, from young children (a few months old) to elderly patients. Alopecia areata has an important impact on the quality of life, leading to a predisposition towards anxiety and depression, especially if the patients are treated with corticoid therapy that heightens the risk for such psychiatric disorders. We present the case of a patient with alopecia areata who was diagnosed at the age of 18 months, and had been followed-up until the age of 27 years.
Anca Chiriac, Cristian Podoleanu and Simona Stolnicu
Background: Self-induced skin lesions, especially in young children, can create confusion within pediatricians, dermatologists, or other medical care providers, leading to different diagnoses, unnecessary investigations, and delaying the correct therapeutic psychiatric evaluation.
Case report: We report the case of a 4-year-old boy who was referred to Dermatology after being hospitalized in the Allergy Department for a chronic allergic contact dermatitis. He had been previously diagnosed with chronic hand dermatitis, atopic dermatitis, and psoriasis, and treated with no favorable outcome. Scaly erythematous plaques were noticed on the dorsal aspects of both hands and on the lateral folds of the fingers. The skin lesions were distributed in a non-symmetrical way. A diagnosis of self-injurious behavior was presumed, and psychiatric evaluation was asked. The child was transferred to the Psychiatry Department, and a diagnosis of schizophrenia was concluded.
Cristian Podoleanu, Bogdan Dobrovat, Simona Stolnicu and Anca Chiriac
Lipodermatosclerosis and diabetic dermopathy are low-risk skin lesions with many similar clinical features, except for venous abnormalities such as chronic venous insufficiency, but are rarely a reason for referring the patient to vascular ultrasound examination. We present 3 serial cases in which the compression ultrasound examination (CUS) of the venous circulation of the affected limbs was of utmost importance in the severity stratification. Asymptomatic deep venous thrombosis (DVT) was found in the first two cases, while in the third case the CUS excluded any type of vascular involvement, leading to a definite diagnosis of diabetic dermopathy. Lipodermatosclerosis may be associated with asymptomatic DVT due to chronic venous insufficiency, and early referral to CUS positively impacts further patient management.
Anca Chiriac, Anca Eduard Chiriac, Cristian Podoleanu and Simona Stolnicu
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.
We present the case of a 77 year old patient with a primary breast carcinosarcoma composed mostly of an osteogenic sarcoma of fibroblastic type in which only immunohistochemical analysis disclosed the presence of a minor malignant epithelial component. The malignant mesenchymal component derives from dedifferentiation of myoepithelial cells since myoepithelial markers are positive. Also, like the majority of the other metaplastic carcinomas in the breast, carcinosarcoma is a basal type of tumor that will not respond to endocrine drugs or Her2/neu therapy.
Anca Chiriac, Mihai Mares, Cristian Podoleanu, Cosmin Moldovan and Simona Stolnicu
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.
Anca Chiriac, Rareș Georgescu, Piotr Brzezinski and Simona Stolnicu
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.
Anca Chiriac, Piotr Brzezinski, Liliana Foia, Cristian Podoleanu, Cosmin Moldovan and Simona Stolnicu
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.