• Title/Summary/Keyword: Skin Lesion Diagnosis

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Ultrasonographic and Computed Tomographic Appearance of Spontaneous Cutaneous Fistula Resulted from Retained Surgical Gauze in a Dog

  • Hwang, Tae-sung;Huh, Chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.36 no.4
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    • pp.238-243
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    • 2019
  • A 6-year-old, spayed female Maltese was presented with the condition of a chronic recurrent abscess formation in the left flank region. Despite the antibiotics and drainage therapy given to the dog, the lesion formed a continued serosanguineous to the point that a purulent discharge was evident. In the meantime, an abdominal ultrasound revealed the presence of a well-defined mass with a hypoechoic outer margin, and a hyperechoic inner rim in the cranial of the kidney. A fistula was noted as being present with a connection between the subcutaneous lesion of the left flank and the abdominal mass. It is emphasized that CT scans revealed the existence of a soft tissue dense mass with low attenuation area, as seen in some internal areas and also a peripheral contrast enhancement was noted within a nonenhancing central region. There was additional nonenhancing fluid found dorsal to the inflammatory tract passing under the epaxial muscles and at the peritoneum. Likewise, the tract exited the skin surface in the left flank. A tentative diagnosis of an abdominal abscess with spontaneous cutaneous fistula was made based on the ultrasonographic and CT appearances. A foreign body such as surgical gauze should always be considered a potential cause of draining tract in small animals, as was considered to be the problem in this case.

Necrotizing Fasciitis of Nose Skin Following Herpes Zoster (대상포진 후 발생한 비부의 괴사성 근막염 치험례)

  • Pae, Woo-Sik;Bae, Chung-Sang;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyung-Moo
    • Archives of Craniofacial Surgery
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    • v.13 no.2
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    • pp.147-150
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    • 2012
  • Purpose: Varicella-zoster virus (VZV) infection is a common childhood disease. However, old and immune compromised patients are also at risk. Necrotizing fasciitis is a life threatening infection of the subcutaneous tissues, rapidly extending along the fascial planes. It is associated with a significant mortality rate, reported between 20% and 50%, and is therefore regarded as a surgical emergency. The authors treated a patient, who developed skin necrosis of her nose and left hemifacial area, following VZV infection. There are few literatures concerning this case; therefore, we present a rare case with review of literature. Methods: A 39-year-old woman had shown a localized, painful, multiple bullae and eschar formation in her nose and left hemifacial area for several days. Her skin lesion had rapidly worsened in size and morphology. Results: We diagnosed her as a necrotizing fasciitis, following herpes zoster, and then we performed a debridement of necrotic tissue and took a full thickness skin graft on her nose and left hemifacial area. Now, she was followed up with acceptable aesthetic result after 6 months. Conclusion: Secondary bacterial skin infection following VZV, can cause a result in a higher risk of complications. Among the complication, a necrotizing fasciitis of the head and neck is uncommon, and involvement of the nose is even more rare. Through this uncommon case report, we intend to emphasize the fact that early diagnosis of necrotizing fasciitis is very important, since it frequently necessitates surgical treatment which improves morbidity and leads to good recovery.

Herpes Zoster Ophthalmicus in Minor Facial Burn (눈대상포진이 병발된 경미한 얼굴의 화상)

  • Han, Jung Kyu;Kim, Sun Goo;Kim, Yu Jin
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.803-805
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    • 2009
  • Purpose: Many conditions can mimic the presentation of burns. Herpes zoster is one of them. The characteristic features of herpes zoster such as vesicles, pustular lesions and crusts can also be found in burns. Herpes zoster ophthalmicus is a disease caused by recurrent infection of varicella - zoster virus in the ophthalmic division of the trigeminal nerve. This virus frequently affects nasociliary branch and serious ocular complications can occur. Thus, early diagnosis and proper treatment of this disease is important to prevent further ocular manifestations. We report a man who sustained minor facial burn injury that was complicated with herpes zoster ophthalmicus. Methods: A 66 - year - old man visited emergency room with multiple whitish vesicles with serous discharge on right forehead, right medial canthal area and nose. At first he was thought to have a secondary infection of facial burn injury. The vesicles on his face began to form crusts on the next day. Since his skin lesion was located on the ophthalmic division of trigeminal nerve, we also suspected herpes zoster ophthalmicus. He was referred to dermatologist and ophthalmologist. Results: We used antiviral agent (Acyclovir) and NSAIDs for treatment. The patient had no ocular complications. His skin lesion was almost healed after 1 month and remained scars. We treated a patient with minor facial burn complicated with herpes zoster ophthalmicus with antiviral agent. Conclusion: In this work, we describe a case of old patient with herpetic infection and emphasize the need for careful examination to diagnose accurately.

Recurrent Chondroid Syringoma of the Alar Rim

  • Yun, Young Mook;Shin, Seungho;Kyung, Hyunwoo;Song, Seung Han;Kang, Nakheon
    • Archives of Craniofacial Surgery
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    • v.17 no.1
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    • pp.35-38
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    • 2016
  • Chondroid synringoma (CS), pleomorphic adenoma of skin, is a benign tumor found in the head and neck region. CS was first reported in 1859 by Billorth for the salivary gland tumor. The usual presentation is an slowly growing, asymptomatic mass. A 53-year-old female with a history of chondroid synringoma had presented with multiple firm, nodular masses found in the left nostril area. The lesion had been excised 8 years prior and was diagnosed histopathologically, but had gradually recurred. Excision of the mass located in subcutaneous layer revealed four whitish, firm tumors surrounded with capsular tissue. Neither recurrence nor complications occurred during the 18 months follow-up period. In the head and neck region, chondroid syringoma should always be considered in differential diagnosis of soft tissue masses despite its rare incidence. For that reason, excisional biopsy with clear margin is the optimal diagnostic as well as therapeutic choice. We report a case of recurred chondroid syringoma on the nose in female patient.

MR Imaging Findings of Recurred Dermatofibrosarcoma Protuberans of the Scalp: A Case Report (두피에서 재발한 융기성 피부섬유육종의 MR영상: 증례 보고)

  • Cho, Joon;Roh, Hong-Gee;Kim, Mi-Young
    • Investigative Magnetic Resonance Imaging
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    • v.10 no.2
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    • pp.121-125
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    • 2006
  • A 48-year-old man presented with a dermatofibrosarcoma protuberans (DFSP) of the scalp associated with local recurrence. Axial T1- and T2-weighted images demonstrated a well-circumscribed hypointense and intermediate hyperintense mass in the skin and subcutaneous layer of the scalp, respectively. Contrast-enhanced T1-weighted images showed the strongly enhanced mass invasion to the skin, subcutaneous layer and adjacent galeal layer. Scalp DFSP is very uncommon but is an aggressive tumor, so MR imaging diagnosis of the extent of the lesion to underlying structures, and initial wide local resection is important to prevent recurrence.

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Subeschar culture using a punch instrument in unstageable wounds

  • Jung, Han Byul;Lee, Yong Jig
    • Archives of Plastic Surgery
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    • v.47 no.3
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    • pp.228-234
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    • 2020
  • Background A patient's overall condition sometimes does not allow for the complete removal of a dead eschar or injured slough in cases involving a pressure-injury skin lesion. This frequently occurs in clinical practice, particularly in bedridden and older patients receiving home care or intensive care. Even after debridement, it is also difficult to manage open exudative wounds in these patients. Nevertheless, when a mature or immature eschar is treated without proper debridement, liquefaction necrosis underneath the eschar or slough tends to reveal a large, open wound with infectious exudates. We hypothesized that if the presence of any bacteria under the eschar can be evaluated and the progression of the presumed infection of the subeschar can be halted or delayed without creating an open wound, the final wound can be small, shallow, and uninfected. Methods Using a punch instrument, we performed 34 viable subeschar tissue cultures with a secure junction between the eschar and the normal skin. Results The bacterial study had 29 positive results. Based on these results and the patient's status, appropriate antibiotics could be selected and administered. The use of suitable antibiotics led to relatively shallow and small exposed wounds. Conclusions This procedure could be used to detect potentially pathogenic bacteria hidden under black or yellow eschars. Since subeschar infections are often accompanied by multidrug-resistant bacteria, the early detection of hidden infections and the use of appropriate antibiotics are expected to be helpful to patients.

Sebaceous carcinoma arising from sebaceoma

  • Lee, Da Woon;Kwak, Si hyun;Kim, Jun Hyuk;Byeon, Je Yeon;Lee, Hyun Joo;Choi, Hwan Jun
    • Archives of Craniofacial Surgery
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    • v.22 no.2
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    • pp.126-130
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    • 2021
  • Sebaceous neoplasms are rare adnexal tumors that can present a challenge to clinicians. Only four cases of sebaceous carcinoma with sebaceoma have been reported in the literature. Herein, we describe the case of a sebaceous carcinoma originating from a sebaceoma in a solitary nodule of the posterior neck. Immunohistochemically, the tumor cells were strongly positive for epithelial membrane antigen and p53. It is possible that adnexal carcinomas may arise from malignant transformation of their benign counterparts as well as de novo. Malignant transformation was likely in this case because the lesion was composed of distinct benign and malignant components, and the benign component showed the typical histopathological features of sebaceoma. This case underscores the fact that partial and superficial biopsies sometimes may not provide the correct diagnosis. If a surgeon suspects malignancy based on a clinical examination, then it is mandatory to perform a deep biopsy.

Sensorimotor Polyneuropathy Associated with Sarcoidosis (사르코이드증에 동반된 다발신경병증)

  • Ahn, Seog-Weon;Kim, Dong-Wook;Hong, Yoon-Ho;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.5 no.1
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    • pp.39-41
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    • 2003
  • Sarcoidosis is a multisystemic granulomatous disease of unknown etiology ogenesis, and most frequently presented with bilateral hilar lymphadenopathy, pulmonary infiltration, skin and eye lesion. However, neurological involvement including peripheral neuropathy is relatively rare. We report a patient who had sensorimotor polyneuropathy without other systemic symptoms or organ involvements frequently reported in sarcoidosis. Laboratory investigation suggestive of sarcoidosis lead to sural nerve biopsy for confirmation, which demonstrated noncaseating granulomatous changes. Sarcoidosis shoud be included in the differential diagnosis in subacute polyneuropathy even if there is no usual symptoms or signs suggestive of the systemic disease.

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Periorbital cutaneous angiomyolipoma: a case report

  • Young Jun Kim;Min Hyub Choi;Ji Seon Cheon;Woo Young Choi
    • Archives of Craniofacial Surgery
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    • v.24 no.2
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    • pp.83-86
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    • 2023
  • Angiomyolipomas are usually found in the kidneys of patients with tuberous sclerosis. They occur less frequently in organs such as the liver, the oral cavity, the nasal cavity, the heart, the large intestines, and the lungs. Angiomyolipomas of the skin are extremely rare, and cutaneous angiomyolipomas generally occur on the elbow, the ends of digits, the ear, and the glabella. Herein we present a rare case of angiomyolipoma occurring on the face-specifically, the right upper eyelid. We propose that upper eyelid angiomyolipoma is a hamartomatous, rather than neoplastic, lesion. Although angiomyolipoma in the periocular area is rare, it should be considered in the differential diagnosis of clinically benign masses. and regular follow-up is warranted.

TUBERCULOUS OSTEOMYELITIS SIMULTANEOUSLY OCCURED ON THE MAXILLA AND MANDIBLE (상악골과 하악골 동시에 발생한 결핵성 골수염)

  • Kim, Il-Kyu;Ryu, Mun-Kwang;Kim, Dong-Soo;Ku, Je-Hoon;Choi, Jin-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.2
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    • pp.164-169
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    • 2005
  • Tuberculosis is a systemic disease with a world-wide distribution, and its occurance in the oral cavity is well documented in the literature. Disease of oral cavity and jaw caused by Mycobacterium tuberculosis is very rare, so it is often difficult to diagnose tuberculosis in the oral cavity. When granulomatous and ulcerative lesion persists in the oral cavity for a long time, it may be considered a tuberculosis. When differential diagnosis is needed, the most reliable indicators of mycobacterial infection are careful clinical evaluation, skin test, acid-fast staining, biopsy and culture. We report a case of tuberculous osteomyelitis which simultaneously occurred on the maxilla and mandible in a 85 years old man that proved diagnosis difficult, but which responded very well to surgical treatment and chemotherapy.