Search

Nodular or keloidal morphea, also known as nodular scleroderma, is a rare form of localized sclerosis (SSc) or morphea. In this paper, we reported a case of this rare entity with a review of the literature. [ABSTRACT FROM AUTHOR]

Key Clinical Message The survival of multiple myeloma patients has improved very significantly over the last decade. Still median overall survival is inferior to 5 years. A small proportion of patients survive longer than 10 years. In this paper we discuss four cases illustrating the nonhomogeneous clinical presentation and evolution of this subset of patients. Surprisingly, these long survivors do not always have deep responses and some require frequent treatments, which include autologous stem cell transplantation and novel drugs. The authors discuss several aspects of these clinical histories, including treatment options, raising hypothesis on their relation with long survivorship which may be important to have in consideration when studying this subject. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Healthcare providers should educate patients on the appropriate use of topical agents and the potential risks associated with non‐standardized formulations, especially for infants and young children. Complementary and alternative medicine (CAM) is an unconventional treatment method used alongside or in addition to conventional medical treatment methods to improve the healing process. Inappropriate administration of CAM can worsen the condition of diseases and have potential hazards for patients. Herbal therapy is one of the most famous and widely used CAMs in treating various skin disorders. In this case, we report a 4‐month‐old girl with atopic dermatitis who demonstrates ulceronecrotic lesions on her face and extremities besides sepsis 3 days after a walnut's homemade cream consumption. She was treated with intravenous clindamycin and wet‐to‐dry dressing to remove the scabs. This case report shows the potentially hazardous effects of misused traditional and homemade herbal therapy. It highlighted the need to pay particular attention when CAMs are used, especially for infants and young children. [ABSTRACT FROM AUTHOR]

Key Clinical Message A 27-year old male with Hodgkin's lymphoma was treated with combined chemotherapy that included bleomycin. He presented with pruritic erythematous, edematous linear lesions and was diagnosed to have flagellate hyperpigmentation, a rare side effect of bleomycin chemotherapy. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Kidney metastasis to the pituitary gland can cause hyperprolactinemia even above 250 ng/mL. Although the treatment of metastasis is palliative, surgical decompression could play a major role in the recovery of symptoms and improve quality of life. Pituitary metastasis should be considered in the evaluation of an unusual pituitary mass. Pituitary tumors are frequently encountered in the neurosurgical setting. Although the majority of them are pituitary adenomas, rare entities encompass pituitary metastasis. They should be differentiated from pituitary adenomas because their management and prognosis are different. We report a 53‐year‐old female who complained of headache and had remarkable hyperprolactinemia (271.1 ng/mL). Having considered macroprolactinoma as the initial diagnosis, medical treatment was initiated with Cabergoline. Subsequently, the patient's vision deteriorated which prompted us to perform endoscopic endonasal transsphenoidal surgery. Histologic examination of the resected tumor revealed metastatic renal cell carcinoma. Main treatment for these subjects is palliative; and unlike the pituitary adenoma, the prognosis is unfortunately poor. Pituitary metastasis should be considered in the evaluation of an unusual pituitary mass associated with hyperprolactinemia. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Patients presenting with an acute ischemic stroke despite dabigatran therapy (last intake <24 h or unknown) should be evaluated for reversal by idarucizumab, making them eligible for safe and effective intravenous thrombolysis. It has been shown to be feasible, well‐tolerated, and easy to manage in an emergency room or stroke unit. [ABSTRACT FROM AUTHOR]

Key Clinical Message In selected cases, homozygosity mapping followed by direct sequencing of one or a few carefully selected candidate genes in a prenatal setting can be beneficial to obtain diagnosis in consanguineous families. [ABSTRACT FROM AUTHOR]

This case aimed to assess the clinical and radiographic outcomes of the All‐on‐4 and the All‐on‐6 concept using three‐dimensional computer‐assisted treatment planning, and computer‐guided surgery. Two years after the treatment, the "All‐on‐4" and "All‐on‐6" concepts provided effective treatment for immediate restoration and showed predictable outcomes in a completely edentulous patient. [ABSTRACT FROM AUTHOR]

Cerebral nocardiosis is a rare and opportunistic cerebral infection caused by Nocardia spp., a gram‐positive, aerobic bacteria of the Actinomycetes order. Patients with cell‐mediated immunodeficiencies are often targeted by this microorganism, for which early diagnosis and therapeutic approach are essential. [ABSTRACT FROM AUTHOR]

Two cases of pyogenic granulomas in burned skin were presented, a 17‐month‐old boy and a 7‐year‐old girl, being given oral propranolol and topical timolol. Both cases showed lesions improvement with no adverse effects, suggesting that beta‐blocker therapy may have a positive impact on the treatment of pyogenic granuloma after burns. [ABSTRACT FROM AUTHOR]

Sellar region is a rare localization for intracranial metastases. The diagnosis is frequently delayed as symptoms are generally non specific. Radiologic diagnosis may be difficult as these tumours present similiraities to other more frequent sellar tumours. There is still no consensus regarding therapeutic approach. Prognosis is related to several features. Pituitary metastases are rare tumors mainly diagnosed in patients with multiple metastatic lesions. Diagnosis is difficult as clinical symptoms are nonspecific. Treatment mainly aims to improve the quality of life. [ABSTRACT FROM AUTHOR]

Three patients affected by plaque psoriasis and presenting with multiple infectious comorbidities and latent tuberculosis infection (LTBI) were initially managed with conventional DMARD therapy. After showing unsuccessful results, treatment with secukinumab was initiated without prophylactic isoniazid and soon led to favorable dermatological outcomes without the reactivation of tuberculosis infection. [ABSTRACT FROM AUTHOR]

A young woman with systemic sclerosis, hypothyroidism, and pulmonary hypertension was admitted to our center with massive pericardial effusion and left ventricular collapse. Despite undergoing successful pericardiocentesis, she passed away a month later. The best therapeutic approach in this situation remains to be determined. [ABSTRACT FROM AUTHOR]

Morgellons disease (MD) is a rare dermatopathy characterized by nonspecific symptoms and the production of multicolored fibers and granular tissue from diffuse skin ulcerations which are described as being either pruritic or painful. The etiology of MD is currently unknown; previous studies have suggested both psychiatric and infectious causes, with increasing interest over the previous decade in elaborating a possible pathogenesis for the disease secondary to infection by Borrelia species. We report a middle‐aged Caucasian female who developed symptoms of MD in the days following exposure to a tick bite after spending an afternoon hiking through a wooded area. She was subsequently treated with a course of Doxycycline and found on two‐week follow‐up to have complete remission of her symptoms. This case report further supports the theory for an infectious etiology of MD and encourages future studies into its pathophysiology. [ABSTRACT FROM AUTHOR]

Screening the MC4R gene showed one rare mutation p.Met215Ile in a Moroccan patient with morbid obesity, which leads to a change in the protein structure. The analysis of MC4R variants may be useful for future therapeutic approaches. [ABSTRACT FROM AUTHOR]

Under-expanded coronary stent related to inadequate preparation of calcified lesion is associated with poor clinical outcomes.Off-label use of S-IVL to correct this clinical issue is effective and safe, probably more than other current techniques. However, this statement needs further evidence. [ABSTRACT FROM AUTHOR]

Rosai‐Dorfman disease is referred to as sinus histiocytosis massive lymphadenopathy. We are reporting a rare case of Rosai‐Dorfman disease, a case of 6‐year‐old boy with a history of multiple painless submandibular and cervical lymphadenopathy. [ABSTRACT FROM AUTHOR]

When the diagnosis of penile calciphylaxis is suggested, the evolution of the disease is rapidly unfavorable; in this case, a rapid medical treatment must be established to obtain an improvement of the disease to avoid penectomy. [ABSTRACT FROM AUTHOR]

We treated PR3‐ANCA positive vasculitis in a patient diagnosed with rheumatoid arthritis using rituximab. Monoclonal antibody therapy can be used to simultaneous treat more than one collagen disease in such patients. This suggests that shared pathogenic pathways exist between different collagen diseases. [ABSTRACT FROM AUTHOR]

Epistaxis management on COVID‐19 patients is concerning for otolaryngologists due to the highly virulence and increased concentration within respiratory droplets and nasal secretions. Authors suggest initial management with oxymetazoline nasal drops and local pressure before considering nasal packing with absorbable material to prevent COVID‐19 transmission to surrounding healthcare workers. [ABSTRACT FROM AUTHOR]

Consideration of facial soft tissue is critical in orthodontic diagnosis and treatment planning to achieve improvement in facial esthetics as well as dental occlusion. As is illustrated by success in orthodontic treatment of an adult Class II division 1 malocclusion with nonextraction and assisted by lip myofunctional training. [ABSTRACT FROM AUTHOR]

There is no established consensus for the treatment of allergic bronchopulmonary mycosis (ABPM) on its diagnosis or at relapse. We reviewed our experience with patients with ABPM, which showed that although systemic corticosteroids are effective in ABPM, and other treatment options can also be selected. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This study describes a patient with symptomatic Killian‐Jamieson, a rare entity, successfully treated by cervical approach with diverticulum resection and esophagomyotomy. [ABSTRACT FROM AUTHOR]

We report here the case of a patient with 4 years long‐term survival after treatment with surgery, chemotherapy, and radiotherapy with good local control. This case highlights the possible role of radiation therapy in this tumor. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Peripartum cardiomyopathy is challenging to diagnose as it mimics symptoms present in normal pregnancy. The clinical course and prognosis are various. In selected cases, a cardioverter implantable defibrillator with/without cardiac resynchronization therapy, mechanical ventricular assist device treatment, and transplantation is indicated. [ABSTRACT FROM AUTHOR]

Key Clinical Message: The primary cutaneous diffuse large B‐cell lymphoma, leg type (PCDLBCL‐LT) has a poor prognosis. R‐CHOP with or without radiotherapy is the available recommendations for first‐line treatment. Relapses/refractory cases are frequent with no standardized therapeutic guidelines. Lenalidomide seems to be an excellent therapeutic option as a second‐line treatment of relapsed PCDLBCL‐LT. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Idiopathic ventricular tachycardia arising from the LV summit epicardial area can be successfully mapped and possibly ablated from the left atrial appendage. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This report describes the successful use of a new intervention to improve respiratory mechanics and gas exchange in a relatively homogeneous group of infants with severe bronchiolitis‐induced PARDS after failure of conventional treatment. These results may open a new interesting area of research and management for PARDS patients. [ABSTRACT FROM AUTHOR]

Key Clinical Message: We present a case of diaphanospondylodysostosis (DSD) which showed increased nuchal translucency at 1st trimester and missing ossification of the lower spine, short ribs with posterior gaps, and absent nasal bone in midtrimester. Autopsy revealed additionally bilateral nephroblastomatosis. Molecular genetic analysis showed a new mutation in the BMPER gene. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Patients with congenital heart disease and duct‐dependent pulmonary circulation can undergo stenting of the patent ductus arteriosus (PDA). This case shows that, due to the physiological changes occurring after stent implantation, sometimes it is necessary to close the stented PDA rather than to redilate it. [ABSTRACT FROM AUTHOR]

Key Clinical Message: We report a case of short stature irresponsive to growth hormone (GH) replacement therapy. Low GH response to provocative tests and undetectable IGF‐1 levels had suggested GH deficiency, while response to therapy indicated GH insensitivity. Molecular evaluation of the GH/IGF‐1 axis should be performed in these cases to improve diagnosis and therapy. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Foreign body‐induced arthritis is a rare etiology of mono‐arthritis. It should be suspected in the case of postoperative arthritis, even if some decades have passed since surgery. Histopathology of the tissues is required for a definitive diagnosis, and debridement is essential for complete recovery. [ABSTRACT FROM AUTHOR]

Key Clinical Message: We have tried to establish a safe and effective method to treat the peripelvic renal cyst combined with renal calculi. The key points are as follows: choose the appropriate target calyx; find the gap between cyst and renal pelvic; put a nephrostomy tube to stimulate the closing of cystic cavity. [ABSTRACT FROM AUTHOR]

Key Clinical Message Adult-onset Still's disease (AOSD) due to visceral leishmaniasis (VL) has not been previously reported. This case report analyzes a single episode of AOSD probably due to a visceral leishmaniasis successfully treated with pentamidine isethionate and prednisone. [ABSTRACT FROM AUTHOR]

Key Clinical Message Cluster-like headache may be associated with pituitary tumors, mostly prolactinomas. Pituitary imaging and prolactin measurement should be assessed in patients presenting with cluster-like headaches with atypical features or unsatisfactory response to treatment. Furthermore, large pituitary adenomas with moderate increase in prolactin levels should prompt prolactin dilutions to avoid 'hook effect'. [ABSTRACT FROM AUTHOR]

Key Clinical Message A major cause for endodontic failure is the inability to treat all anatomy. Studies report endodontic retreatments contain 42% missed canals. This case illustrates dentin preservation of a molar with an uninstrumented mesiobuccal-3 canal revealed post-GentleWave Procedure. Efficient cleaning and disinfection with maintained healing to 18 months is demonstrated. [ABSTRACT FROM AUTHOR]

Key Clinical Message We report a rare case of an immunocompetent patient with Mycobacterium avium complex (MAC) disease in which bilateral hilar lymphadenopathy developed during anti-MAC treatment. This case indicates that Propionibacterium acnes would be present and might be a cause of sarcoidosis even in patients with MAC. [ABSTRACT FROM AUTHOR]

Key Clinical Message Hemangioma is a benign tumor rarely found in adult, especially in oropharynx. This study describes the first case of mixed hemangioma occurring as an oropharyngeal asymptomatic pedunculated mass. Biopsy is excluded given the risk of hemorrhage. Diagnosis and treatment are based on the surgical resection and the histopathologic examination. [ABSTRACT FROM AUTHOR]

Key Clinical Message An acute ileus and/or urinary retention are recognized as emergent complications requiring appropriate depressurizing treatments. Meningitis should be suspected as a cause of these autonomic disturbances. [ABSTRACT FROM AUTHOR]

Key Clinical Message This case demonstrates the rare coexistence of a prolactinoma with craniopharyngioma and documents its radiological growth. This case suggests that patients with pituitary neoplasms should be followed closely and although prolactinomas can often be managed medically, a coexistent other lesion may require surgery for histological assessment and to reduce mass effect. [ABSTRACT FROM AUTHOR]

Key Clinical Message Zinc phosphide (Zn3P2/ZnP) is used as a rodenticide. The most common signs of toxicity are nausea, vomiting, hypotension, and metabolic acidosis; patients presenting such signs are referred to the emergency department (ED) of the hospitals. Therefore, this study aimed to report two cases of hepatotoxicity following accidental and intentional ZnP poisoning and successful management with N-acetylcysteine (NAC). [ABSTRACT FROM AUTHOR]

Key Clinical Message Asenapine, a novel second-generation antipsychotic is effective in acute treatment of bipolar I disorder patients in combination with mood stabilizers even in resistant cases. Although there is no evidence for asenapine's efficacy to be superior to currently available agents, asenapine's favorable weight and metabolic profile are of clinical interest. [ABSTRACT FROM AUTHOR]

Key Clinical Message: We report here a new adverse event of romiplostim which is a protein analog of thrombopoietin. Leukemic mature B‐cell neoplasm was observed during the treatment of thrombocytopenia in a patient with liver cirrhosis. Their relationship was suggested clinically but the mechanism of leukemic expansion of lymphoma cells was not clarified. [ABSTRACT FROM AUTHOR]

Key Clinical Message Patent foramen ovale (PFO) is a risk factor for cryptogenetic stroke; its closure should be considered in selected patients. It is not always clear whether symptoms (presyncope, paresthesia) apparently due to paradoxical embolism are related with other cardiovascular disorders such as arrhythmias. Flecainide administration for post- PFO-closure supraventricular arrhythmias can unmask a latent undiagnosed Brugada syndrome. [ABSTRACT FROM AUTHOR]

Key Clinical Message Chondroblastoma is a rare, benign bone tumor that represents 1-2% of all primary bone tumors. Denosumab, a monoclonal antibody, has been demonstrated to inhibit the growth of giant cell tumors. We report a case of recurrent chondroblastoma of the squamous temporal bone that is currently suppressed with denosumab. [ABSTRACT FROM AUTHOR]

Key Clinical Message Acute urinary retention secondary to vasculitic penile swelling in children is extremely rare. Henoch-Schönlein purpura is a self-limiting IgA-mediated cutaneous vasculitis, which can cause soft tissue edema. Acute urinary retention requires urgent intervention to prevent obstructive uropathy. Suprapubic catheterization provides an effective management strategy in the emergency setting. [ABSTRACT FROM AUTHOR]

Key Clinical Message A 65-year-old male, Parkinson's disease patient, was evaluated for GPR109A expression, niacin index, UPDRS scale, handwriting test, and quality of sleep with and without niacin treatment. The evaluation was repeated 3 months after niacin was stopped. Niacin modulated the abovementioned parameters and showed the overall improvement without side effects. [ABSTRACT FROM AUTHOR]

The purpose of this image is to raise awareness of the early diagnosis and treatment of Blount's disease. Failure to distinguish between physiologic genu varum and early onset of Blount's disease can lead to irreversible outcomes, including progressive deformity with gait deviations, limb‐length discrepancy, and premature arthritis of the knee. [ABSTRACT FROM AUTHOR]