BACKGROUND Dystrophic epidermolysis bullosa pruriginosa(DEB-Pr)is a rare subtype of DEB,characterized by recurrent pruritus of the extremities,pruritus papules,nodules,and mossy-like plaques.To date,fewer than 100 cas...BACKGROUND Dystrophic epidermolysis bullosa pruriginosa(DEB-Pr)is a rare subtype of DEB,characterized by recurrent pruritus of the extremities,pruritus papules,nodules,and mossy-like plaques.To date,fewer than 100 cases have been reported.We report a misdiagnosed 30-year-old man with sporadic late-onset DEB-Pr who responded well to tacrolimus treatment,thereby serving as a guide to correct diagnosis and treatment.CASE SUMMARY A 30-year-old man presented with recurrent itching plaques of 1-year duration in the left tibia that aggravated and involved both legs and the back.Examination revealed multiple symmetrical,purple,and hyperpigmented papules and nodules with surface exfoliation involving the tibia and dorsum of the neck with negative Nissl's sign,no abnormalities in the skin,mucosa,hair,or fingernail,and no local lymph node enlargement.Blisters were never reported prior to presentation.Serum immunoglobulin E level was 636 IU/mL.Clinical manifestations suggested DEB-Pr.Histological examination showed subepidermal fissure,scar tissue,and milia.Direct immunofluorescence showed no obvious abnormalities.However,we were unable to perform electron microscopy or genetic research following his choice.We treated him with topical tacrolimus.After 2 wk,the itching alleviated,and the skin lesions began to subside.No adverse reactions were observed during treatment.CONCLUSION Topical tacrolimus is a safe treatment option for patients with DEB-Pr and can achieve continuous relief of severe itching.展开更多
BACKGROUND The most common site of paragonimiasis is in the lungs.The migratory route passes through the duodenal wall,peritoneum,and diaphragm to the lungs;thus,the thoracic cavity and central nervous system,as well ...BACKGROUND The most common site of paragonimiasis is in the lungs.The migratory route passes through the duodenal wall,peritoneum,and diaphragm to the lungs;thus,the thoracic cavity and central nervous system,as well as the liver,intestine,and abdominal cavity may be involved.Here,we present a case of intraperitoneal paragonimiasis without other organ involvement,mimicking tuberculous peritonitis.CASE SUMMARY A 57-year-old man presented with recurrent abdominal pain for 4 wk.Physical examination revealed tenderness in the right lower quadrant.Laboratory findings showed complete blood counts within the normal range without eosinophilia.Multiple reactive lymph nodes and diffuse peritoneal infiltration were noted on abdominal computed tomography(CT).There were no abnormalities on chest CT or colonoscopy.Intraoperative findings of diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis included multiple small whitish nodules and an abscess in the peritoneum.Pathological reports confirmed the presence of numerous eggs of Paragonimus westermani(P.westermani).A postoperative serum enzyme-linked immunosorbent assay revealed P.westermani positivity.Persistent and repetitive history-taking led him to retrospectively recall the consumption of freshwater crab.After 3 d of treatment with praziquantel(1800 mg;25 mg/kg),he recovered from all symptoms.CONCLUSION In patients who require diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis,repetitive history-taking and preoperative serologic antibody tests against Paragonimus may be helpful in diagnosing intraperitoneal paragonimiasis without other organ involvement.展开更多
87 patients with pulmonary space-occupied lesions of the peripheral type which were either adhesive of close to pleura were examined using ultuasonography.Of them,64 cases of lung cancers and 23 of bening lesions were...87 patients with pulmonary space-occupied lesions of the peripheral type which were either adhesive of close to pleura were examined using ultuasonography.Of them,64 cases of lung cancers and 23 of bening lesions were then confirmed by展开更多
基金National Natural Science Foundation of China,No.81874393.
文摘BACKGROUND Dystrophic epidermolysis bullosa pruriginosa(DEB-Pr)is a rare subtype of DEB,characterized by recurrent pruritus of the extremities,pruritus papules,nodules,and mossy-like plaques.To date,fewer than 100 cases have been reported.We report a misdiagnosed 30-year-old man with sporadic late-onset DEB-Pr who responded well to tacrolimus treatment,thereby serving as a guide to correct diagnosis and treatment.CASE SUMMARY A 30-year-old man presented with recurrent itching plaques of 1-year duration in the left tibia that aggravated and involved both legs and the back.Examination revealed multiple symmetrical,purple,and hyperpigmented papules and nodules with surface exfoliation involving the tibia and dorsum of the neck with negative Nissl's sign,no abnormalities in the skin,mucosa,hair,or fingernail,and no local lymph node enlargement.Blisters were never reported prior to presentation.Serum immunoglobulin E level was 636 IU/mL.Clinical manifestations suggested DEB-Pr.Histological examination showed subepidermal fissure,scar tissue,and milia.Direct immunofluorescence showed no obvious abnormalities.However,we were unable to perform electron microscopy or genetic research following his choice.We treated him with topical tacrolimus.After 2 wk,the itching alleviated,and the skin lesions began to subside.No adverse reactions were observed during treatment.CONCLUSION Topical tacrolimus is a safe treatment option for patients with DEB-Pr and can achieve continuous relief of severe itching.
文摘BACKGROUND The most common site of paragonimiasis is in the lungs.The migratory route passes through the duodenal wall,peritoneum,and diaphragm to the lungs;thus,the thoracic cavity and central nervous system,as well as the liver,intestine,and abdominal cavity may be involved.Here,we present a case of intraperitoneal paragonimiasis without other organ involvement,mimicking tuberculous peritonitis.CASE SUMMARY A 57-year-old man presented with recurrent abdominal pain for 4 wk.Physical examination revealed tenderness in the right lower quadrant.Laboratory findings showed complete blood counts within the normal range without eosinophilia.Multiple reactive lymph nodes and diffuse peritoneal infiltration were noted on abdominal computed tomography(CT).There were no abnormalities on chest CT or colonoscopy.Intraoperative findings of diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis included multiple small whitish nodules and an abscess in the peritoneum.Pathological reports confirmed the presence of numerous eggs of Paragonimus westermani(P.westermani).A postoperative serum enzyme-linked immunosorbent assay revealed P.westermani positivity.Persistent and repetitive history-taking led him to retrospectively recall the consumption of freshwater crab.After 3 d of treatment with praziquantel(1800 mg;25 mg/kg),he recovered from all symptoms.CONCLUSION In patients who require diagnostic laparoscopy for the differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis,repetitive history-taking and preoperative serologic antibody tests against Paragonimus may be helpful in diagnosing intraperitoneal paragonimiasis without other organ involvement.
文摘87 patients with pulmonary space-occupied lesions of the peripheral type which were either adhesive of close to pleura were examined using ultuasonography.Of them,64 cases of lung cancers and 23 of bening lesions were then confirmed by
