Confluent Distribution Research Articles

Comprehensive Treatment Approaches in a Unique Case of Generalized Pustular Psoriasis

Psoriasis is an immunological inflammatory disease characterized by skin inflammation and epidermal hyperplasia. One type of psoriasis is Generalized Pustular Psoriasis (GPP), which is usually preceded by other diseases. A 56-year-old woman presented to the Department of Dermatology and Venereology with a recent onset of red spots accompanied by pustules distributed across her body. The initial manifestation of these symptoms occurred approximately one month prior, and the condition has progressively worsened over the past three days. Physical examination of dermatological status showed erythematous plaques with smooth, well-defined scales with irregular, round edges, lenticular size, multiple, discrete, and confluent distribution, generalized distribution in the pedis dextra et sinistra, manus dextra et sinistra, and femoral regions. Skin biopsy examination results showed skin tissue with hyperkeratosis, acanthosis, and parakeratosis, with PMN inflammatory cells (Munro's micro abscess). The conclusion of the skin biopsy is pustular psoriasis. The patient was diagnosed with GPP. Patients were given Methotrexate, calcitriol tablets 0.25 mcg twice a day, cetirizine tablets 10 mg twice a day, and topical cream. After one week of treatment, the patient's lesions improved. Treatment continues, and patients are given education to avoid trigger factors such as stress, excessive activity, extreme temperature changes, and focal infections. The management must consider various influencing factors, including genetic factors, skin barriers, predisposing factors, and trigger factors. Prevention is also important. The patient needs to be educated about the details of the disease, how to prevent a recurrence, and treatment when the disease recurs.

Endoscopic and Pathological Characteristics of Cronkhite– Canada Syndrome: A Retrospective Analysis of 76 Cases

Cronkhite-Canada syndrome (CCS) is a disease of unknown etiology characterized by the presence of multiple gastrointestinal polyps, chronic diarrhea, loss of appetite, alopecia, onychodystrophy, and cutaneous hyperpigmentation. CCS is a rare disease with an incidence rate of 1 per million. Clinicians are not aware of this disease, and the discovery of gastrointestinal polyps is often a starting point for the diagnosis of this disease. By analyzing the endoscopic and pathological characteristics of CCS, this study aims to deepen our understanding of gastrointestinal polyposis and facilitate early diagnosis of CCS.We screened databases, including the Chinese Biomedical Literature Database (CBM Web), the China Academic Journals Fulltext Database (CJFD), and PubMed for CCS cases reported from January 2010 to January 2020, and conducted a retrospective analysis of endoscopic and pathological characteristics of these cases.The endoscopic data of the 76 retrieved cases revealed that CCS is gastrointestinal polyposis with the intensive and confluent distribution. The greater the number of polyps and the higher their distribution, the brighter their color. A pathological assessment revealed that both gastric polyps and intestinal polyps are mainly juvenile hamartomatous polyps and have a high malignant transformation rate. Interstitial edema, eosinophil infiltration, and cystic dilation of glands are common features of CCS polyps, distinguishing them from other gastrointestinal polyposis syndromes.CCS is a polyp disease different from other gastrointestinal polyposis. Analysis of its endoscopic and pathological characteristics can contribute to the understanding and early diagnosis of the disease.

Dermatologic Manifestations of Systemic Diseases in Childhood

Dermatologic Manifestations of Systemic Diseases in Childhood

Leprosy neuropathy masquerading as cellulitis

Tropical diseases are increasingly reported outside their areas of high prevalence.1 Not only that many physicians are unfamiliar with these conditions but also there is the added challenge that it...

Growing Candida albicans Biofilms on Paper Support and Dynamic Conditions.

A stainless steel paper-embedded biofilm reactor (PEBR) was developed for Candida spp. growth, permitting confluent distribution of nutrients by capillary diffusion through ordinary laboratory filter paper. Antibiogram disks were distributed along the filter paper rim, and the PEBR received 0.1 or 0.01 % crystal violet (CV) at 200 μL min(-1) and at 37 °C, for 48 h. CV was recovered from the disks and measured at 540 nm. Candida albicans SC5314 cells were applied onto antibiogram disks. The bioreactor was assembled, and YEPD broth was admitted (200 μL min(-1)) at 37 °C, for 72 h. Biofilm growth was estimated via the MTT reduction test. Controls were disks that received the same treatments, except for the fungus. The PEBR was considered high-throughput table, low-cost, and feasible to grow C. albicans biofilms.

Neurogenic Bladder Due to Hypoxic‐Ischemic Demyelination

Hypoxia is commonly known to target neuronal cell bodies. Although myelin is a non-infrequent target, posthypoxic demyelination is a rarely described entity. We describe the case of a man who developed neurogenic bladder following a motor vehicle accident. Following a severe motor-vehicle accident involving massive blood loss, a 46-year-old man developed urinary urgency requiring catheterization, with hyperactive reflexes and bilateral Babinski signs on exam. Magnetic resonance imaging of the brain and cervical cord revealed diffuse, isolated white matter signal abnormality in a symmetric, confluent distribution, extending inferiorly into the spinal cord, with changes consistent with bilateral Wallerian degeneration. Serologic and CSF evaluations were normal. Unlike previous reports of hypoxic-ischemic demyelination, our patient lacked any cortical abnormalities, presumably due to isolated white matter changes. This report alerts physicians to the possibility of hypoxic-ischemic demyelination due to global hypoxia-ischemia as an etiologic factor for neurogenic bladder.