1.Not all swellings are lymph nodes! A case of subcutaneous panniculitis-like T-cell lymphoma
Chiaw Ting Tee ; Evelyn Yap Wen Yee
The Medical Journal of Malaysia 2019;74(5):441-442
Subcutaneous Panniculitis-like T-cell Lymphoma (SPTL) is a
rare cutaneous neoplasm of mature cytotoxic T cells, first
described in 1991 by Gonzalez et al.
1 The incidence of SPTL
in Asian countries ranges from 2.3% to 3%. In Malaysia, only
5 cases were reported from 2001 to 2004 in Hospital Kuala
Lumpur, Malaysia.
2 SPTL typically presents as skincoloured or erythematous subcutaneous nodules, most
often on the extremities and trunk, but it can also involve the
face, back and neck. Diagnosis of SPTL is made based on
correlation of clinical findings and subcutaneous tissue
biopsy along with immunohistochemical staining patterns
2.No Epidermis: Is it the drug, COVID-19 or Something Else?
Vivian Tai ; Chiaw Ting Tee ; Min Moon Tang
Malaysian Journal of Dermatology 2022;48(Jun 2022):87-93
Summary
Staphylococcal toxic shock syndrome (TSS) is a clinical disease with acute onset of fever, rash,
hypotension and multi-organ system involvement. Staphylococcal scalded skin syndrome (SSSS),
mostly described in neonate and children, is a superficial blistering disease caused by the exfoliative
toxin of specific strains of Staphylococcus aureus. TSS and SSSS rarely occur concurrently in adults.
We here describe a 35-year-old woman who was initially referred to dermatology team as toxic
epidermal necrolysis. She presented with a rapid epidermal detachment without mucosal involvement,
fever and shock, associated with acute kidney injury and transaminitis, severe metabolic acidosis,
complicated by COVID-19 infection, and finally succumbed within 36 hours of hospitalization. Early
recognition and prompt treatment are the key factors in the management as TSS itself can lead to
mortality. Staphylococcal TSS and SSSS are important differential diagnosis to consider in acute
epidermal detachment, as not all cases are drug-induced.
Staphylococcal Infections
;
Shock, Septic