The acquired immunodeficiency syndrome patients with compromised immunity are prone to hemophagocytic syndrome secondary to opportunistic infections.This paper reports a rare case of hemophagocytic syndrome secondary to human parvovirus B19 infection in an acquired immunodeficiency syndrome patient,and analyzes the clinical characteristics,aiming to improve the diagnosis and treatment of the disease and prevent missed diagnosis and misdiagnosis.
Humans ; Lymphohistiocytosis, Hemophagocytic/drug therapy* ; Erythema Infectiosum/complications* ; Acquired Immunodeficiency Syndrome/complications* ; Parvoviridae Infections/diagnosis* ; Parvovirus B19, Human

INTRODUCTION: Kawasaki disease (KD) is a challenging diagnosis. Erythema and induration of the Bacillus Calmette-Guérin (BCG) site is increasingly recognised as a significant clinical clue. However, there is little data to support its specificity for KD as compared to other febrile illnesses. We aimed to evaluate BCG reaction or induration as a diagnostic tool for KD. METHODS: A retrospective case-controlled study of patients discharged with a diagnosis of KD from 2007 to 2010 was conducted. Another group of patients admitted over the same period for possible KD, but later found not to have KD, served as control. RESULTS: Significantly more infants with KD (69.7%) had BCG site changes than older children (27.8%; p < 0.001). It also presented earlier in the course of KD; < 5 days (53.3%) compared to ≥ 5 days of fever (30.0%; p < 0.001). Positive predictive value of BCG site reaction or induration for KD was 90.8% (95% confidence interval [CI] 0.819-0.962) for infants and 96.2% (95% CI 0.868-0.995) for older children. The prevalence rate of changes at the BCG site was 9.9% among patients with non-KD febrile illnesses and 42.6% among patients with KD. CONCLUSION BCG site reaction or induration is a useful clinical clue for the diagnosis of KD in both infants and older children, with a higher prevalence in infants. Physicians should consider KD in children with febrile illness and redness or crust formation at the BCG site, especially in view of low rates of BCG reaction or induration in non-KD febrile illnesses.
BCG Vaccine ; administration & dosage ; adverse effects ; Case-Control Studies ; Child, Preschool ; Erythema ; complications ; epidemiology ; Female ; Fever ; complications ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; epidemiology ; Risk Factors ; Singapore ; epidemiology

Adult ; Asian Continental Ancestry Group ; Biopsy, Needle ; Disease Progression ; Erythema ; complications ; physiopathology ; Female ; Foot Dermatoses ; complications ; diagnosis ; pathology ; Hand Dermatoses ; complications ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Pemphigus ; diagnosis ; pathology ; Prognosis ; Pruritus ; complications ; physiopathology ; Rare Diseases ; Singapore ; Syndrome

Aged ; Biopsy ; methods ; Diagnosis, Differential ; Erythema ; diagnosis ; etiology ; Extremities ; pathology ; Fever ; complications ; Humans ; Immunoglobulin A ; analysis ; Male ; Purpura ; diagnosis ; etiology ; Skin ; diagnostic imaging ; pathology ; Vasculitis ; complications ; immunology

PURPOSE: Kawasaki disease (KD) is an acute systemic vasculitis. Both the etiology of KD and the erythema of Bacille Calmette-Guérin (BCG) injection sites observed in the disease are poorly understood. We investigated the association between KD and single nucleotide polymorphisms (SNPs) in two candidate genes: inositol 1,4,5-triphosphate 3-kinase (ITPKC), a well-studied KD-associated gene, and solute carrier 11a1 (SLC11A1), which is associated with the hypersensitive reaction to the BCG strain in Koreans. MATERIALS AND METHODS: Associations between KD and SNPs in two genes were evaluated. Potential associations between BCG injection site erythema and SNPs in two genes were also evaluated. Gene-gene interactions between ITPKC and SLC11A1 in KD and BCG injection site erythema were also analyzed. RESULTS: Three tagging SNPs in ITPKC and five tagging SNPs in SLC11A1 were genotyped in 299 KD patients and 210 control children. SNP rs28493229 in ITPKC was associated with KD and coronary artery complications. SNP rs77624405 in SLC11A1 was associated with KD. Comparisons of KD patients with and without BCG injection site erythema revealed that SNP rs17235409 in SLC11A1 was associated with erythema; no erythema-associated SNPs in ITPKC were identified. Interactions between ITPKC rs28493229_GG and SLC11A1 rs17235409_GA and between ITPKC rs10420685_GG and SLC11A1 rs17235409_AA were strongly associated with BCG injection site erythema. CONCLUSION: This study identified several important polymorphisms in the ITPKC and SLC11A1 genes in Koreans. The genetic variants identified in this study affected KD and erythema of BCG injection sites independently and through gene-gene interactions. Also, the effects of the polymorphisms were age-dependent.
Asian Continental Ancestry Group/genetics ; BCG Vaccine/administration & dosage ; Case-Control Studies ; Cation Transport Proteins/genetics ; Child ; Child, Preschool ; Epistasis, Genetic ; Erythema/complications ; Female ; Genetic Association Studies ; Genetic Predisposition to Disease ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome/genetics ; Mutation Rate ; Phosphotransferases (Alcohol Group Acceptor)/genetics ; Polymorphism, Single Nucleotide/genetics ; Republic of Korea

Adult ; Erythema ; etiology ; Female ; Humans ; Leprosy ; complications ; diagnosis

Adult ; Erythema ; etiology ; Female ; Humans ; Leprosy ; complications ; Male

PURPOSE: Incidence of radiographic contrast media extravasation has increased owing to the escalating availability of contrast enhanced imaging. Potential complications of extravasation include localized swelling, itching sensation, hypesthesia, erythema, limitation of finger movement, compartment syndrome, skin sloughing, and necrosis. We describe clinical characteristics and treatment of computed tomography contrast media extravasation. METHODS: A retrospective chart review was performed on 26 consulted patients experiencing contrast extravasation, between January 2005 and December 2011. Age, signs, symptoms, types of contrast administered, volume of extravasation, treatment and patient outcomes were documented and evaluated, retrospectively. RESULTS: Extravasation of less than 100 mL occurred in 85%. Immediate surgical therapy was necessary in 23% of cases. There were no postoperative complications and it rendered excellent cosmetic outcomes. In 77% of cases, conservative management was recommended, such as elevation and immobilization of extremity, application of ice pack, and careful monitoring. CONCLUSION: Prevention is the most important for extravasation injuries. Diagnosis and treatment must be made on the spot in order to avoid severe soft tissue damage. Hand surgeons' decision on the necessity of surgical treatment within 6 hours is important in the prognosis of patients.
Compartment Syndromes ; Contrast Media ; Cosmetics ; Erythema ; Extravasation of Diagnostic and Therapeutic Materials ; Extremities ; Fingers ; Hand ; Humans ; Hypesthesia ; Ice ; Immobilization ; Incidence ; Necrosis ; Postoperative Complications ; Prognosis ; Pruritus ; Retrospective Studies ; Sensation ; Skin ; Upper Extremity

Since its first description in 1887 as the appearance of psoriatic lesions in the uninvolved skin of psoriatic patients as a consequence of trauma, the Koebner phenomenon has been described in numerous diseases. Several types of injury can trigger the Koebner phenomenon, such as physical injury, surgical wound, irritation, sunburn, or radiation therapy. In this report, we describe a 43-year-old woman who developed erythema multiforme which was accompanied by the Koebner phenomenon after getting acupuncture and cupping glass therapy. The purpose of the report is to broaden our awareness of the spectrum of injury that can trigger the Koebner phenomenon.
Acupuncture ; Adult ; Erythema ; Erythema Multiforme ; Female ; Glass ; Humans ; Intraoperative Complications ; Skin ; Sunburn

Erythema nodosum is the most common form of septal panniculitis and the most frequent skin manifestation associated with inflammatory bowel disease, affecting up to 15% of Crohn's disease patients. Since the development of erythema nodosum is closely related with a variety of disorders and condition, it can serve as an important early sign of systemic disease. Here, we present the occurrence of erythema nodosum as an early sign of Cronh's disease in a 16-year-old woman.
Adolescent ; Anti-Inflammatory Agents/therapeutic use ; Azathioprine/therapeutic use ; Colonoscopy ; Crohn Disease/complications/*diagnosis/drug therapy ; Erythema Nodosum/complications/*diagnosis/pathology ; Female ; Humans ; Mesalamine/therapeutic use ; Prednisolone/therapeutic use ; Skin/pathology