Syphilis is one of the most common sexually transmitted diseases in the world. It is known as “the great mimicker” due to its varied cutaneous presentations, which can make it challenging to diagnose. We report a case of a 20‑year‑old female presenting with a nonhealing, pruritic, annular plaque on the left malar area of 3‑month duration. She was initially treated as a case of tinea faciei. The lesion was unresponsive to topical antifungals and steroids with continued increase in size and number. Skin biopsy revealed secondary syphilis with histopathologic features of granuloma annulare. Degenerated collagen, not a feature of secondary syphilis, was seen, prompting further studies to confirm the diagnosis of secondary syphilis. Alcian blue stain was negative, which helped rule out granuloma annulare. She was then given benzathine penicillin G 2.4 million U, which led to a significant decrease in the size of the lesion noted 1 week posttreatment. Only postinflammatory hyperpigmentation was noted after 1 month of treatment. Clinically, secondary syphilis may present as an annular lesion that can mimic tinea. This can also present with atypical histopathologic features and an in‑depth investigation is needed to further confirm the diagnosis.
Granuloma Annulare ; Syphilis

Inflammatory myofibroblastic tumor （IMT） is a rare mesenchymal soft tissue tumor characterized by borderline or low-grade malignancy. It is rare childhood tumor with an average age of onset of 10 years old. It is even rarer in infants and toddlers, and the etiology and pathogenesis of this tumor are still unclear. The clinical presentation of IMT is non-specific and are related to the location of the tumor. When the tumor compresses adjacent organs, it can cause pain and functional impairment. According to the current literature, IMT is most commonly found in the digestive and respiratory systems, but also occasionally occur in the genitourinary system, head and neck, and limbs. At present, there have been no reports of nasopharyngeal IMT involving nasal cavity of infants and toddlers at home and abroad.This article reports a case of a massive inflammatory myofibroblastic tumor involving the nasal cavity and nasopharynx in an infant. Plasma-assisted minimally invasive surgery was performed through multiple surgical approaches and achieved satisfactory therapeutic results. This case report may provide valuable reference for the treatment of similar diseases.
Humans ; Infant ; Granuloma, Plasma Cell/pathology* ; Nasopharynx/pathology* ; Neoplasms, Muscle Tissue ; Soft Tissue Neoplasms

Inflammatory myofibroblastic tumor is a rare tumor of mesenchymal origin. A case of intratracheal inflammatory myofibroblastic tumor in a male child was reported. The clinical characteristics, diagnosis, treatment and prognosis of the disease were reviewed based on the literature, and a differential diagnosis between inflammatory myofibroblastic tumor and hamartoma was performed to ultimately confirm the nature of the tumor in the child.
Humans ; Child ; Male ; Trachea/pathology* ; Granuloma, Plasma Cell/diagnosis* ; Prognosis ; Diagnosis, Differential ; Tomography, X-Ray Computed

Male ; Humans ; Penis ; Granuloma/etiology* ; Pelvis ; Iatrogenic Disease

Humans ; Granuloma, Pyogenic/pathology* ; Hemangioma, Capillary

Epstein-Barr virus (EBV), a double-stranded DNA virus with an envelope, is a ubiquitous pathogen that is prevalent in humans, although most people who contract it do not develop symptoms (Kerr, 2019). While the primary cells EBV attacks are epithelial cells and B lymphocytes, its target range expands to a variety of cell types in immunodeficient hosts. Serological change occurs in 90% of infected patients. Therefore, immunoglobulin M (IgM) and IgG, serologically reactive to viral capsid antigens, are reliable biomarkers for the detection of acute and chronic EBV infections (Cohen, 2000). Symptoms of EBV infection vary according to age and immune status. Young patients with primary infection may present with infectious mononucleosis; there is a typical triad of symptoms including fever, angina, and lymphadenectasis (Houen and Trier, 2021). In immunocompromised patients, response after EBV infection may be atypical, with unexplained fever. The nucleic acid of EBV can be detected to confirm whether high-risk patients are infected (Smets et al., 2000). EBV is also associated with the occurrence of certain tumors (such as lymphoma and nasopharyngeal carcinoma) because it transforms host cells (Shannon-Lowe et al., 2017; Tsao et al., 2017).
Humans ; Trachea ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Virus Diseases ; Fever ; Granuloma

Colon ; Dendritic Cell Sarcoma, Follicular/surgery* ; Dendritic Cells, Follicular ; Granuloma, Plasma Cell/diagnostic imaging* ; Herpesvirus 4, Human ; Humans

INTRODUCTION: Subungual squamous cell carcinoma is rare, though it is the most common primary malignant neoplasm in the nail unit. Fingernails are more commonly involved than toenails with nonspecific and mild features. Histopathologic presentation may be difficult to distinguish from other tumors. With this, there is often a delay in diagnosis.

CASE REPORT: A 64-year-old male presented with a subungual yellowish granulomatous plaque, eventual dystrophy, and persistent bleeding on the fi rst digit of the right foot of two years' duration. Initially diagnosed as pyogenic granuloma through skin punch biopsy, debridement with ungiectomy was done. Upon recurrence, he underwent wide excision with matricectomy, wherein deeper sections revealed features of basosquamous carcinoma. A positive Epithelial Membrane Antigen and negative BerEP4 staining later confirmed a diagnosis of SCC. Since bone involvement was repeatedly suspected in magnetic resonance imaging after postoperative radiotherapy, amputation was eventually done.

CONCLUSION: We report a case of subungual SCC initially diagnosed as a pyogenic granuloma. Full-thickness biopsy should be done in persistent nail conditions using special stains to confirm the diagnosis. Surgical treatment or radiotherapy with or without systemic therapy is the first line of treatment for subungual SCC. In cases of bone involvement, amputation may be warranted.

KEYWORDS: nail, pyogenic granuloma, squamous cell carcinoma, tumor

OBJECTIVES: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis, which often starts with respiratory symptoms such as asthma, and it is difficult to make early clinical diagnosis.This study aims to improve the therapeutic level of EGPA with lung involvement via analyzing the clinical characteristics, diagnosis, and treatment . METHODS: We retrospectively analyzed the clinical data of 13 EGPA patients with lung involvement who were diagnosed from February 1, 2014 to July 31, 2021 in the Second Xiangya Hospital, Central South University. RESULTS: The ratio of male to female in 13 patients was 7꞉6. The patients were diagnosed at median age 52 (46-68) years old and 6 had been diagnosed as "bronchial asthma". Pulmonary clinical manifestations mainly included cough, expectoration, wheezing, and shortness of breath; while extra-pulmonary manifestations mainly included rash and subcutaneous mass, fever, limb numbness, muscle and joint pain, abdominal pain, etc. Peripheral blood tests of all patients showed that 11 patients had eosinophils ≥10%, 10 had elevated inflammatory indicators, and 3 were anti-neutrophil cytoplasmic antibody (ANCA) positive. The major lung imaging features were patches or strips of increased density, multiple nodules, bronchiectasis, bronchial wall thickening, exudation, mediastinal lymph nodes, and so on. Eight patients had sinusitis and 9 with abnormal electromyography. Extravascular eosinophil infiltration was found in 9 patients. Six patients with lung biopsy showed eosinophil, lymphocyte, and plasma cell infiltration, 3 patients were involved in small blood vessels, and 1 had granuloma. Pulmonary function tests were performed in 7 patients, 5 of them showed different degrees of pulmonary ventilation dysfunction, and 4 of them had diffusion dysfunction. Almost all patients respond well to glucocorticoid and immunosuppressant. CONCLUSIONS EGPA is rare in clinical, often involving multiple systems with great harm and may combine with asthmatic manifestations. Pulmonary involvement is relatively common. However, due to insufficient recognition of this disease and huge heterogeneity of pulmonary imaging manifestations, misdiagnosis and missed diagnosis are easy to occur. Relevant laboratory, imaging, and biopsy examination should be performed as early as possible with comprehensive consideration of extrapulmonary involvement. Early identification has great significance to improve the diagnosis rate and prognosis of diseases.
Humans ; Male ; Female ; Middle Aged ; Aged ; Churg-Strauss Syndrome/pathology* ; Granulomatosis with Polyangiitis/pathology* ; Retrospective Studies ; Lung/pathology* ; Asthma

Granuloma, Plasma Cell/surgery* ; Humans ; Neoplasms