السلام عليكم ورحمة الله وبركاته,

مبدأ هالموضوع أنو نحط صور لأمراض جلدية أو صور dermatopathology أو case report لمريض جلدية ,

بمعنى أنو الحكي هون بس للأمراض الجلدية ,

يا ريت تحاولوا تحطو تشخيص تفريقي وبعدين تحطو التشخيص الارجح -حسب رأيكم - مع التعليل ...وياريت In English

NB :

أكيد في جائزة للي رح يعرف أكتر -بغض النظر عن نوعية الجائزة - يعني ممكن تكون كلمة شكر أو مثلا صورة

رح بلش معكم بصور سهلة وبعدين منزيد الجرعة .....

بسم الله الرحمن الرحيم

الحالة الأولى :

TURBO, your answers are excellent

Rubella in some words

it is a benign common childhood viral infection manifested as exanthem and lymphadenopathy

synonyms: German Measles
or three-day measles

Epidemiology:
the cause : Rubella virus
Transmission: inhalition aerosolized respiratory droplets

it is a moderately contagious infection
while as you remember measles is a highly contagious infection

period of infectivity : from the end of incubation periond to disappearince of rash


incubation period :2 to 3 weeks
there are 10%-40% cases of rubella are Asymptomatic

prodrome : usually absent or mild as anorexia, fatigue conjunctivitis, mild URTI,
LOW-GRADE FEVER

arthralagia especially in adults and women

Skin Lesions:
(Pink macules and papules (as we say maculopapular rash
starts on forehead and spreads to face,trunk and extremities in the same day

in the third day , the rash begins to disappear so we called it three-day measles

General examination:
Lympadenopathy during the prodrome and it disappears after one week ,but it will continue to months
retroauricular, suboccipital and posterior cervical lymph nodes enlargement are the commonest

spleen may occasionally enlarge
Joints :
arthritis in adults may occur with joint effusion
Mucous Membranes:
Forchheimer,s sign is petechiae on the soft palate appears during prodrome and we can see them also in EBV infection

DD:
1-other viral exanthem
2-drug eruptions
3-scarlet fever
Exanthem + Arthritis
1- acute rheumatic fever
2-rheumatoid arthritis

Again
Rubella is mild inconsequential disease in general

BUT,
In first -trimesteraffected pregnant women the virus is transmited by placenta to fetus and cause in 1/2 of them what we called

Congenital Rubella Syndrome which consists of:
1-congenital heart disease especially PDA
2-cataract , microphthalmia
3-deafness
4-microcephaly or hydrocephally


Finally the management of Rubella is of course symptomatic



Hopeful

This is the last case in the subject the viral exanthem

so let us see the case report

Case Report :

this 4-years old boy presents with this pruritic rash
when you try to take details about his case , you know that he had coryza, headache, fever 2-days before the appearance of this rash that started on his face and scalp and spreaded to his trunk and less on his extremities
you know the diagnosis , but you make a close-up
and confirm your diagnosis

so,
1-what is your diagnosis? what is the cause of it?how is it transmitted?
2-when you make a close-up view , what is the key of the diagnosis that you found it?
write a recipe for this boy-3-
4-have you ever hear the term Tzanck smear ? wher is it positive also?
5-finally, this boy is in nursery school and this is the second day of his rash ,when do you let him return back?


Hopeful.......

المشاركة الأصلية بواسطة Hopeful

This is the last case in the subject the viral exanthem
Case Report :

this 4-years old boy presents with this pruritic rash
when you try to take details about his case , you know that he had coryza, headache, fever 2-days before the appearance of this rash that started on his face and scalp and spreaded to his trunk and less on his extremities
you know the diagnosis , but you make a close-up
and confirm your diagnosis
Hopeful.......

1-what is your diagnosis? what is the cause of it?how is it transmitted?
varicella also known as chiken pox,,,VZV...............by respiratory droplets
2-when you make a close-up view , what is the key of the diagnosis that you found it?
erythmatous single vessels

write a recipe for this boy-3-
nothing specific .... and i think i doesnt need any prescription
and we have to avoid ASA

4-have you ever hear the term Tzanck smear ? wher is it positive also?
yes,,,, to be honest with you ,,,, I forget where its positive
but maybe in other herpes virus such as HSV and EBV

5-finally, this boy is in nursery school and this is the second day of his rash ,when do you let him return back?
???? I know the patient is contagious before the apperance of the Rash
but maybe 1 week

Thank you

first , iam so sorry because the second image is for a girl and i have a real problem with loading the images

then the image has the name of disease

really iam ashamed of you due to these mistakes

electron ......
thank you for your answers but i wait more complete ones


this nice rose for you

sorry i made a mistake

VZV ( varicella zoster virus) belong to herpes family which include :
HSV - VZV - EBV - CMV
this family spreade by direct contact with the lesion

the paramyxo viruses include mesels and rubella
and they spreade by respiratory droplets

mmmmm

i will put the answers later on , but i have these image about varicella

Varicella or Chickenpox

The Answers :

1-Varicella is caused by VZV Varicell Zoster Virus
it is a highly contagious primary infection transmitted by airbrone droplets as well as direct contact
2-you can see simultaneously all stages of evolution i.e papules,vesicles,pustule,crust
3-As we do in our clinic
-Hexamidine
-cefadroxil
-chlorpheniramine
4-Tzanck smear: cytology of fluid or scraping from base of pustule shows both giant cells and multinucleated acantholytic epidermal cells
you can see it also positive in HSV infections
5-patients are contagious several days before the exanthem appears and until last crop of vesicles disappear
CRUSTS ARE NOT INFECTIOUS


In this case we end the subject Viral Exanthem

I hope that you are able now to distinguish between them.................

Case Report
a 40-year old man presents with a history of 4-weeks of rapidly growing moderately painful lesion on his finger
ther is no history of medical illness and he is otherwise well, with no lymphadenopathy nor other skin lesions
there is no history of trauma
he seeks a medical help from a surgeon who diagnoses it as a malignant tumor that recommended urgent amputation of his finger

Clue : this patient is a sheep herdsman


now,
1- put DD and then what do you think the most likely diagnosis?
-2-do you agree with this surgeon about his advice
3- what is the cause of this disease, and what is the course of it

Hopeful.........

1- put DD and then what do you think the most likely diagnosis?
my DD is:
1-ORF
2-SCC
3-Leishmaniasis
4-Furuncle

and the most likely diagnosis is ORF or Contagious Ecthyma
because the patient had a history of contact with sheeps
but the lesion morphologically is not typical


-2-do you agree with this surgeon about his advice
no, this lesion is benign

3- what is the cause of this disease, and what is the course of it
the cause is a virus from the Pox viruses

the treatment: nothing specific...just topical antibiotics and antiseptics

the desease course: it reliefs spontaneously in 4-6 weeks


thanx