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 :

المشاركة الأصلية بواسطة Hopeful

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
Hopeful.........

DD:
1-ORF >>> but i think its acute and usually doesnt last longer than 1 wk
SCC
BCC
actinic keratosis

the most likely one is ORF and i will consider actinic keratosis ( although its not usually occure on the hands

=do you agree with this surgeon about his advice
NO ,,,, i will make a biopsy

what is the cause of this disease, and what is the course of it
a Pox viruse

the treatment:
nothing specific

Thanks TURBO and electron for your answers

TURBO , when you put your book infront of you and write the answers
I cant add anything to your complete answers

1- DD:

-SCC
-leishmaniasis
-PG pyogenic granuloma
-furuncle
-ORF

the most likely one is ORF due to the clinical findings and the history of contact with sheeps

3- of course i dont agree with this surgeon and when i suspect i will do a biopsy to role out the malignancy

2- the cause of disease is parapox virus
and the skin lesion develops as a solitary or few in number
location : most often seen on fingers and hands or exposed areas
-onset is usually with red papule leading to a pustule or abulla , becoming weepy or crusted and then nodular
-it may be painful or tender
-the course : it resolves spontaneously within 4-6 weeks
-the treatment: nothing except antiseptic and antibiotic if secondary infection occurs


see these images , and i will see you with another case

thanks hopeful
but the first image that u put wasnt clear ( not typical as the ORF that i know) as the others

I have a question :
you said:

-onset is usually with red papule leading to a pustule or abulla , becoming weepy or crusted and then nodular

I couldnt understand this statment,,,,, after the lesion crusted ,,,, it will be a nodule

thank u very much

electron

as i said to TURBO the image is not typical and i put it to dont depend only on the clinical findings
you must concentrate well on the history
so after you know the right diagnosis , i put typical ones

then , thanks for your notice i mean that the lesion may be infiltrate and enlarge and become nodular and then ulcerate
so sorry if the statement was not clear

thanks again , electron

Hello,

today i want to present an interisting case that Dr.Anwar diagnosed it

okay , let us go on

these two brother 4,6 years old came to our departement , their complaint started when
they were at age of 2,3 years
it started with papules and umbilicated vesicles on their faces and the dorsum of their hands
they have stinging and burning feelings within 24 hours from they expose to sunligt
these lesions crusted with necrotic centers
and some of them left scars

their complaint increases in spring and summer

now , think in the answers of these questions
1-put your DD and what is the most likely one in your opinion?
2-what is the cause of this disease, is it hereditary?
3-is it releated to exposure to sunlight, which type?
4-explain to me the course of this disease and is there any risk of developing malignsncy?
5-finally,how do you treat it and what do you advice the parents?

the dd is: Acne Varioliformis Hebra
Eczema vaccinatum
Erythropoietic Protoporphyria
Juvenile Spring Eruption
Polymorphic Light Eruption
Porphyria Cutanea Tarda
Variola
i think the most important dd is variola

the cause of this disease is unkown
the type of sunlight uva
A vesicular and bullous eruption having a tendency to recur in summer during childhood and commonly appearing on sun-exposed skin
The lesions are surrounded by an erythematous zone and resemble a vaccination.
frankly i don't know if this disease is related to malignancy so i waite your opinion
my advice to the parents is keep thier children away from sun
i'm sooryy ,i forget writing the name of this disease:hydroa vacciniforme
last but one ,I should thank you hopeful for your devotion and continuing

I Agree with my freind m'm with his DD
but I disagree with his diagnosis

I think it's Polymorphic Light Eruption
because the complaint increases in spring and summer

The cause: is unknown but there is usually family history
and it's exacerbated by the UVA
I think there is no risk of developing to malignancy

Treatment: avoid the sun and usage of sun screens

Hello, we come back.......

- Congratulations mm your diagnosis - Hydroa Vacciniform-is right

but your answers are not complete

but,you are so smart and really i am admirer of your answers

you win with us this laptop ,

TURBO, hard luck

i will put the answers later on

thank you for the kind words,and
encouragement,.
I WAITING YOUR answers
and this for you

Okay, this is the image of the smaller brother