Pyodermatitis-Pyostomatitis Vegetans (PD-PSV) remains a rare disorder of unknown etiology that is often associated with underlying inflammatory bowel disease (IBD). It is also worth noting that PD-PSV is particularly rare in the paediatric population with 15.4 years as the average age of onset in reported cases. Although adults and children with IBD may exhibit similar clinical features, children often manifest with additional features of failure to thrive and delayed puberty due to the background chronic inflammatory process. In this case report, we present a case of paediatric PD-PSV without underlying inflammatory bowel disease in a 3-year-old African girl. This case presents a unique opportunity of reminding clinicians that not all cases of paediatric PD-PSV may be associated with underlying IBD at presentation.
With the advent of the HIV/AIDS pandemic within the South Saharan region, clinicians are faced with accentuated clinical presentations of previously well-known diseases. Bacillary angiomatosis is no exception to this rule. Bacillary angiomatosis is a cutaneous and systemic bacterial infection caused by gram-negative Bartonella species. We report a case of an immunocompromised 44 years old female patient who presented with a solitary tumor-like bacillary angiomatosis that was treated successfully with azithromycin in a bi-weekly pulsed dosing regimen. This patient had a considerably large (12 x 10cm’s) single lesion of the disease. The case highlights the potential that immunosuppressed patients are not only at risk of disseminated disease, but also of developing severe localized disease. Furthermore, Azithromycin pulse treatment may offer a convenient alternative as there is still no clear consensus regarding treatment protocol for using azithromycin in the treatment of cutaneous bartonellosis.
We discuss the case of a 23 years old female with chronic myeloid leukemia. This patient developed keratosis pilaris nearly three months after she was treated with imatinib mesylate for her chronic myeloid leukemia. She was then referred to our dermatology outpatient clinic for assessment of the skin lesions. Prior to initiating the tyrosinase kinase inhibitor, the patient had no skin lesions at all. The skin lesions were widespread and diffuse in distribution and featured a primary morphology of follicular keratotic papules. This clinical picture was in keeping with keratosis pilaris. The further histological evaluation also confirmed features compatible with this diagnosis. The tyrosine kinase inhibitors are considered first-line therapy for the treatment of chronic myeloid leukemia. Imatinib mesylate belongs to the first generation of oral tyrosine kinase inhibitors and has a long-term control on the chronic myeloid leukemia and good safety profile. Most cases of keratosis pilaris are reported to arise from the second generation of tyrosine kinase inhibitors such as Nilotinib. We report a case of keratosis pilaris associated with imatinib mesylate in a patient with chronic myeloid leukemia.
The actinobacteria have an important role to play in humans. On one hand the actinobacteria, especially the streptomyces spp. are used medicinaly for synthesis of some novel anti-microbial medicines whilst on the other hand, Actinomyces species also exist as normal commensals as well as pathogens that cause disease in humans. The bacteria play a role in the maintenance of healthy human organs where they are considered normal inhabitants. The genus, Actinomyces is normally found in the mouth, gut and the female genital tract of human beings. This chapter elaborates on different clinical manifestations of actinomycosis in humans, making use of visual illustrations depicting the vast array of pathology therein. Finally, the diagnosis and treatment of these infections in humans is also fully discussed.
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