HighlightsEctopic Cushing’s syndrome is a form of Cushing’s in which a tumor outside the pituitary gland produces a hormone called (ACTH).Small cell carcinoma and carcinoid of the lung comprises half of its cases.Ectopic cushing syndrome is a complicated medical problem especially when it comes to identification of the ectopic spot.The surgical treatment could be curative when the spot is determined.
Introduction: Hidradenitis suppurative (HS) is a chronic inflammatory skin condition that can be resistant to medical treatment, in which case the surgical option stands out as the only solution. In this paper, we present a case of severe hidradenitis treated surgically, and we introduce a simple way to secure a graft on a big circumferential area. Presentation of case: Our case is a severe form of HS involving both the axillary, the inguinal region and the scrotum that required multistaged surgery; the challenge was in the final stage, that is the grafting of the scrotum. To secure the graft on a big circumferential area we used our own technique that is simple and can be conducted in any hospital setting. Discussion: Surgical treatment of HS includes wide debridement and reconstruction with grafts or flaps. Using a piece of sterile glove to secure the graft is useful because of its stretchable properties that can compress the graft and the ability to maintain a moist environment that promotes healing, with making slits it can also help in draining excess fluids. Conclusion: We recommend testing this technique when grafting the scrotum or any circumferential area to secure the grafts.
Summary: Most cases of hand infections are caused by gram-positive cocci and gram-negative bacilli. Atypical hand infections are rare and are caused by uncommon pathogens like Mycobacterium tuberculosis (TB). Musculoskeletal tuberculosis accounts for 20% of TB cases, and only 2% of these cases involve the hand and foot. In this article, we describe a case of hand TB that had spread from the thenar space to the space of Parona. The patient was treated with a combined surgical and medical approach. A 29-year-old male patient presented to our clinic with the complaint of pain and swelling of the right hand that had been worsening for 4 months before presentation. It was associated with mild weakness and night sweats. On physical examination, he had two separate swellings: one at the thenar eminence and one at the volar side of the wrist. He was taken for incision, which showed caseous material on both sites. It was sent for culture that revealed mycobacterium tuberculosis. The patient was placed on anti-TB medications for a total of 6 months. Tuberculous infection of the hand is a rare condition; the most common musculoskeletal sites are the spine, hip, and knee. Early diagnosis and treatment of TB infection in hand are essential for retaining optimal function. The diagnosis usually depends on the clinical presentation supported by laboratory tests and imaging studies. Treatment consists of medical, surgical, or combined treatment. Surgical intervention should aim to remove all the infected material in addition to debridement of the involved tissues.
Background: Hidradenitis suppurativa is a chronic inflammatory condition that affects apocrine gland-bearing areas‚ causing abscesses and sinuses. Multimodality treatment is suggested for management. The surgical option is becoming more widely used, especially in drug-resistant cases. In this article, we describe a series of bilateral axillary hidradenitis cases which we treated with wide local excision and immediate reconstruction with lateral chest flap. Methods: Fourteen patients presented to our clinic with bilateral hidradenitis suppurativa of the axilla. The cases were all resistant to medical treatment. They were managed by excision and simultaneous reconstruction with lateral chest flaps. Results: At 3 months postoperatively, all patients had full shoulder range of motion and were completely satisfied with the aesthetic outcome, except for one patient who complained of the bulky look of his axilla. Liposuction was performed for him‚ with a pleasant resultant outcome. Conclusions: Our patients underwent wide local excision of bilateral disease plus reconstruction with lateral chest flaps in the same session. Our aim was to introduce a treatment option for moderate to severe axillary hidradenitis suppurativa that offers good aesthetic and functional outcomes.
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