Background. Degos acanthoma is rare benign tumor. Typical signs of this disease are localization on the lower limbs, abdomen and anterior chest in middle-aged and elderly patients (50–70 years old). The only one clinical case of pale cell acanthoma with the atopic dermatitis, and eczema in the area of areoles in the 26 years old patient was described.Clinical Case Description. The boy had redness and swelling in the area of the right mammary gland at the age of 11 years. This mass lesion was regarded as the eczema of the areola region due to burdened allergic history (atopic dermatitis), thus, antihistamine therapy was prescribed. Similar lesion has appeared in the area of the left areola 3 months later, the same therapy was used. Saniopurulent discharge was occasionally noted from the lesions. The child was consulted by dermatologist, endocrinologist and surgeon at the place of residence, and diagnosed with chronic purulent mastitis. Conservative therapy had no positive dynamics. Bilateral changes in areoles were revealed during hospitalization at the age of 13 years. There were red lesions with non-homogenous surface, yellow discharge, hyperemia around the right areola. The lesion sizes were 2.03.0 cm on the left and 3.03.5 cm on the right side. Biopsy has revealed pale cell acanthoma. Conservative treatment with oral and systemic glucocorticosteroids was prescribed, positive dynamics was obtained for 3 days after the therapy initiation.Conclusion. The presence of eczema in the area of the nipple associated with sanioserous discharge requires the differential diagnosis with pale cell acanthoma. The conservative therapy (with glucocorticosteroids) efficacy for pale cell acanthoma is shown.
Background. KID syndrome (keratitis-ichthyosis-deafness) is an orphan genetic multisystem disease with autosomal recessive and dominant types of inheritance, it manifests in the neonatal period. The leading triad of symptoms is: skin lesions, ophthalmological diseases and hearing organ pathology. Clinical Case Description. Girl V., 17 years old, with KID syndrome applied to the hospital complaining on painful infiltrates of the parietal region. Multiple abscesses were lanced. Hyperkeratotic crusts were removed, unviable skin regions were excised, and abscesses' cavities were washed with antiseptic solution during daily dressings. Purulent discharge from wounds has been maintaining for 7 days. Conclusion. Where is no pathogenetic treatment for KID syndrome yet. Prevention of secondary surgical infections remains the crucial aspect in the management of such patients. Local wound treatment, symptomatic and antibacterial therapy are effective in case of skin infection.
Introduction. The uterine appendage torsion (UAT) is an urgent pathology accompanied by a painful abdominal syndrome and requiring urgent diagnostic and therapeutic measures. In childhood, UAT develops mainly due to organic causes and due to the specific location of internal organs in children. The literature data on organ-preserving surgeries in the long-lasting UAT is very controversial and dubious. There are no objective criteria for assessing ovarian viability after detorsion what impacts the selection of surgical intervention tactics - unjustified adnexectomy may be performed.Clinical case. Girl P., 12 years old, was admitted to the hospital with a clinical picture of long-lasting torsion of the uterus appendages. Right uterine appendages were detorsed. The child was under observation. In two years, laparoscopic appendectomy was performed for chronic appendicitis. When examining pelvic organs, the right ovary was found reduced in size compared to the left one; there were no macroscopically visible changes; single follicles were visualized in it; the fallopian tube was not changed.Conclusion. A painful sensation before surgery indicates that the uterus appendages are viable; if there is no abdominal pain, necrosis of the ovary and fallopian tube may be suspected. A surgical tactics is chosen on making a comprehensive analysis of clinical and instrumental findings.
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