Dermatology online journal
-
Dermatol. Online J. · Sep 2015
Review Case ReportsA 7-year-old with indurated skin and unilateral progressive joint immobility: A case of stiff skin syndrome.
Stiff skin syndrome is a rare sclerotic condition that presents during infancy or early childhood. It has an insidious chronic course and may lead to significant co-morbidity and reduced quality of life. ⋯ As it is a condition with limited treatment options, prompt diagnosis and early initiation of physical therapy is crucial to prevent joint restriction and maintain quality of life. We describe a case of a 7-year-old with stiff skin syndrome, and review the literature to discuss the clinical presentation, histological findings, and management of this condition.
-
Dermatol. Online J. · Sep 2015
Case ReportsImmediate resolution of severe bullous chronic regional pain syndrome with onset of spinal paralysis.
Complex regional pain syndrome (CRPS) is an incompletely understood disorder characterized by progressive regional pain and sensory changes, with fluctuating cutaneous edema and erythema. We describe a patient with a rarely reported severe bullous CRPS variant on the left lower extremity, which resolved immediately upon developing spinal paralysis.
-
Dermatol. Online J. · Aug 2015
Case ReportsAtypical propylthiouracil-induced ANCA-positive vasculitis: report of a case with unusual clinical and histopathologic findings.
The side effects of propylthiouracil, including cytopenia and vasculitis, are well established. We present an interesting case in which cytopenia and cutaneous vasculopathy occurred concomitantly in a critically ill patient. The patient was initially treated for suspected infection until dermatologic and rheumatologic workup revealed ANCA-positivity and vasculopathy on histopathology, most consistent with an atypical presentation of ANCA-positive vasculitis. Upon initiation of immunosuppressive therapy, the patient's condition rapidly improved emphasizing the importance of early recognition of this condition.
-
Dermatol. Online J. · Aug 2015
Case ReportsVesicular erythema migrans: an atypical and easily misdiagnosed form of Lyme disease.
Erythema migrans is the initial sign in the majority of patients infected with Borrelia, the genus of spirochetes that causes Lyme disease. Early identification and treatment decrease the risk of progression to later stages of disease. ⋯ Herein, we describe the case of a patient with Lyme disease in which the presence of atypical vesicular features, in conjunction with the initial absence of clearing, resulted in multiple misdiagnoses and delayed treatment. We also review the literature on the epidemiology and management of erythema migrans for cases in which the diagnosis may pose a challenge.
-
The cost of prescription medicines has recently been rising faster than other healthcare costs. This is also true for traditionally inexpensive generic medications that have long served as a fundamental healthcare safety net in the USA. These changes increasingly present challenges for individuals to obtain common medications. Owing to rising insurance co-pays, even patients who have prescription medication insurance coverage are beginning to experience challenges in this area. This document was created to help patients and their families consider various strategies and programs that exist in 2015 for reducing their out-of-pocket costs for their prescription medications. We believe that this information can also be helpful to healthcare providers when counseling patients about managing rapidly rising prescription drug costs. An effort has been made to make this document readable to patients and their families as well as to healthcare providers.