Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
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Case Reports
[Late secondary syphilis with ulceration of the tongue during HIV coinfection: case report].
With the continuing rise of syphilis incidence, late stages and atypical courses with HIV-coinfection can be expected. A 45 year old HIV infected male presented with an unusual manifestation of late secondary syphilis on the tongue, which was first diagnosed as a squamous cell carcinoma but cleared after therapy with penicillin. ⋯ A TPHA test was negative due to a prozone phenomenon. With this case, we would like to emphasize the formerly well known relationship between the lesions of tertiary syphilis on the tongue and development of secondary carcinoma.
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The incidence of chronic wounds is increasing in developed Western countries. There are many causes for chronic or non-healing wounds. A multidisciplinary diagnostic approach and attention to underlying disorders are essential. ⋯ Because of the lack of comparative investigations the phase-adapted use of wound dressings is still empiric. Application of modern wound dressings may help to create an optimized wound milieu and accelerate healing. Treatment of the underlying causes is an absolute requirement for long-term complete healing.
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Eczema herpeticum is an acute, disseminated herpes simplex virus infection which remains a feared complication of eczematous skin diseases, especially atopic dermatitis. The vesicular and erosive clinical picture is often accompanied by systemic signs and symptoms. ⋯ The pathogenesis appears to involve a complex interplay of factors, including demasking of binding sites for the virus through the dermatitis, failure to up-regulate antiviral proteins and a lack of plasmacytoid dendritic cells. Treatment of choice is systemic acyclovir therapy.
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We report on a female patient with brachioradial pruritus, in whom the cause could be verified by purposeful diagnostics (e. g., MRI). The clinical symptoms with localized itching result from circumscribed nerve root compression and hyperexcitation of the nerve fibers. Under treatment with gabapentin, an anticonvulsant with a very good analgesic and good antipruritic effect, the itch ceased and the skin changes healed. This case shows that this special form of neuropathic itch requires targeted therapy, which apart from symptomatic treatment should primarily focus on remedying the cause, if feasible.