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Eruptive xanthoma is defined by the combination of its clinical and histopathological features. While a nodular dermal infiltrate rich in foamy macrophages and associated with extracellular lipid deposition is typical of eruptive xanthoma, some microscopical variability can be seen. Herein, we report an unusual case of eruptive xanthoma exhibiting triglyceride deposition in a peculiar configuration. ⋯ Such material has been previously termed 'urate-like crystals'. An immunohistochemical analysis using antibodies to lipoprotein suggested that the substance is composed of chylomicrons. This observation suggests that naked chylomicrons may be deposited in the dermis of patients with severe hypertriglyceridemia.
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The University HealthSystem Consortium Clinical Database-Resource Manager (UHC CD-RM) is an administrative database increasingly queried for both research and administrative purposes, but it has not been comprehensively validated. To address this knowledge gap, we compared the UHC CD-RM with an institutional dataset to determine its validity and accuracy. ⋯ Most of the clinically significant patient- and intervention-specific variables within the UHC CD-RM are reliably reported. With recognition of its limitations, the UHC CD-RM is a reliable surrogate for institutional medical records and should be considered a valuable research tool for health service researchers.
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Cerebrovascular diseases · Jan 2010
Review Comparative StudyRisk of aneurysm rupture at intracranial arterial bifurcations.
Aneurysms on the posterior circulation, most commonly located at the basilar top, have a higher risk of rupture than aneurysms on the anterior circulation. If hemodynamic shear stress, which has its maximum impact at the distal carina of bifurcations, explains the higher rupture rate of basilar top aneurysms, aneurysms at the top of the carotid artery should have similar rupture rates given their geometrical similarities. ⋯ Aneurysms are less frequently located on the carotid than on the basilar artery bifurcation. The proportion of ruptured carotid aneurysms is smaller than that of unruptured carotid aneurysms, suggesting a lower rupture risk for aneurysms at the carotid artery bifurcation. The anatomical geometry of the bifurcations and concomitant hemodynamic stress are considered an unlikely explanation for the higher risk of posterior circulation aneurysms.
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Int. J. Clin. Pract. · Nov 2014
ReviewTherapeutic management of anal eczema: an evidence-based review.
To conduct a systematic review of treatments for anal eczema (AE). ⋯ This review highlights the need to conduct more high-quality clinical trials in patients with AE in order that specific guidelines for the management of this difficult proctological condition can be prepared.
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We present a case of an 18-year-old female with clinical, histological and immunopathological features of overlapping pemphigus vulgaris and bullous pemphigoid. This case is unique both in the context of the distinctive hybrid nature of the bullous disorder and the young age of onset. ⋯ A subsequent biopsy however confirmed a combined pemphigus and pemphigoid pattern both in the context of the light microscopic findings and by immunofluorescence. The pathophysiologic basis of this distinctive hybrid dermatosis along with the other reported cases of overlapping pemphigus and pemphigoid are reviewed.