Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The histopathology, clinical presentation, and epidemiology of a cutaneous and oral mucosal disease affecting 40 black rhinoceroses (Diceros bicornis) at 21 zoological parks (50% of the captive US population) were investigated. Twenty-seven biopsies were examined from recent lesions, and clinical information was available from 127 episodes. The cutaneous lesions began as plaques that progressed to vesicles, bullae, or ulcers. Lesions waxed and waned in individual cases. Lesions were predominantly bilaterally symmetrical, affecting pressure points, coronary bands, tips of the ears and tail, and along the lateral body wall and dorsum. Oral lesions were first noticed as ulcers and were present on the lateral margins of the tongue, palate, and mucocutaneous junctions of the lips. All recent lesions had similar histopathologic findings of prominent acanthosis, hydropic degeneration of keratinocytes in the stratum spinosum, spongiosis, intraepithelial vesicles, and parakeratosis without dermal inflammation. Chronic lesions were ulcerated. No pathogens were identified by culture or electron microscopy. Most episodes coincided with stress events (transportation, sudden cold temperatures, intraspecific harassment, estrus, advanced pregnancy) or concurrent diseases (toxic hepatopathy, hemolytic anemia, respiratory or urinary tract infections). Affected rhinoceroses usually were lethargic and had weight loss. Affected rhinoceroses also had lower hematocrit, serum albumin, and cholesterol values than captive healthy or wild rhinoceroses. The clinical patterns and histopathologic findings are similar to those of superficial necrolytic dermatitis in dogs and necrolytic migratory erythema in humans. The high prevalence of this skin disease in captive black rhinoceroses under many circumstances suggests that their epidermis is acutely sensitive to any disruption of metabolic homeostasis. We propose that metabolic changes secondary to a stress response from maladaptation or nutritional inadequacy of captive diets may contribute to the development of this disease in rhinoceroses without hepatopathies.
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PMID:Vesicular and ulcerative dermatopathy resembling superficial necrolytic dermatitis in captive black rhinoceroses (Diceros bicornis). 954 33

The ingestion of large amounts of boric acid, a component of household insecticides, is a rare occurrence, characterized by a diffuse desquamative skin eruption, neutropenia, thrombocytopenia, delirium, acute renal failure and prolonged ileus. A 56-year-old male with a history of multiple previous suicide attempts was witnessed ingesting household roach killer and 4 days later presented to the hospital with lethargy, stiffness and a diffuse erythematous and desquamative eruption with bullous formation. He subsequently developed erythema of both palms as well as alopecia totalis. Histopathology from a right arm shave biopsy revealed a mostly intact epidermis with subtle vacuolar alteration of the basal layer, scattered intraepidermal apoptotic keratinocytes, parakeratosis with alternating layers of orthokeratosis and considerable superficial exfoliation; accompanying dermal changes included vasodilatation and mild perivascular inflammation. This report describes the cutaneous and systemic complications in a rare case of boric acid ingestion. There is little published material on the symptoms and histopathology following boric acid ingestion, but knowledge of this entity is important, both to differentiate it from other causes of desquamative skin rashes and to allow the initiation of appropriate clinical care.
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PMID:Boric acid ingestion clinically mimicking toxic epidermal necrolysis. 2399 46