Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-seven patients with perplexing pleural effusion were studied to determine clinical outcome. The value of performing pleuroscopic examination or open pleural biopsy (or both) in search of a diagnosis was assessed. After a mean follow-up period of six months, a diagnosis was reached in 16 patients, while 11 patients had no diagnosis after a mean follow-up period of 24 months. The causes for the effusions were neoplasm (eight patients), tuberculosis (one patient), blastomycosis (one patient), systemic lupus erythematosus (one patient), pulmonary infarction (two patients), and fractures of the ribs (three patients). The diagnosis was made by pleuroscopic examination or open biopsy in five patients, by autopsy in four, and by long-term follow-up studies in seven patients. When neoplasm or granulomatous disease was not suspected before surgery, pleuroscopic examination or open biopsy or both were nondiagnostic. These data support a policy of selecting patients for these procedures when a presumptive diagnosis of neoplasm or granulomatous disease is made but cannot be confirmed by less invasive methods. When the clinical data are too nonspecific to formulate a meaningful clinical impression, a more conservative approach is recommended.
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PMID:Perplexing pleural effusion. 69 49

A case of disseminated blastomycosis is reported. The patient presented with lung involvement, lupus vulgaris-like lesions, mainly of the face, and subcutaneous abscesses overlying areas of bone destruction. The diagnosis was confirmed by mycological microscopy and culture of skin material from involved areas. The importance of early diagnosis and the favourable response to treatment are emphasized.
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PMID:A further indigenous case of 'North American' blastomycosis from South Africa. Importance of skin lesions in early diagnosis. 378 6

Cutaneous lesions in patients with systemic lupus erythematosus (SLE) represent diagnostic challenges. Opportunistic infections should be considered when lupus patients are on immunosuppressive therapy and other causes, such as disease activity, are less likely to explain the skin lesions. Within the spectrum of skin opportunistic infections that might occur in SLE patients, Blastomyces dermatitidis should be suspected when acid-fast positive material with no bacilliform organisms is seen on Ziehl-Nielsen skin biopsy preparations. In this study, we describe one patient with SLE on immunosuppressive therapy, who developed cutaneous blastomycosis despite living in a non-endemic area. Because of lack of awareness about this association and misinterpretation of the skin biopsy results, the diagnosis of atypical mycobacterial infection was initially considered. Subsequent proper tissue staining and interpretation revealed the correct diagnosis of disseminated cutaneous blastomycosis. This description represents the first report of this rare opportunistic skin infection in SLE, illustrating the importance of performing correct preparation and elucidation of the skin biopsy to avoid misdiagnosis and treatment delay.
Lupus 2009 Oct
PMID:A rare opportunistic infection in a woman with systemic lupus erythematosus and multiple skin lesions. 1976 86

We describe a case of a 65-year-old male presenting with a large plaque with a rolled-out interrupted margin, atrophic center, and island of normal skin over the left arm. It grew peripherally with central healing, and there was a history of recurrence after inadequate excision. Investigations ruled out other clinical mimickers; namely, squamous cell carcinoma, lupus vulgaris, botryomycosis, and blastomycosis-like pyoderma. Histopathological sections showed irregularly shaped craters filled with keratin and epithelial pearl but no evidence of granuloma or cellular atypia. Clinicopathological correlation proved the lesion to be keratoacanthoma centrifugum marginatum (KCM), a rare variant of keratoacanthoma, which spreads centrifugally, attains a huge size, and never involutes spontaneously. Treatment of KCM has been a problem always and, in our case, systemic retinoid (acitretin for three months) proved ineffective. The patient also had a history of recurrence following surgical intervention previously, necessitating wide excision to achieve complete clearance of tumor cells. Hence, after failure of retinoid therapy, the decision of excision with a 1-centimeter margin was taken and the large defect was closed by a split thickness skin graft. The graft uptake was satisfactory, and the patient is being followed-up presently and shows no signs of recurrence after six months, highlighting wide local excision as a useful treatment option.
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PMID:Keratoacanthoma centrifugum marginatum: unresponsive to oral retinoid and successfully treated with wide local excision. 2538 37

The authors present four cases of Wegener's granulomatosis patients with multiorganic manifestation forms, but with a prevalent involvement in upper-airway. Granulomatosis diseases of the nose include bacterial infections (rhinoscleroma, tuberculosis, syphilis, lupus, and leprosy), fungal infections (rhinosporidiosis, aspergillosis, mucormycosis, candidosis, histoplasmosis, and blastomycosis) and diseases with unspecified etiology (Wegener's granulomatosis, mediofacial malignant granuloma, and sarcoidosis). We consider an interesting experience regarding Wegener's granulomatosis due to its rarity, being an autoimmune systemic disease, with continuous evolution and multiorganic involvement. The beginning of the disease is like upper airway affection, a kind of "persistent cold", being difficult to differentiate it from a common cold in the head, with a prolonged evolution. It is important to mention that we establish the diagnosis of Wegener's granulomatosis starting with Ear Nose and Throat (ENT) clinical exam, followed by other tests and investigations realized in our Clinic and completed with specialty tests (nephrology, internal medicine and dermatology), meaning that we need a close cooperation with these medical specialties. All the patients presented multiorganic involvement. Notably significant for our four cases is the prolonged evolution in a stable condition in one patient.
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PMID:The involvement of upper airway in Wegener's granulomatosis - about four cases. 2619 39

Sporotrichosis is a cutaneous mycosis caused by a dimorphic fungus, Sporothrix schenckii species complex clinically presenting as lymphocutaneous, fixed, or disseminated forms. A typical lesion is an erythematous papule, noduloulcerative lesion usually occurring at the site of penetrating trauma, mostly on the extremities. Verrucous lesion is an unusual presentation of sporotrichosis which can mimic the verrucous lesions seen in chromoblastomycosis, tuberculosis verruca cutis/lupus vulgaris (TBVC/LV), cutaneous leishmaniasis, and blastomycosis leading to diagnostic dilemma. Herein, we describe a case of facial verrucous sporotrichosis in a child from sub-Himalayan region.
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PMID:Lymphocutaneous Sporotrichosis of Face with Verrucous Lesions: A Case Report. 3114 78