Depigmentation of the vulvar area: Is it an alarming sign?

A 34‐year‐old female patient presented with recurrent bilateral hypopigmented macules on the labia majora. The lesions were treated with topical steroids, which led to mild improvement, but erosive plaques developed after discontinuing the treatment. Histopathological findings were compatible with extramammary Paget disease (EMPD), which was treated with radical vulvectomy with no recurrence in the next months of follow‐up.     

Traumatic carotid-cavernous fistula: A case report

Direct carotid-cavernous fistulas are a rare complication of craniofacial trauma that often presents with proptosis, chemosis, and other visual symptoms. Disruption of blood flow from a carotid-cavernous fistula can cause cortical and cranial nerve ischemia which requires emergent intervention. Upon clinical suspicion of a carotid-cavernous fistula, patients should undergo computed tomography angiography (CTA) or magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) if no other etiology is suspected. We present a case of a middle-aged patient with a gunshot wound in the posterior pharynx that resulted in a direct carotid-cavernous fistula of the left internal carotid artery.     

Simultaneous spontaneous pneumomediastinum and pneumopericardium in a critically ill patient with COVID-19

Case in the paper is of a 24-year-old woman presenting to Baqiyatallah hospital, Tehran, Iran with the occasional fever, weakness, myalgia, fatigue, body aches, and headache who was diagnosed with Coronavirus disease-19 (COVID-19) PCR test. Chest computed tomography (CT) showed spontaneous pneumomediastinum (SPM) and pneumopericardium (SPP). Here, we described SPM, and SPP in a patient with COVID-19, presenting a severe course of the disease.