Laser and light-based therapies in the management of rosacea: an updated systematic review

Lasers in Medical Science - Unlike other rosacea therapies which need daily takings or applications over long periods, the edge of lasers and light-based therapies (LLBT) is the limited number of...     

A middle-age woman with subcutaneous plaque and hilar adenopathies

Subcutaneous sarcoidosis (SS) is an unusual and specific subtype of nodular sarcoidosis 1. The presence of SS with no elements of systemic manifestations is a rare condition: it is reported only in 1.4% to 6% of patients with systemic sarcoidosis, with the trunk being the most predilected area. Such cases with rare presentation are challenging for physicians because it can mimic several chronic infections, amyloidosis, hypothyroidism, lysosomal storage diseases and other conditions. Typical imaging (specially bilateral hilar adenopathies), histological exam and laboratory findings are the baseline to establish the diagnosis of sarcoidosis. In our case, the presence of subcutaneous manifestations avoided the performance of invasive procedures to get confirmation from other target organs: The epithelioid cells granulommas in subcutaneous fat and the representative radiological images were enough features to make the certain diagnosis. The first-line therapy for SS is oral steroids (20–40 mgr/day) with responses observed only 4–8 weeks after initiation of the treatment2. Prognosis of SS is good with spontaneous remission in some cases; however, when granulommas or fibrosis involves vital organs sarcoidosis can be life-threatening. Physicians should consider diagnosis of SS in patients with clinical suspicious history as sometimes skin manifestations are the first sign of systemic presentation of disease     

Tongue infarction as first symptom of temporal arteritis

Giant cell arteritis (GCA) is the most common systemic vasculitis affecting people over 50 years. This disease is a diagnostic challenge with a range of clinical symptoms and findings due to different affected vessels. Because of this, the initial diagnosis can be tricky, and some of the patients present at first time with a real unusual initial manifestation. One of these can be tongue necrosis, which is according to the literature in accordance with scalp necrosis, the rarest initial manifestation of GCA We describe a patient who presented with tongue necrosis as initial symptom of GCA. The belated diagnose resulted in subtotal necrosis of the mobile part of the tongue.