International Medical Case Reports Journal最新文献

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Delayed Vesicocutaneous Fistula 18 Years After Tension-Free Vaginal Tape: A Rare Case Report. 无张力阴道贴带后18年发生迟发性膀胱皮瘘1例。
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-08-05 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S580339
Mohamed Bashir, Rogers Kajabwangu, Aditi Nadkarni, Anfal Zuhair Alkinani, Akshay Nadkarni
{"title":"Delayed Vesicocutaneous Fistula 18 Years After Tension-Free Vaginal Tape: A Rare Case Report.","authors":"Mohamed Bashir, Rogers Kajabwangu, Aditi Nadkarni, Anfal Zuhair Alkinani, Akshay Nadkarni","doi":"10.2147/IMCRJ.S580339","DOIUrl":"10.2147/IMCRJ.S580339","url":null,"abstract":"<p><strong>Background: </strong>Synthetic mid-urethral slings are widely used for female stress urinary incontinence and are generally safe. However, complications such as erosion, infection, bladder or urethral perforation, vascular or bowel injury, and postoperative voiding difficulties have been reported. Very rarely, vesicocutaneous fistulas may occur due to bladder erosion resulting from mesh-related reactions, which begin with chronic inflammation and weakening of the bladder wall, then extend to the perivesical tissues and the anterior abdominal wall, forming a fistulous tract to the skin.</p><p><strong>Case presentation: </strong>We report a 65-year-old woman, para 4, with multiple comorbidities, including diabetes mellitus and hypertension and a history of total abdominal hysterectomy for adenomyosis 20 years earlier, who developed anterior vaginal wall prolapse and stress urinary incontinence. She underwent a tension-free vaginal tape (TVT) procedure 18 years ago. Last year, she presented with urinary leakage from her abdominal incision. Computed tomography and cystoscopy confirmed a vesicocutaneous fistula secondary to erosion of the TVT. The tape was removed, and the fistula was repaired with a layered closure of the bladder and abdominal wall. She was discharged after two days with a Foley catheter, which was removed after two weeks. Four weeks later, she presented with a recurrence of stress urinary incontinence for which we planned surgical correction later. Anterior repair and Kelly plication were performed at 6 months after removal of the tape, resulting in urinary continence. The patient was reviewed 8 weeks later and remained continent with no major complications.</p><p><strong>Conclusion: </strong>Vesicocutaneous fistula after TVT is rare but serious; chronic mesh-tissue interactions, compounded by comorbidities such as diabetes and estrogen deficiency, can lead to delayed erosion and fistula years postoperatively. This case highlights the importance of early recognition of urinary symptoms, timely surgical management, and ongoing long-term surveillance, even when initial surgery is technically successful.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"580339"},"PeriodicalIF":0.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infantile Onset Haploinsufficiency of A20 Treated by Infliximab, a Case Report and Brief Review of Literature. 英夫利昔单抗治疗婴幼儿A20单倍功能不全1例并文献复习。
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-08-04 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S587900
Farhad Salehzadeh, Faeze Babazadeh Khoei
{"title":"Infantile Onset Haploinsufficiency of A20 Treated by Infliximab, a Case Report and Brief Review of Literature.","authors":"Farhad Salehzadeh, Faeze Babazadeh Khoei","doi":"10.2147/IMCRJ.S587900","DOIUrl":"10.2147/IMCRJ.S587900","url":null,"abstract":"<p><strong>Background: </strong>Haploinsufficiency of A20 (HA20) is a rare genetic autoinflammatory syndrome caused by heterozygous loss-of-function variants in TNFAIP3. It typically appears in early childhood with recurrent fevers, mucocutaneous ulcers, gastrointestinal symptoms, and occasional eye involvement. The overlapping features with Behçet disease and other autoinflammatory disorders often make diagnosis challenging.</p><p><strong>Case presentation: </strong>We describe a 5-year-old girl who developed periodic fevers from age 2, along with oral ulcers, eye redness and swelling, abdominal pain, diarrhea, perianal tenderness, and dysuria. Initial treatments with colchicine and intermittent prednisolone provided little benefit. Whole exome sequencing revealed a likely pathogenic variant in TNFAIP3 (TNFAIP3 Chr6 138197257 138197257 C: NM_001270507.2: (5/9): c.759delC: p. Asp253fs), consistent with a diagnosis of Behçet-like autoinflammatory syndrome (HA20), with additional variants in PIK3R1, HBB, and SERPINA1 possibly modifying the phenotype.</p><p><strong>Management and outcome: </strong>After the genetic diagnosis, therapy was escalated to infliximab, which led to improvement, this highlights the effectiveness of targeted biologic therapy in refractory pediatric HA20 insufficiency who unresponsive to conventional therapies.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"587900"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Refining Knee Radiofrequency Ablation with a Palisade- Guided Technique: A Case Report. 用栅栏引导技术改进膝关节射频消融:1例报告。
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-08-04 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S602310
Talgat Anashev, Tamerlan Shokanov, Dina Saginova, Yerdar Shaukhin
{"title":"Refining Knee Radiofrequency Ablation with a Palisade- Guided Technique: A Case Report.","authors":"Talgat Anashev, Tamerlan Shokanov, Dina Saginova, Yerdar Shaukhin","doi":"10.2147/IMCRJ.S602310","DOIUrl":"10.2147/IMCRJ.S602310","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis is a leading cause of chronic pain and disability, and many patients have persistent pain despite conservative treatment or are not candidates for arthroplasty. Contemporary anatomical studies show that the classical three-nerve genicular radiofrequency ablation (RFA) model does not adequately reflect the multibranch innervation of the anterior knee capsule, which may limit efficacy. Structured preprocedural planning may help standardize cannula placement, however, its clinical and anatomical validity requires further investigation.</p><p><strong>Case presentation: </strong>We report a 53‑year‑old man with Kellgren-Lawrence grade II knee osteoarthritis and chronic refractory anterior knee pain who underwent RFA using this technique. We developed a periosteal multi‑cannula \"palisade‑guided\" genicular RFA technique that combines a ruler‑based cannula alignment with individualized mathematical preoperative planning. Insertion points are calculated on anteroposterior radiographs using the formula: a = b × tan (α)° where b is the length of the active electrode tip and α is the cortical inclination angle of the femoral and tibial condyles, allowing creation of elongated, overlapping lesions along the medial and lateral femoral condyles and the medial tibial condyle. The procedure was completed without vascular or neurological complications. The patient experienced complete pain relief (VAS 0) from the second postoperative day with full restoration of daily activities, and only mild transient discomfort at puncture sites. Pain remained low during follow‑up (VAS 2 at 3 months, VAS 3 at 6 and 9 months), consistent with sustained clinical regression of symptoms.</p><p><strong>Conclusion: </strong>This single case suggests that a structured, geometrically guided modification of genicular RFA may be feasible and may provide sustained pain reduction. However, the actual lesion dimensions, degree of target-branch denervation, and functional benefit were not objectively confirmed. Therefore, these preliminary findings should be interpreted cautiously and require validation in anatomical, imaging-based, prospective, and comparative studies.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"602310"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mechanical Ptosis as the Initial Presentation of Eosinophilic Granulomatosis with Polyangiitis. 机械性上睑下垂是嗜酸性肉芽肿合并多血管炎的最初表现。
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-08-04 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S631445
Roberto Ramirez Hernandez, Dominguez-Salgado LA, Angel Nava Castañeda
{"title":"Mechanical Ptosis as the Initial Presentation of Eosinophilic Granulomatosis with Polyangiitis.","authors":"Roberto Ramirez Hernandez, Dominguez-Salgado LA, Angel Nava Castañeda","doi":"10.2147/IMCRJ.S631445","DOIUrl":"10.2147/IMCRJ.S631445","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare ANCA-associated small-vessel vasculitis that may involve the orbit. Dacryoadenitis presenting as unilateral mechanical ptosis is an unusual ophthalmic manifestation that may mimic inflammatory or neoplastic orbital disease.</p><p><strong>Case presentation: </strong>A 68-year-old man presented with unilateral eyelid swelling and lacrimal gland enlargement associated with orbital inflammation. Orbital imaging demonstrated dacryoadenitis. Systemic evaluation revealed a history of childhood asthma, chronic rhinosinusitis, mononeuritis, positive p-ANCA serology, and lacrimal gland histopathology demonstrating eosinophilic-rich inflammation consistent with EGPA. The patient was treated with systemic corticosteroids, with favorable clinical improvement.</p><p><strong>Conclusion: </strong>Unilateral dacryoadenitis is a rare manifestation of eosinophilic granulomatosis with polyangiitis and should be considered in the differential diagnosis of orbital inflammatory disease. Early recognition may facilitate prompt systemic treatment and improved clinical outcomes.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"631445"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Rare Combination of Legionella ARDS and Pulmonary Embolism: A Case Report. 军团菌急性呼吸窘迫综合征合并肺栓塞1例。
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-08-04 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S615885
Abhishek Vadher, Kirill Ruban, Mehwish Zeb, Abed Dabaja, Sujata Kambhatla
{"title":"A Rare Combination of Legionella ARDS and Pulmonary Embolism: A Case Report.","authors":"Abhishek Vadher, Kirill Ruban, Mehwish Zeb, Abed Dabaja, Sujata Kambhatla","doi":"10.2147/IMCRJ.S615885","DOIUrl":"10.2147/IMCRJ.S615885","url":null,"abstract":"<p><p>Legionnaires' disease is a severe atypical pneumonia caused by <i>Legionella pneumophila</i>, an aerobic gram-negative bacillus acquired through inhalation of aerosolized contaminated water. Although venous thromboembolism (VTE) has been reported in association with severe infections, its occurrence in Legionella pneumonia remains uncommon and has been hypothesized to be related to infection-driven endothelial injury and systemic inflammatory activation. We report a case of a 38-year-old male with alcohol use disorder and chronic pancreatitis who presented with severe hypoxemic respiratory failure and acute respiratory distress syndrome (ARDS) secondary to severe necrotizing Legionella pneumonia. Imaging demonstrated multifocal pneumonia with cavitary changes and a subsegmental pulmonary embolism in the left lower lobe. The patient met criteria for ARDS based on the 2023 Global Definition of ARDS. He was treated with targeted antibiotic therapy and anticoagulation, later transitioned to oral therapy, and discharged on room air in stable condition. This case highlights the occurrence of pulmonary embolism in the setting of severe Legionella pneumonia and ARDS. While chronic pancreatitis and critical illness are recognized prothrombotic conditions, infection-related hyperinflammation and endothelial dysfunction may have further contributed to thrombotic risk. Clinicians should maintain a high index of suspicion for pulmonary embolism in patients with severe Legionella pneumonia who develop unexplained or disproportionate hypoxemia.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"615885"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Orbital Compression Syndrome Mimicking Severe Malaria in a Child with Sickle Cell Disease in a Ugandan Refugee Settlement: A Case Report. 乌干达难民安置区镰状细胞病儿童的眼眶压迫综合征模仿严重疟疾:一例报告。
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-07-27 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S620021
James Nelson Okema, Stephenson Ocen Oryem, Lydia Joyce Atto, Jude Ocen Okello, Jael Mary Nalukenge, Grace Acomo, Ronald Obal, Joel Atim Abong
{"title":"Orbital Compression Syndrome Mimicking Severe Malaria in a Child with Sickle Cell Disease in a Ugandan Refugee Settlement: A Case Report.","authors":"James Nelson Okema, Stephenson Ocen Oryem, Lydia Joyce Atto, Jude Ocen Okello, Jael Mary Nalukenge, Grace Acomo, Ronald Obal, Joel Atim Abong","doi":"10.2147/IMCRJ.S620021","DOIUrl":"10.2147/IMCRJ.S620021","url":null,"abstract":"<p><strong>Background: </strong>Orbital compression syndrome (OCS) is a rare, sight-threatening complication of sickle cell disease (SCD), caused by vaso-occlusive infarction of orbital bone marrow with subperiosteal hematoma formation. Its presentation overlaps with orbital cellulitis and severe malaria, creating diagnostic uncertainty in resource-limited humanitarian settings.</p><p><strong>Case presentation: </strong>A 9-year-old boy with homozygous SCD (HbSS) presented to a primary health facility in Palabek Kal refugee settlement, Lamwo District, northern Uganda, with a 1-day history of sudden severe bilateral frontal headache radiating to the eyes, high-grade fever, and rapidly progressive bilateral periorbital edema, epiphora, and photophobia, without altered consciousness, seizures, vomiting, or respiratory distress. He was febrile (39.3°C) and unwell, with bilateral periorbital swelling, mild scleral icterus, and hepatomegaly (approximately 6 cm below the right costal margin); visual acuity, pupillary responses, extraocular movements, and proptosis assessment were normal. Laboratory evaluation showed severe anemia (hemoglobin 6.5 g/dL), leukocytosis (14.81 × 10<sup>3</sup>/µL), and 3+ malaria parasitemia. Orbital imaging and cultures were unavailable. The clinical picture was most consistent with OCS secondary to vaso-occlusive crisis, with severe malaria, orbital cellulitis, and septicemia considered as concurrent or alternative diagnoses.</p><p><strong>Management and outcome: </strong>The child received intravenous artesunate, empirical broad-spectrum antibiotics, intravenous fluids, analgesics, and one unit of blood transfusion for severe anemia, with close ophthalmic monitoring. Fever resolved, periorbital swelling subsided, and visual function was preserved without surgical intervention.</p><p><strong>Conclusion: </strong>This case illustrates the diagnostic challenge of OCS in a child with SCD in a malaria-endemic humanitarian setting. OCS should be considered in any child with SCD presenting with acute bilateral periorbital swelling, headache, and fever, even when malaria is confirmed and orbital imaging is unavailable. Early recognition, parallel management of competing diagnoses, close clinical monitoring, and expanded access to orbital imaging in humanitarian settings are critical to prevent avoidable visual morbidity.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"620021"},"PeriodicalIF":0.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Selection of Superficial Temporal Artery Flaps for Eyebrow Reconstruction: Two Illustrative Cases. 选择颞浅动脉皮瓣重建眉毛:两例说明。
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-07-23 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S625467
Phung Van Nguyen
{"title":"Selection of Superficial Temporal Artery Flaps for Eyebrow Reconstruction: Two Illustrative Cases.","authors":"Phung Van Nguyen","doi":"10.2147/IMCRJ.S625467","DOIUrl":"10.2147/IMCRJ.S625467","url":null,"abstract":"<p><strong>Background: </strong>Eyebrow reconstruction remains challenging because an optimal outcome depends on restoring both stable soft-tissue coverage and natural hair-bearing characteristics. Several options are available, including hair transplantation, hair-bearing grafts, local flaps, and hair-bearing fascio-cutaneous flaps based on the superficial temporal artery (STA). Recipient-site and defect characteristics, together with patient factors, guide whether an STA-based flap is indicated. Once an STA flap has been chosen, however, the decision between a pedicled and a free transfer is determined primarily by donor-site availability, namely the condition of the ipsilateral temporal region and its vessels. Explicit decision-making criteria for this two-step reasoning are not well defined.</p><p><strong>Cases presentation: </strong>We present two cases that illustrate flap selection rather than a comparison of techniques. In the first case, a pedicled STA flap was used to reconstruct a partial eyebrow defect when the ipsilateral temporal region was intact. In the second case, previously reported elsewhere, a contralateral free STA flap was used for total eyebrow reconstruction because the ipsilateral temporal region had been compromised by prior surgery.</p><p><strong>Results: </strong>Both flaps survived completely without major complications. At long-term follow-up, both reconstructions showed restoration of the eyebrow contour with acceptable symmetry, hair direction, and density relative to the contralateral side, and high patient satisfaction.</p><p><strong>Conclusion: </strong>STA fascio-cutaneous flaps are a reliable option for eyebrow reconstruction. When an STA-based flap is indicated, the choice between a pedicled and a free transfer is governed mainly by donor-site availability: a pedicled flap when the ipsilateral temporal region is preserved, and a free flap when it is unavailable. These cautious, case-based observations are intended to illustrate clinical reasoning rather than to establish the superiority of one technique.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"625467"},"PeriodicalIF":0.7,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recurrent Pyoderma Gangrenosum with Initial Onset in Early Pregnancy: A PARACELSUS-Supported Clinical Diagnosis in a Resource-Limited Setting in South-Western Uganda. 复发坏疽性脓皮病与早期妊娠的初始发作:paracelsus支持的临床诊断在乌干达西南部资源有限的设置。
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-07-21 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S622264
Gerald Olwit, Charles Tumwesige, Arthur Jonathan Nek, Hans Chinomso Chris-Uchendu, Sam Tumwijukye, Ivan Darcy Omalla, Aime Ishimwe Mugisha, Arnold Atuhaire, Andrew Mutekanga, Leo Odongo
{"title":"Recurrent Pyoderma Gangrenosum with Initial Onset in Early Pregnancy: A PARACELSUS-Supported Clinical Diagnosis in a Resource-Limited Setting in South-Western Uganda.","authors":"Gerald Olwit, Charles Tumwesige, Arthur Jonathan Nek, Hans Chinomso Chris-Uchendu, Sam Tumwijukye, Ivan Darcy Omalla, Aime Ishimwe Mugisha, Arnold Atuhaire, Andrew Mutekanga, Leo Odongo","doi":"10.2147/IMCRJ.S622264","DOIUrl":"10.2147/IMCRJ.S622264","url":null,"abstract":"<p><strong>Background: </strong>Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly progressive, painful cutaneous ulceration and remains a diagnosis of exclusion because no single laboratory or histopathological test is diagnostic. Establishing a clinically well-supported diagnosis is particularly challenging in resource-limited settings where histopathology and other advanced investigations are often unavailable, necessitating reliance on structured clinical assessment and validated diagnostic frameworks.</p><p><strong>Case presentation: </strong>A 26-year-old multiparous woman from South-Western Uganda presented with recurrent, progressively painful multifocal ulcerations involving both lower limbs and upper extremities. The initial episode developed during the first month of pregnancy as pruritic pustules that rapidly evolved into ulcerative lesions following minor trauma, with recurrence occurring two years later from a persistent non-healing ulcer. Comprehensive clinical evaluation found no evidence suggestive of inflammatory bowel disease (IBD) or other major associated systemic conditions, while wound cultures were sterile, supporting a non-infectious process. Because histopathology, gastrointestinal endoscopy, and other advanced investigations were unavailable, diagnosis relied on careful clinical assessment, systematic exclusion of important differential diagnoses, characteristic lesion morphology, pathergy, previous response to immunosuppressive therapy, and a PARACELSUS score supportive of PG. The patient was treated with oral prednisolone, cyclosporine, structured wound care, supportive therapy, and physiotherapy, resulting in marked clinical improvement at three-month follow-up.</p><p><strong>Conclusion: </strong>This case demonstrates how structured clinical reasoning and validated diagnostic frameworks can support a clinically well-substantiated diagnosis of probable PG when confirmatory investigations are inaccessible. It also describes a temporal association between disease onset during early pregnancy and pregnancy loss, an observation that should be interpreted cautiously and requires further investigation rather than implying causality. Careful exclusion of alternative causes of ulceration remains fundamental before initiating immunosuppressive therapy.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"622264"},"PeriodicalIF":0.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hydroa Vacciniforme-Like Lymphoproliferative Disorder in the Elderly: A Case Report and Diagnostic Challenges. 老年人疫苗样水淋巴增生性疾病:一例报告和诊断挑战。
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-07-20 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S611417
Xihan Long, Liyan Lai, Qiaomin Lin, Dejian Duan, Dan Huang, Muyuan Yu
{"title":"Hydroa Vacciniforme-Like Lymphoproliferative Disorder in the Elderly: A Case Report and Diagnostic Challenges.","authors":"Xihan Long, Liyan Lai, Qiaomin Lin, Dejian Duan, Dan Huang, Muyuan Yu","doi":"10.2147/IMCRJ.S611417","DOIUrl":"10.2147/IMCRJ.S611417","url":null,"abstract":"<p><strong>Background: </strong>Hydroa vacciniforme-like lymphoproliferative disorder is a rare Epstein-Barr virus -associated T/NK cell proliferation predominantly.</p><p><strong>Case presentation: </strong>A 72-year-old female presented with persistent skin lesions and high fever. The atypical distribution of lesions, along with the spontaneous regression of some of them, and the positive Staphylococcus aureus culture, initially made the diagnostic process complicated. However, skin biopsies revealed CD3+CD8+ T-cell infiltration, partial loss of CD5 expression, a high proliferative index, and positive Epstein-Barr virus-encoded RNA in situ hybridization. Reactive lymph node hyperplasia ruled out systemic lymphoma, thus supporting the diagnosis of HVLPD.</p><p><strong>Conclusion: </strong>HVLPD can present in the elderly with lesions in unexposed areas. Diagnostic challenges require accounting for infectious confounders.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"611417"},"PeriodicalIF":0.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Colocalization of Vitiligo and Lichen Planus in a Young Man: Coincidence or Something Beyond That? 白癜风和扁平苔藓在年轻人身上的局部分布:巧合还是其他原因?
IF 0.7
International Medical Case Reports Journal Pub Date : 2026-07-17 eCollection Date: 2026-01-01 DOI: 10.2147/IMCRJ.S573756
Fatemeh Mohaghegh, Mahdieh Zabihi, Zeinab Aryanian, Mina Saber, Parvaneh Hatami
{"title":"Colocalization of Vitiligo and Lichen Planus in a Young Man: Coincidence or Something Beyond That?","authors":"Fatemeh Mohaghegh, Mahdieh Zabihi, Zeinab Aryanian, Mina Saber, Parvaneh Hatami","doi":"10.2147/IMCRJ.S573756","DOIUrl":"10.2147/IMCRJ.S573756","url":null,"abstract":"<p><p>Vitiligo and Lichen Planus are expected to coexist, but their colocalization is extremely rare. There are several theories regarding their immunopathogenesis connection. In this report, we report a thirty-five-year-old man without any medical, familial, or social history, who was presented with simultaneous lichen planus and vitiligo, both generalized at the time of observation and also concomitant throughout their entire course of progression. Lichen Planus Pigmentosous patches and vitiligo were located in both sun-exposed and non-exposed areas. Further extensive researches on larger scales seem warranted to propose any kind of theory regarding their interconnection.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"573756"},"PeriodicalIF":0.7,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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