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✅ Neutrophilic dermatosis of dorsal hand (#NDDH)


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✅ Paget’s disease of the breast or nipple is a rare type of breast cancer that affects the nipple and spread to the dark circle around the nipple or areola. Most of people who have Paget’s disease of the breast have cancer in the affected breast. These tumors are either invasive breast cancer or ductal carcinoma in situ.

📌 Symptoms:

👉🏻 Scaly vesicular or ulcerated lesion
👉🏻 Bloody discharge
👉🏻 Pain
👉🏻 burning sensation
👉🏻 itching

📌 Diagnosis:

1⃣ Detailed history and physical examination about the length of time the lesion has been present and any symptoms including pain, scaly skin, nipple discharge, burning sensation and bleeding
Bilateral breast examination should be performed because breast malignancy is present in about 85% of patients and a palpable mass is present in approximately half of them.
2⃣ Biopsy needs to be performed when there is nipple discharge
3⃣ Bilateral mammography is mandatory to identify any existent mass and also synchronous cancer or calcifications.
4⃣ Breast ultrasound and Magnetic resonance imaging are used to produce images of deep tissue of breast

📌 Treatment:

1⃣ If there is any sign of mass, simple mastectomy is the standard treatment.
2⃣ Radiation therapy
3⃣ Hormonal therapy
4⃣ Chemotherapy
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✅ Final diagnosis:
#Paget's_disease of the breast

➡️ What is the reasons of strawberry tongue?

▶️ Differential diagnosis?

▶️ Management?

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📌 Neonatal reflexes 📌

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📌 Molluscum contagiosum


✅ Pictures
✅ Symptoms
✅ Risk factors
✅ Diagnosis
✅ Treatment
✅ Prevention

▶️ What is the diagnosis?

▶️ Management?

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✅ Ganglion cyst

A 3 year old boy with this lesion on the face, 2 weeks after bee bite

1⃣ Differential diagnosis?

2⃣ Management?

▶️ Cellulitis is an infection of deeper layer of the skin. It is commonly caused by bacteria that normally live on the skin surface. The infection happens when bacteria find a break on the skin to enter the body. Some risk factors can increase the chance of developing cellulitis such as insect bite, any kind of injury on the skin like cut, burn or fracture, Underlying disease such as diabetes or weakened immune system, use intravenous drugs and chronic edema of arms or legs. Cellulitis can affect any area of the body but it is more common on the arms, legs and face.

▶️ symptoms:

1⃣ Swelling, in case of insect bite, it usually occurs around the site of the insect bite
2⃣ The skin may be tender or painful
Redness and erythema of the affected area
3⃣ The skin can be warm and tight in touch
4⃣ And in some cases, patients may experience fever and malaise

▶️ The diagnosis is based on physical examination of the affected area. Any sign of swelling, redness, tender and warmness should be assessed.

👉🏻 Laboratory testing is not required in uncomplicated situation when the patient has no comorbidities or complications. Laboratory testing and culture are needed in some special circumstances:

📌 Severe local infection
📌 Recurrent or multiple abscesses
📌 No response to initial antibiotic therapy
📌 Systemic sign of infection like presence of fever and general malaise
📌 And presence of underlying comorbidities such as diabetes, malignancy or immunodeficiency

✅ The treatment of cellulitis after an insect bite typically involves:

1⃣ Oral antibiotic that is commonly prescribed to eliminate the bacterial infection. Our choice of antibiotic depends on the severity and the location of the cellulitis and the suspected bacteria. In some special cases we need to use parenteral antibiotic therapy instead of oral forms. These circumstances include:
📌Systemic signs of infections such as presence of high degree fever, hypotension and tachycardia,
📌 Inability to tolerate oral antibiotics,
📌 Rapid progression of erythema
📌 and progression of symptoms despite of taking oral antibiotics after 48 hours.
2⃣ Elevating the affected limb can reduce swelling and pain and promote fluid drainage
3⃣ Using warm compress to help relieve pain and promote healing
Resting
4⃣ Avoid moving the affected area can aid in the recovery process
5⃣ Using over the counter pain relievers can alleviate the pain and reduce fever

In addition to these prescribed treatments, there are some other tips that can ease the symptoms such as:

🍀 Cleaning the affected area gently with mild soap and water several times daily to prevent further infection
🍀 Using local corticosteroid creams like hydrocortisone to reduce itching and inflammation.
🍀 Drinking plenty of water to keep body hydrated to boost the healing process
🍀 Avoid scratching the bite site to prevent worsening the infection

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Final diagnosis:

✅ Cellulitis after insect bite

1⃣ Differential diagnosis?

2⃣ Most likely diagnosis?

3⃣ Management?