25 Mar

The Red Scourge

The Red ScourgeA 33-year-old caucasian man was admitted to the Kansas University Medical Center for evaluation of a fever, nonproductive cough and persistent headaches. Physical examination revealed a red asymptomatic nodule present on his right antecubital fossa for six months (Fig 1). His admission chest roentgenogram can be seen below (Fig 2). The patients condition deteriorated during his hospitalization and he ultimately expired. What is the diagnosis?

a) Systemic lupus erythematosus
b) Bacterial endocarditis
c) Familial Mediterranean fever
d) Acquired immunodeficiency syndrome cheap-asthma-inhalers.com
Answer: The diagnosis is (d) acquired immunodeficiency syndrome
Acquired immunodeficiency syndrome (AIDS) is a complex medical problem that affects many organ systems. Due to the increase in prevalence in recent years, rapid and accurate diagnosis is necessary to avoid serious life-threatening infectious complications. Familiarity with the cutaneous manifestations of the syndrome may provide a clue for establishing early diagnosis.
The skin signs associated with AIDS can be divided into three categories: neoplasm, opportunistic infections, and miscellaneous. Malignant tumors of the skin include Kaposi’s sarcoma, Hodgkin’s disease, undifferentiated lymphomas, basal cell carcinoma, and anorectal squamous cell carcinoma. Kaposi sarcoma is the most common neoplasm and is often found on the trunk, but can occur anywhere on the skin or mucosa. These lesions are characteristically reddish oval plaques. They may mimic other skin conditions, so skin biopsy is essential in making a diagnosis.
A second category of skin lesions includes opportunistic infectious organisms such as: 1) viruses (herpes simplex, herpes zoster, verrucae, molluscum contagio-sum, cytomegalovirus); 2) fungi (Cryptococcus neo-formans, Histoplasma capsulatum, Candida albicans); 3) Mycobacterium avium-intracellulure; and 4) protozoa (Acanthamoeba castellani). The last category contains various skin signs which appear to be associated with AIDS. These include seborrheic dermatitis, yellow nails and nutritional deficiencies (scurvy, zinc, etc) papular eruption of AIDS, xerosis, icthyosis.

Figure 1

Figure 1

Figure 2

Figure 2

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