Journal of Case Reports in Practice
Volume:6 Issue: 1, Jan 2018

Kawasaki disease (KD) is the most common systemic vascular is in childhood after Henoch-Schonlein purpura, and the most common cause of acquired cardiac disease among the children living in western countries. Its diagnosis relies on clinical findings; however, the certain laboratory tests are useful to rule out the other causes of unexplained fever but are not specific for the diagnosis of KD. While the cause of KD is remained unknown, a choice diagnostic test is not available, and diagnosis is made on clinical findings. The diagnostic criteria for KD are extremely useful for establishing the diagnosis, and are particularly useful in preventing over-diagnosis. However, the use of such criteria may result in incomplete forms of illness being unrecognized or missed. In this report, a 9-month-old boy presented with an acute myocardial infarction and found to have coronary artery aneurysms as well. These may have been caused by a KD, a health condition that should be considered with cardiac presentations such as proximal discrete coronary artery aneurysms as explained in the current study.

Keratoacanthoma is typically a skin lesion which rarely occurs in Conjunctiva. On the literature review, only 16 Cases of Conjunctival Keratoacanthoma have previously been reported in the English language. All previously described lesions occurred at the limbus. We describe here a case of a 43-year-old Woman with a lesion that is compatible both clinically and histopathologically with conjunctival keratoacanthoma. The treatments given were excisional biopsy and amniotic membrane transplant. The outcome was a complete clinical remission during the follow-up period (3 months). Conjuctival keratoacathoma is rare and making correct differential diagnosis between kerathoacanthoma and Squamous cell carcinoma is very important. We recommend complete surgical exicision and carrying out close monitoring after surgery due to the possibility of relapse and conversion to Squamous cell carcinoma.

Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) syndrome is an auto-inflammatory bone and skin disorders that is presented by dermatological manifestation such as palmoplantar pustulosis, pustular psoriasis, psoriasis vulgarism, severe acne, and hidradenitis suppurativa and joints and bones inflammation such as sacroiliac joint and vertebra. In this case report, a 16-year-old boy is presented that is suffering from low back pain, conglobata acne on trunk and face, and hidradenitis supportive (Dissecting Cellulitis) on the scalp. Diagnosis was based on clinical findings and laboratory tests. Treatment conducted by non-steroidal anti-inflammatory drugs and orally administered Isotretinoin. Dramatic improvement in low back pain was reported by patient in a few days. In follow-up examination of the patient after discharge from Hospital, we detected improving acne follicles and hidradenitis suppurativa on the scalp in clinic of rheumatology.

This is true that many cases of acute low back pain are caused by radicular pain due to discopathy, however, the history and physical examination in low risk patients as well as continuous radiography usually provide clues to the rare but potentially serious causes of low back pain such as malignancy. The patient is an 18-year-old man who referred to an orthopedist for the first time three months prior to the study with a complaint of a backache and received out-patient treatment. One month ago he visited a doctor for lack of improvement and aggravation of the symptoms. In X ray imaging from pelvis performed three months earlier, nothing was found except for a lesion that was probably differentiated from intestinal gas and not reported. However, by repeated X-ray a month later and because of lack of relocation of lesion created high doubt ex parte lytic lesion for the patient, A biopsy specimen was taken from this site. The primary result indicated sarcoma, while after immunohistochemistery, final result revealed peripheral malignancy nerve sheath tumor for patient. Malignant peripheral nerve sheath tumor (MPNST) are rare malignancies from the origin of peripheral nerve sheath cells. These tumors almost present as an enlarging mass from a peripheral nerve root. We should consider the importance of low back pain in a patient that does not have serious risk factors and inflammatory or mechanical nature of the pain because in some cases low back pain can indicate severe diseases.