A 32-YO ♂️ sex worker, sex with men unprotected, HIV under treatment: 20 lesions scattered throughout the body of umbilicated, erythematous, violaceous papules with central ulcerations & pustules, fevers, cervical & axillary lymph nodes
1/5

#IDtwitter #primarycare #healthcare
HIV viral load of 1577 copies/mL and a CD4 + count of 932 cells/mm3

PCR: ➕ for Mpox virus

MPOX (MONKEYPOX)
2/5

#internalmedicine #microbiology doi.org/10.1016/j.idcr…
Mpox had been a neglected disease until May, 2022, and since then, there has been a notorious increase in the number of human monkeypox cases in non-endemic areas
3/5

#MedTwitter #MedStudentTwitter #dermtwitter
The Mpox lesions could be easily confused with other diseases, such as smallpox, molluscum contagiosum, or herpes simplex.

A number of people in the current outbreak have also genital lesions and proctitis
4/5

#dermatology #emergency #resident
Mpox is particularly prevalent in a subgroup of men co-infected with HIV, due to transmission via sexual contact and the level of immunosuppression that these patients may show.
5/5

#medicine #MedicalStudents #MedEd

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More from @guerreroespejo

Jan 27
An 86-YO ♂️, injury on his L leg 47 years prior, several debridements, skin grafts, & vein stripping procedures: chronic bilateral leg progressive ulcers.

Superficial🧫: multiple organisms including E. coli & coagulase➖Staphylococcus.
1/6

#internalmedicine #IDtwitter Image
Skin biopsy🔬: bilateral invasive squamous cell carcinomas.

BILATERAL INVASIVE SQUAMOUS CELL CARCINOMAS (MARJOLIN ULCERS)
2/6

#dermatology #dermpath
doi.org/10.1093/cid/ci… Image
The mean time period between development of a wound to malignancy is 30–35 years.

The most common malignancies seen in Marjolin ulcers are squamous cell carcinomas, but basal cell carcinomas and melanomas have been reported.
3/6

#Doctor #healthcare #MedStudentTwitter
Read 6 tweets
Jan 26
9 años ♂️, dermatitis atópica tratada con metrotexato: lesiones vesiculosas en pulgar izq., ganglio axilar izq., y aftas en boca.
1/8

✍️@Mercede49161978, D. Mora, M. Díaz
continuum.aeped.es/courses/info/1…
@ContinuumAEP @aepediatria
#pediatría #dermatología
@Mercede49161978 @ContinuumAEP @aepediatria Cultivo exudado de vesículas:➕ para VHS tipo 1.

PANADIZO HERPÉTICO

Recibió aciclovir
2/8

#MIR #AtencionPrimaria
@Mercede49161978 @ContinuumAEP @aepediatria El panadizo herpético empieza con sensación de hormigueo, y puede causar dolor intenso, eritema y edema del dedo; en ocasiones, fiebre y adenopatía.

Aparecen vesículas coalescentes en la falange, generalmente después de 2 o 3 días de comenzado el dolor.
3/8

#infecciosas
Read 8 tweets
Jan 24
A 24-YO♀️: a 10-year of episodes of redness & photophobia in eyes, &⬇️visual acuity
SLE: conjunctival hyperemia & peripheral corneal opacification, inflammation & crystalline deposits on the corneal
⬇️
INTERSTITIAL KERATITIS
1/5

DOI: 10.1056/NEJMicm1709103
#eye #internalmedicine
Etiologies:
✔️Bacterial: SYPHILIS, Lyme borreliosis, tuberculosis, etc.
✔️Viral: Herpesviridae (HERPES SIMPLEX, H. zoster, E-B)...
✔️Parasitic: Onchocerciasis, Acanthamoeba...
✔️Immune: Cogan's syndrome, contact lens-associated keratitis, autoimmune disease…
2/5

#microbiology
ESR:⬆️& evaluation for infectious causes: unremarkable.
6 months after the diagnosis of interstitial keratitis: vertigo, tinnitus, & hearing loss.
Audiometry: sensorineural hearing loss in both ears.
Clinical findings consistent with COGAN´S SYNDROME
3/5

#Ophthalmology #MedEd
Read 5 tweets
Jan 23
6 años ♀️, de Marruecos: lesión en la extremidad superior derecha y otra en extremidad inferior izquierda de 7 meses de evolución, indoloras.
1/6

✍️ I Santacreu & @ayats_roser
continuum.aeped.es/screens/play/1…
#pediatría #AtencionPrimaria
@ContinuumAEP @aepediatria
@ayats_roser @ContinuumAEP @aepediatria LEISHMANIASIS CUTÁNEA

Recibió antimoniato de meglumina intralesional.
Buena evolución quedando una atrofia residual en el lugar de las lesiones.
2/6

#dermatología #parasitología
@ayats_roser @ContinuumAEP @aepediatria La leishmaniasis se manifiesta con formas cutáneas, mucosas y viscerales

Está causadas por varias especies de protozoos del género Leishmania.
3/6

#medicinainterna #MIR
Read 6 tweets
Jan 21
A 64-YO ♂️ from a rural community: pain, itching, bleeding in the L ear, & mobile larvae occluding the L external auditory canal
1/4

DOI: 10.1056/NEJMicm2005407
#primarycare #Otolaryngologist Image
AURAL MYASIS
An ear aspirator, forceps, and irrigation with sterile water were used to remove the larvae
Perforation of the tympanic membrane was identified.
2/4

DOI: 10.1056/NEJMicm2005407
#healthcare #parasitology Image
Aural myiasis:
📌infestation of the middle or external ear
📌by fly larvae of the order Diptera.

Risk factors:
✔️chronic otitis media,
✔️diabetes mellitus, and
✔️impaired hygiene.
3/4

DOI: 10.1056/NEJMicm2005407
#Otolaryngology #parasites
Read 4 tweets
Jan 20
A 20-YO ♀️, college wrestling, Mexico: itching in the past 2 months, erythematous & fine-scaling papules with annular plaques having a raised border affecting the face, neck, & torso.
1/6

doi: 10.18502/cmm.6.4.5439
#dermatology #primarycare #MedTwitter
KOH: multiple thin & septate hyphae.
🧫, MALDI-TOF-MS: Trichophyton tonsurans
T. tonsurans was isolated in 4 cases belonging to the school fighting team & from one of the training mats

TINEA GLADIATORUM DUE TO TRICHOPHYTON TONSURANS IN A SCHOLL WRESTLING TEAN
2/6

#mycology
Oral terbinafine for 3 weeks: clinical & mycological cure.
Tinea gladiatorum is a type of dermatophytosis that occurs in combat athletes, such as wrestlers and judo fighters, as a result of Trichophyton species.
3/6

doi: 10.18502/cmm.6.4.5439
#IDtwitter #microbiology #Doctor
Read 6 tweets

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