Galina Balakirski

Nonhealing ulcers on the scalp: Case for Diagnosis

A 77-year-old man presented to our department with a sixmonth history of nonhealing ulcers on the scalp, which had occurred after a minor trauma. At the time of onset, he had had no preexisting medical condition except for arterial hypertension. Initially, he had been admitted to another hospital where he was diagnosed with paroxysmal atrial fi brillation and started on oral phenprocoumon. At that time, the histology of a biopsy had only revealed necrotic tissue. Bacterial swabs taken from the ulcers had likewise been unremarkable. Given the suspected diagnosis of impaired posttraumatic wound healing, the patient had subsequently received conservative, stage-adapted wound treatment with daily dressing changes. Due to lack of clinical improvement, the patient had then been referred to the department of plastic surgery where he had undergone extensive debridement, wound excision and closure using a rotation fl ap. At that time, histological studies of the removed tissue were not performed. About four weeks post surgery, he had suffered a recurrence of symptoms with severe pain and repeated wound hemorrhage. Nonhealing ulcers on the scalp Case for Diagnosis

Acne conglobata induced by adalimumab

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Extensive herpes simplex infection of the skin in an immunocompetent, previously skin-healthy female patient.

A 61-year-old female patient presented to our outpatient clinic with a three-month history of asymptomatic skin lesions on her entire body. Up to this point, she had not received any treatment. Her past medical history included arterial hypertension, but no other chronic diseases. For several years, she had been on a combination of metoprolol and hydrochlorothiazide. There had been no recent changes of her medication. The patient denied any known allergies.

Unilateral leg swelling: frequent symptom, rare diagnosis. A case of liposarcoma.

A 73-year-old man with a history of mild cardiac and renal insufficiency and varicose veins of the leg was referred to our outpatient clinic by his family physician with a 2½-year history of swelling of his right lower leg. This worsened during the evening hours, but the patient denied pain or pruritus. Ultrasonography and MRI showed diffuse subcutaneous tissue infiltration and edema but no involvement of underlying bones. Because of this unilateral swelling of unknown origin, the family physician [...]