Lepromatous Leprosy
A 40-year-old man presented to the dermatology clinic with a 1-year history of painless swelling of his earlobes. He also reported having nasal congestion and intermittent nosebleeds. On examination, painless, indurated, contiguous nodules along the helixes of both ears were observed (Panel A). Thickening of the greater auricular nerve (Panel B) on both sides and patchy loss of sensation in the distal arms and legs were also present. Dermal fluid was obtained from an incision in the earlobe for a skin smear, which was stained with the use of the modified Ziehl–Neelsen method and examined under an oil-immersion lens. The skin smear showed innumerable acid-fast bacilli (Panel C). A diagnosis of lepromatous leprosy was made. Leprosy, also known as Hansen’s disease, is a chronic infection involving the skin and nerves that is caused by Mycobacterium leprae complex. Lepromatous leprosy, the most severe form, is characterized by a weak immune response and high burden of organisms. Patients with lepromatous leprosy often present with diffuse skin involvement and even infiltration of the nasal mucosa, as was observed in this patient. A 12-month course of uniform multidrug therapy was prescribed, but the patient was lost to follow-up after 2 months. Shekhar Neema, M.D. Santosh Battula, M.B., B.S. Armed Forces Medical College, Pune, India source: nejm.org
Anal rash and itchingRuptured eardrum If you get a hole in your tympanic membrane, it’s called a ruptured eardrum. (Your eardrum separates your outer ear from your middle ear.) Infection, trauma, loud sounds or foreign objects in your ears can cause a ruptured eardrum. In most cases, a ruptured eardrum will heal on its own in a few weeks. But sometimes, it requires surgical repair, such as tympanoplasty.Otosclerosis Otosclerosis is when abnormal bone remodeling occurs in your middle ear. Bone remodeling is a normal lifelong process in which existing bone tissue replaces itself with new bone tissue. When this process doesn’t go as expected, however, it can cause health problems. With otosclerosis, the tiny bones inside of your middle ear (the malleus, incus and stapes) become hardened and stop vibrating. As a result, sound doesn’t travel properly. Surgery is usually necessary to treat otosclerosis.Hallmarks of cell aging: Classical hallmarks of aging cells include increased levels of reactive oxygen species, DNA damage, accumulation of dysfunctional organelles, oxidized proteins and lipids. These all contribute to a progressive decline in the normal physiological function of the cell and to the onset of age-related conditions.Red Itchy bumps on right thigh.DermatomyositisGet Glowing Skin and Clear Face
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