We herein report two cases of post-operative hip trauma accompanying gluteus maximus muscle injury. Both patients had painful, well-demarcated erythema with or without ulcer on the hip after surgical operations. In both cases, the serum level of CPK elevated, and magnetic resonance imaging (MRI) revealed gluteus maximus muscle injury underneath the erythema. The location of the erythema and the injured muscle were apparently unrelated to the site where pressure had been applied during and after the operation. Therefore, we assume that the post-operative hip trauma was triggered by a gluteus maximus muscle injury. We speculated that the current generated by the electric coagulator caused this gluteus muscle injury; however, the underlying mechanism requires further future study.
A 20-month-old Japanese girl presented with blond hair, brown irises, white skin, and no Mongolian spots. Genetic analysis for albinism-related genes detected heterozygosity for p. V507L, a known pathogenic mutation in SLC45A2, a causative gene for type 4 oculocutaneous albinism. Based on the absence of other albinismrelated gene mutations, type 4 oculocutaneous albinism was diagnosed. During the clinical follow-up, pigmentation was noted in the hair and skin at 3 years of age. No ocular symptoms have been identified.
We reviewed 75 cases (60 patients) infected with human immuno-deficiency virus (HIV) and/or syphilis who were treated in the Department of Dermatology and Laboratory Medicine at Tokyo Medical University Hospital between September of 2005 and October of 2008. Thirteen of the reported patients had been infected with syphilis twice or more. During the same period, 30 patients were infected with syphilis alone and received treatment. The patients infected only with syphilis were frequently in their forties and fifties; those with both HIV and syphilis were all males in their thirties and forties. Approximately half of the cases were of asymptomatic syphilis: the other half of the patients had symptomatic syphilis, with the majority of cases at the secondary, rather than the primary, stage. The CD4+ lymphocyte count at the time of the diagnosis of syphilis varied and did not cluster in the lower values. The patients were treated with antibiotics such as amoxicillin, and all were cured. Among these cases, 51 were treated for less than one month using the normal dosage of antibiotics. Eight patients were found to be positive for HIV at the time they were diagnosed with syphilis.
Case 1) A 72-year-old man with extramammary Paget carcinoma suddenly complained of right chest pain one week postoperatively later. A CT scan showed a right pulmonary artery thrombus. We started anticoagulation and utilized a temporary inferior vena cava filter. Case 2) An 82-year-old man suffered a general scald (50%). Protracted bed rest treatment included a central venous catheter in his left femoral vein. A left external iliac vein thrombus was detected by CT after six weeks. Anticoagulation was started, but a CT after 12 weeks revealed a thrombus in his inferior vena cava because we were not able to effectively treat this complication coincidence. Case 3) An 85-year-old woman with pemphigus vulgaris developed DIC during primary disease control by steroid. Protracted bed rest included a central venous catheter in her right femoral vein. A right external iliac vein thrombus was detected by CT after five weeks later. We started anticoagulation and applied a lasting inferior vena cava filter. Recently, there have been increases in operations in high-risk, aging patients, and physicians should always consider the possibility of pulmonary thromboembolism and deep vein thrombosis as complications during treatments for skin diseases.