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A flock of 50,000 28-day-old broiler breeder chickens experienced an elevated mortality event. Chickens from that flock, five pullets and six cockerels, were submitted for diagnostic investigation. Necropsy revealed bacterial septicemia with fibrinous polyserositis in the majority of the birds while two cockerels had coccidial typhlitis. Because sulfadimethoxine was not available at the time, sulfaquinoxaline (SQ) was prescribed at label dosage with water treatment for 2 days, followed by 3 days of no medication, followed by 2 days of medication. The mortality rose dramatically 9 days after the last treatment. Lesions at that time consisted of skin discoloration, subcutaneous petechiation, and enlarged pale kidneys. Mortality remained elevated for 14 days. Analysis of blood, kidney, and liver revealed elevated levels of SQ. Recalculation of dosage, water consumption, amount of drug administered, remaining drug stock, and concentration of supplied SQ were analyzed and determined to be as predicted. Reporte de caso- Toxicosis por sulfaquinoxalina en una parvada de reproductores de pesados jóvenes. Una parvada de 50,000 pollos de engorde de 28 días de edad experimentó un evento de mortalidad elevada. Pollos de esa parvada, cinco pollitas y seis gallitos, se enviaron para una investigación de diagnóstico. La necropsia reveló septicemia bacteriana con poliserositis fibrinosa en la mayoría de las aves, mientras que dos gallos tenían tiflitis coccidial. Debido a que la sulfadimetoxina no estaba disponible en ese momento, se prescribió sulfaquinoxalina (SQ) de acuerdo a la dosis de la etiqueta con tratamiento en el agua durante dos días, seguidos por tres días sin medicación, y por último, seguidos por dos días de medicación. La mortalidad aumentó dramáticamente nueve días después del último tratamiento. Las lesiones en ese momento consistían en decoloración de la piel, petequias subcutáneas y riñones agrandados y pálidos. La mortalidad se mantuvo elevada durante 14 días. El análisis de sangre, riñón e hígado reveló niveles elevados de sulfaquinoxalina. Se analizó el recálculo de la dosis, el consumo de agua, la cantidad de fármaco administrado, el stock de fármaco restante y la concentración de sulfaquinoxalina suministrada y se determinó que eran los previstos. [ABSTRACT FROM AUTHOR]

Background: Breast hemangiomas are benign vascular lesion occurring within breast tissue. The main aim of this case report revolves around the importance of follow-up and excision of these benign lesions since they carry the risk of future malignancy. We report herein a histopathologically confirmed case of breast hemangioma diagnosed at routine sonomammogram. Case presentation: A 58-year-old female presented with skin discoloration and vague mass in the lateral aspect of the left breast for one month. Physical examination, mammography and ultrasonography along with histopathological correlation have been carried out which helped us to arrive at the diagnosis of breast hemangioma. Conclusion: For lesions with conclusive evidence of benignity in core needle biopsy, follow-up imaging is ideal and for those cases with atypical radiological and pathological findings, a complete surgical resection is mandatory in order to exclude the possibility of an underlying angiosarcoma. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the efficacy and tolerability of carboxytherapy in the cosmetic correction of dark circles. Carboxytherapy is a cosmetic technique based on the subcutaneous injection of carbon dioxide that improves the quality and elasticity of the dermis by increasing the oxygen release to the tissue through an enhancement of the Bohr effect. A prospective clinical trial was conducted on 35 patients requesting the correction of dark cicles. Our protocol was based on weekly treatment sessions and lasted 3 weeks. Each treatment session was based on the bilateral injections of the tear-through defect. Pre- ∖treatment photographs and 6-month post-procedural follow-up photographs were examined and analysed through a face objective assessment scale. All 35 patients were treated. The average scores showed a significant reduction of the skin discoloration without major side effects (p < 0.00001). This study proves that it is possible to carry out multiple injections during the same session to increase the application time of the carbon dioxide and to decrease the number of sessions. These results allowed us to validate a 3-sessions injection protocol to increase the patient compliance. [ABSTRACT FROM AUTHOR]

The non-radioactive method that uses the magnetic tracer (SPIO/Sienna) has shown to be a feasible technique for the SLN detection in breast cancer patients. The aim of this study is to assess the efficacy of different doses of a new magnetic tracer Sienna XP (Magtrace) compared to Tc-99 m and to evaluate its non-inferiority. Patients diagnosed with early-stage breast cancer cT1-3 N0, from October 2016 to August 2018 were eligible and consecutively randomized to three different doses of new SPIO used: group 1 (1 mL), group 2 (1.5 mL) and group 3 (2 mL). A total of 135 patients were included in the study, 45 in each group. Detection of SLNs with the three doses of Sienna XP (1 mL, 1.5 mL and 2 mL) showed non-inferior rates compared to the conventional technique with radiotracer (p = 0.654). Concordance by patients with SLN positive was 100% for all groups. 83 (70.3%) patients reported skin staining at one month postoperatively, significantly lower in group 1 (p = 0.042). At 6 months follow up, group 1 remains with significantly lower skin discoloration (p = 0,01). In multivariate analysis, dose of 2 mL showed statistically significant for the skin staining. The majority of patients (70%) felt that skin discoloration does not represent a problem. The use of the Sienna XP magnetic tracer at 1 mL is not inferior to higher doses of magnetic tracer neither is inferior to radiotracer. 1 mL of magnetic tracer resulted in significantly less skin discoloration compared to higher doses. [ABSTRACT FROM AUTHOR]

A 60-year-old female presented with a 20-year history of progressive dark bluish discoloration of skin and passage of dark colored urine, painful arthritis and a recent history of invasive ductal carcinoma of right breast. Skin biopsy revealed hyaline material which was Periodic-Acid-Schiff stain positive and Congo-red stain negative, urine analysis revealed dark urine with presence reducing substance and radio-imaging showed intervertebral ossification and joint ankyloses. The patient was managed symptomatically with physiotherapy and acetaminophen on as required basis. This image is reported as a classic case of Alkaptonuria with clinical, histopathological and radio-imaging findings and the presence of invasive ductal breast carcinoma in the same patient. [ABSTRACT FROM AUTHOR]

• The Random forest classifier is essential for imbalanced data. • During performance metric evaluation, F-measure is implemented to handle imbalanced normal and abnormal samples. • The novel method of hybrid Structural Color Grey Coherent Feature (SCGCF) extraction is implemented to enhance feature extraction. • Evaluation of risk assessment strategy is performed. • Comparison with the existing systems is tabulated. • The result of the proposed system is described in the conclusion. In the first few days of life, neonatal jaundice is the situation that causes yellow discoloration on the skin of the baby. The severity level of the disease is determined by using a bilirubin meter. It may lead to poor performance due to a lack of severity level identification. The severity level should be resolved by using some techniques or methodology. Therefore, the proposed system is in the method of developing feature fusion techniques and CNN-based severity level detection to enhance the diagnosis of the disease. In this work, first, data are grouped as jaundiced babies and healthy babies. Consider the babies among 24 and 48 hr after birth. It is performed to remove the small hairs and noises from the baby's skin. Fourth, the Feature Fusion Framework to extract and select highly informative features. It includes feature extraction, feature fusion, and feature selection respectively. Feature extraction is carried out by a novel method of Structural Color Grey Coherent Feature (SCGCF) Extraction, feature fusion by a concatenation operation, and feature selection by the enhanced method of Salp Swarm Optimization. Sixth, the CNN model was trained along with color-card techniques to identify their severity level. The performance evaluation of the model provides class 1 and class 2 sensitivity of 0.99 and 0.98, specificity of 0.98 and 0.98, the accuracy of the 0.98 and 0.98, MCC of 0.97 and 0.96, and f-measure of 0.98 and 0.98 respectively. [ABSTRACT FROM AUTHOR]

Objective: To identify and characterize cases of chemical leukoderma, an underrecognized adverse event, associated with the methylphenidate transdermal system (MTS) reported to the US Food and Drug Administration Adverse Event Reporting System (FAERS).Study Design: We searched the Food and Drug Administration Adverse Event Reporting System for reports of chemical leukoderma associated with MTS, received by the Food and Drug Administration from April 6, 2006 to December 23, 2014.Results: We identified 51 cases of chemical leukoderma reported with the use of MTS. The median age was 11 years; 43 cases reported leukoderma at or near the application site only, and 7 reported leukoderma at other parts of the body in addition to the application site; 1 case did not provide enough information to confirm the affected site. The time to onset ranged from 2 months to 4 years after the initiation of MTS. MTS was discontinued in 31 cases. Thirteen patients were prescribed treatment for repigmentation. Three cases reported continued spread of leukoderma after MTS was discontinued. Nineteen cases were diagnosed as vitiligo, including 5 cases reporting histologic features consistent with vitiligo. Leukoderma was persistent in all cases. The median follow-up interval after the discontinuation of MTS in 23 cases was 14 months.Conclusions: As outlined in recent changes to the prescribing information for MTS, health care professionals need to be aware of the potential risk of chemical leukoderma caused by MTS, especially given that chemical leukoderma is often misdiagnosed as idiopathic vitiligo. MTS should be discontinued at the earliest sign of pigment loss and other treatment options considered. [ABSTRACT FROM AUTHOR]

The article provides information on a study on the induction of Thiosulfate-citrate-bile-sucrose (TCBS) agar, a transmissible disease, in the coral-eating crown-of-thorns starfish Acancthaster planci (COTS). TCBS culture medium was injected into COTS to induce a disease characterized by discoloured and necrotic skin, ulcerations, and loss of body turgor. The study found that TCBS promoted the growth of COTS' occurring Vibrionales to high densities with symbiont imbalance followed by disease and death.

Neurofibromas are common peripheral nerve sheath tumors. Symptoms vary according to the site, including skin discoloration, disfiguration or neurologic deterioration. Neurofibromas cannot be seen on plain X-ray film unless they involve the bone and cause intraosseous lytic lesions. Ultrasonography plays an important role in the examination of soft tissue mass because it is inexpensive and has the advantage of being real-time for initial screening. In this study, we present a patient with a palpable mass over her right popliteal fossa. The texture of the mass was solid, without pulsation or fluctuation during palpation examination. There was no bruit on auscultation. Ultrasonography showed a well-defined, oval, solid and hypoechoic mass containing anechoic areas. Magnetic resonance imaging revealed the location of the tumor enveloped by the tibial nerve. An electrodiagnostic study supported the impression of entrapped neuropathy at the right popliteal area. After surgical excision of the mass, pathological findings confirmed the diagnosis of neurofibroma. This case report is clinically significant due to the rare site of the neurofibroma. [ABSTRACT FROM AUTHOR]

Abstract: Background: Congenital melanocytic nevi (CMN) are nevomelanocytic nevi which are present at birth. In this study, we set out to determine the clinical and dermoscopic properties of CMN. Methods: A total of 239 lesions were diagnosed as CMN. Dermoscopic properties were noted. Age, sex, nevus location and nevus size of the patients were also collected from the patient records. Results: A total of 239 lesions were diagnosed as CMN in 239 patients (age ranged from 1 month to 63 years (20.79 ± 13.76 yr); 114 [47.7%] males and 125 [52.3%] females). Most of the lesions were medium-sized CMN, followed by small and large ones. The most common localization was upper extremities (23.8%), followed by head and neck, back, and lower extremities respectively. Dark brown was the most common colour seen in dermoscopy (115 patients, 48.1%), followed by light brown (69 patients, 28.9%) and black (55 patients, 23%) respectively. The most common dermoscopic findings of CMN was hair follicles followed by dots (70%) and perifollicular hypopigmentation (51%). Conclusions: Our study describes the normal clinical and dermoscopic features of CMN. It should be kept in mind that, CMNs are quite common lesions, and melanomas can arise from them. Knowing and being familiar with the normal properties of these common nevi will help us determine whether a nevus is suspicious or not. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 46-year-old- man who was taken to the hospital because of blue-gray discoloration of his skin. He has neurogenic bladder, multiple sequences of urinary tract infection, and long-term use of existing urinary catherer. His discoloration was assigned to argyria in connection to his normal oxygen level, history of silver ingestion, and denial of exposure to other metals that can discolor skin. Thus, skin biopsy or serum silver assay is required.

Aneurysms of the superficial temporal artery (STA) were first described in 1740, yet it remains a very uncommon post traumatic entity usually associated with sporting activities in young men or recurrent falls in older patients. A 10-year-old boy presented 4 weeks after blunt trauma to the head with a slowly enlarging left temporoparietal swelling. Clinical examination revealed a pulsatile and expansive mass of 4 cm with discoloration of the overlying skin. The ultrasound revealed a pseudoaneurysm of the left anterior superficial temporal artery. Excision was performed under general anesthesia. The mass was exposed, and the proximal and distal branches were ligated. The lesion was entirely removed and hemostasis was easily obtained. Histological examination showed a lesion consistent with pseudoaneurysm. The diagnosis of aneurysms or pseudoaneurysms of the STA can usually be made based on a thorough patient history and physical examination. They are easily treated with few long-term consequences. However, left untreated theses lesions can rupture leading to significant hemorrhage or cause compression of neighboring vessels and nerves. Treatment involves external compression, thrombin injection or surgical resection. [ABSTRACT FROM AUTHOR]

Abstract: Cutis rhomboidalis nuchae is a skin alteration which comes from chronic sun exposure and it integrates the solar elastosis group, acquiring a coriaceous aspect, with a yellowish and grooved surface. There is the occurrence of elastic and collagen fibers degeneration found in the dermis caused by ultraviolet radiation [1]. Another group of skin diseases which has solar exposure as a determining factor is the group of actinic keratoses, the non-melanoma malignant epithelial tumors {basal cell carcinoma (CBC) and squamous cell carcinoma (CEC)} [2]. However, the occurrence of actinic keratoses, CBCs or CECs on the area of cutis rhomboidalis is infrequent in dermatology clinical practice. The authors do not know why people with neoplasias and pre neoplastic lesions in some areas with chronic photo damage amendments (face and upper limbs), do not present the same pre and neoplastic lesions in areas with similar appearance of chronic sun damage (nape). The authors seek to understand why the nape is protected for pre and neoplastic lesions. We suggest that cutis rhomboidalis protects skin from malignant epithelial tumors in nuchae. [Copyright &y& Elsevier]