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Upper Thigh (upper + thigh)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

A case of necrobiotic xanthogranuloma without paraproteinemia presenting as a solitary tumor on the thigh

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2003
Sung Eun Chang MD
A 82-year-old Korean woman had had a 6-month history of an asymptomatic, flat, hard, red to brown tumor on her right thigh. This lesion had been slowly enlarging with an advancing margin. She had noted gradually developing pain associated with necrosis and ulceration on the lesion. Examination revealed a solitary, 8 × 7.5 cm, yellow to dark red, telangiectatic tumor with multiple areas of punched out ulceration and a peripheral elevated yellowish margin on the right inner upper thigh (Fig. 1). No clinically similar lesions on the periorbital area or other sites were seen. Histologic examination revealed a massive palisading granulomatous infiltration with several layers of extensive bands of necrobiotic zone in the entire dermis and deep subcutaneous tissue (Fig. 2a). In the granulomatous infiltrate in the dermis and subcutis, many various-shaped, some bizarre, angulated, foreign-body type multinucleated giant cells, many Touton giant cells, and a few Langhans giant cells were found to be scattered (Fig. 2b). There were numerous xanthomatized histiocytes. Dense infiltration of lymphoplasma cells was seen in the periphery of the granuloma and perivascularly. Conspicuous granulomatous panniculitis composed of lymphoplasma cells, polymorphonuclear cells, foam cells, and Touton and foreign-body giant cells was also seen. However, cholesterol clefts and lymphoid follicles were not seen. Subcutaneous septae were widened by necrobiotic change and fibrosis with thrombosed large vessels. Gram, Gomeri-methenamine silver and acid-fast stains were negative. The necrobiotic areas were positive to alcian blue. Laboratory investigation revealed elevated white blood cell counts, anemia and elevated erythrocyte sedimentation rate. The following parameters were within the normal range: lipids, glucose, renal and liver function tests, serum complements, serum immunoglobulins, cryoglobulins and antinuclear antibodies. The findings of chest X-ray, skull X-ray and ectorcardiography were normal. Serum electrophoresis and serum immunoelectrophoresis revealed no abnormality. The patient was diagnosed as having necrobiotic xanthogranuloma without paraproteinemia. She was treated with oral steroid (0.5,0.6 mg/kg) and NSAIDS for 1 month with partial improvement of pain and the lesion ceased to enlarge. In the following 1 year of follow-up, with only intermittent NSAIDS, her lesion did not progress and there were no signs of systemic involvement or new skin lesions. Figure Figure 1 . (a) A solitary, red to brown plaque with multiple ulcerations and a peripheral elevated yellowish margin on the inner upper thigh Figure 2. (a) A dermal and subcutaneous massive xanthogranulomatous infiltrate with zonal necrobiosis of collagen (× 20). (b) Prominent infiltrate of xanthomatized histiocytes and giant cells with perivascular lymphoplasma cells (H&E, × 100) [source]

Successful treatment of extensive muscle calcification in a patient with primary idiopathic polymyositis with diltiazem

INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 3 2006
Yasser EMAD
Abstract A 25-year-old female patient with documented diagnosis of polymyositis developed extensive muscle calcification in the left thigh muscles with overlying skin induration one year after her disease onset, despite well controlled myositis. Plain X-ray of the left femur and hip revealed extensive calcification involving the periarticular soft tissue shadows around the left hip and left upper thigh. The patient received diltiazem 90 mg/day in divided doses and follow-up plain X-ray study after 6 months of treatment revealed almost complete resolution of the muscle calcifications. [source]

Therapy-resistant skin ulcers on hypoplastic leg associated with neurofibromatosis type 1

THE JOURNAL OF DERMATOLOGY, Issue 2 2008
Taku FUJIMURA
ABSTRACT We describe a case of therapy-resistant skin ulcers in sporadic neurofibromatosis type 1. A 40-year-old woman had suffered from neurofibromata on her trunk and extremities since 30 years prior. She suffered from hypoplasia of her right leg from a young age and had a 1-year history of therapy-resistant skin ulcers on the leg and inguinal region. Magnetic resonance angiography disclosed a narrowed femoral artery at the level of the upper thigh with poor root in the inner side corresponding to the ulcerated lesions. The vascular changes were thought to be the cause of the skin ulcers. [source]

Effects of Ischaemia on Subsequent Exercise-Induced Oxygen Uptake Kinetics in Healthy Adult Humans

EXPERIMENTAL PHYSIOLOGY, Issue 2 2002
Michael L. Walsh
Leg muscles were occluded (33 kPa) prior to exercise to determine whether the induced metabolic changes, and reactive hyperaemia upon occlusion release just prior to the exercise, would accelerate the subsequent oxygen consumption (V,O2) response. Eight subjects performed double bouts (6 min duration, 6 min rest in-between) of square wave leg cycle ergometry both below and above their lactate threshold (LT). Prior to exercise, large blood pressure cuffs were put around the upper thighs. Occlusion durations were 0 min (control), 5 min and 10 min. Ischaemia was terminated within 5 s prior to exercise onset. Heart rate, V,O2, ventilatory rate (V,E), electromyogram (EMG) and haemoglobin/myoglobin (Hb/Mb) saturation were recorded continuously. Single exponential modelling demonstrated that, compared to control (time constant = 53.9 ± 13.9 s), ischaemia quickened the V,O2 response (P < 0.05) for the first bout of exercise above LT (time constant = 48.3 ± 14.5 s) but not to any other exercise bout below or above LT. The 3-6 min integrated EMG (iEMG) slope was correlated to the 3-6 min V,O2 slope (r = 0.73). Hb/Mb saturation verified the ischaemia but did not show a consistent relation to the V,O2 time course. Reactive hyperaemia induced a faster V,O2 response for work rates above LT. The effect, while significant, was not large considering the expected favourable metabolic and circulatory changes induced by ischaemia. [source]