Asplenic fulminant sepsis secondary to a dog bite complicated by toxic epidermal necrolysis/Stevens-Johnson syndrome.

We report a case of asplenic fulminant sepsis in Australia following a dog bite which was complicated by toxic epidermal necrolysis/Stevens-Johnson syndrome (TENS/SJS). Capnocytophaga canimorsus, the infective organism, is a rare cause of septicaemia: a high degree of suspicion of this unusual organism and its early aggressive management is paramount. The diagnostic and management difficulties of TENS/SJS in the context of a patient with fulminant sepsis, DIC and on inotropes are also highlighted.

Achieving autologous breast reconstruction for breast cancer patients in the setting of post-mastectomy radiotherapy.

Introduction: Breast cancer is now associated with long-term disease-free and overall survival, and in the setting of mastectomy, long term psycho-sexual health becomes an important consideration. To this end, breast reconstruction has been shown to significantly improve quality of life for mastectomy patients. With adjuvant radiotherapy often required in the setting of breast reconstruction, it is unclear what interaction the two can have.

Post-mastectomy breast reconstruction: a history in evolution.

Although the need for mastectomy has been evident for many years, postmastectomy reconstruction has been recognized as an achievable outcome for only a little over a century. A review of the evolution of both autologous and prosthetic options for reconstruction was undertaken. The earliest attempts at reconstruction used autologous techniques that were either unsuccessful, not reproducible, or were associated with significant morbidity.

Does the preoperative imaging of perforators with CT angiography improve operative outcomes in breast reconstruction?

Background: Breast reconstruction is increasingly performed with the use of the abdominal wall donor site, with potential complications including donor site morbidity and impaired flap viability. As a tool for selecting the optimal perforators which will ultimately supply the flap, preoperative imaging with computed tomography angiography (CTA) has become increasingly popular. Potential benefits include reduced intramuscular dissection, with faster and safer dissection, reduced donor site morbidity and improved flap vascularity and survival.

Synchronous carcinoma and lymphoma of the breast.

Primary breast lymphoma is a rare entity. Furthermore, extranodal marginal zone B-cell lymphoma affecting the breast is exceedingly rare. We report a unique case of invasive lobular carcinoma diagnosed simultaneously with an extranodal marginal zone B-cell lymphoma of the breast.

Nephrogenic systemic fibrosis in a gadolinium-naive renal transplant recipient.

A 36-year-old woman presented with a 2-year history of multiple, raised, brown papules and indurated skin over her lower legs. She had received a renal transplant 11 years earlier, and had a history of recurrent deep vein thromboses despite a negative thrombophilic screen. The patient had no history of exposure to gadolinium.

Sweet's syndrome in an Australian hospital: a retrospective analysis.

A retrospective analysis was performed of patients meeting the clinicopathological diagnosis of Sweet's syndrome identified over a 10-year period, in a metropolitan hospital. Nine patients met the inclusion criteria. Two patients had preceding streptococcal infection, two had associated inflammatory bowel disease, two had idiopathic Sweet's syndrome, and three had an underlying malignancy, one of whom was receiving granulocyte colony-stimulating factor.

Heterozygous prothrombin gene mutation associated with livedoid vasculopathy.

A 53-year-old woman presented with a chronic history of recurrent, painful ulcers, predominantly involving her lower legs. Both her clinical picture and histopathological findings were consistent with a diagnosis of livedoid vasculopathy, although she did have unusual findings of deep tender nodules and the presence of lesions over her elbows. Multiple investigations were undertaken, the only abnormality being a heterozygous mutation of the prothrombin G2021A gene.

Facial Sweet's syndrome mimicking rosacea fulminans.

A 36-year-old man presented with a non-pruritic, erythematous facial rash with peri-oral and peri-orbital sparing. The initial clinicopathological diagnosis was rosacea fulminans, which was treated with 25 mg oral prednisolone and cephalexin. The patient re-presented 1 week later with exacerbation of his rash in addition to constitutional symptoms of fever and malaise.

Occupational allergic contact dermatitis to cobalt octoate included as an accelerator in a polyester resin.

A 46-year-old woman, who worked as a laminator of spa baths, presented with hand dermatitis, which was suspected to be related to her occupation. Patch testing revealed strong reactions to both cobalt chloride and a polyester resin that the patient had been using at her workplace. She also reacted to latex and had been wearing cotton gloves underneath rubber gloves at work.