Unknown primary Merkel cell carcinoma with cutaneous spread.

The authors present the case of a woman in the seventh decade of life with medical history of: left nephrectomy for renal tuberculosis and non-Hodgkin's lymphoma treated with chemotherapy (QT) and radiotherapy. She presented with a 2-month history of non-tender, left inguinal lymph node enlargement. Positron Emission Tomography (PET)CT -scanshowed hypermetabolic inguinal and retroperitoneal lymphadenopathies, no primary tumour.

and Co-infection in a Patient with Giant-cell Arteritis.

Unlabelled: Immunosuppressed patients are at greater risk of unusual infections. The authors present the case of a woman with giant-cell arteritis, on oral steroids, who developed cavitating pneumonia due to co-infection with and . Reports of such co-infection are rare in the literature.

Non-Uremic Calciphylaxis: A Rare Diagnosis with Limited Therapeutic Strategies.

Unlabelled: Calciphylaxis is a rare condition characterized by the emergence of non-healing skin ulcers secondary to arterial calcification and thrombosis, typically diagnosed in patients with end-stage kidney disease (ESKD). When it develops in patients without ESKD, it is called non-uremic calciphylaxis (NUC). The latter is an even rarer diagnosis with an uncertain pathophysiology and a high mortality rate (52%), mainly due to sepsis (50%).

ERCP in Portugal: A Wide Survey on the Prevention of Post-ERCP Pancreatitis and Papillary Cannulation Techniques.

Background/aims: Recently the European Society of Gastrointestinal Endoscopy delivered guidelines on the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) and on the papillary cannulation and sphincterotomy techniques at endoscopic retrograde cholangiopancreatography (ERCP). There are no data concerning current practices in Portugal. The aim of this study was to capture practice patterns of Portuguese pancreaticobiliary endoscopists with special interest in the prevention of PEP and cannulation techniques.

Cytomegalovirus pseudotumor of the colon in an HIV patient.

Cytomegalovirus (CMV) is the most common cause of severe opportunistic viral disease among patients with acquired immunodeficiency syndrome, and colitis is the most frequent manifestation of CMV infection. Nevertheless, the development of a colonic pseudotumor is a rare benign entity that can be easily misdiagnosed as a colonic neoplasm if the radiologist is not aware of this condition. We present a case of a 42-year-old male with a CMV pseudotumor of the colon.

Multiple miliary osteoma cutis: a comprehensive review and update of the literature.

Multiple miliary osteoma cutis consists of heterotopic foci of bone tissue in the dermis and subcutaneous tissue. Patients usually present with multiple, asymptomatic facial papules of several millimetres in diameter which cause distress regarding their cosmetic appearance. The condition is described as rare, as only a few cases have been reported since its first description in 1864 by Virchow.

Subungual Solitary Angiokeratoma Simulating a Squamous Cell Carcinoma.

Subungual angiokeratoma is extremely rare. Only 1 case is reported in the literature, presenting as a longitudinal pigmented band on a toenail. We report a case of a subungual angiokeratoma on a fingernail of a 43-year-old woman, clinically mimicking a squamous cell carcinoma.

Safety and Effectiveness of Fingolimod in Real-World Multiple Sclerosis Portuguese Patients.

Objectives: The aim of this study was to evaluate postmarketing fingolimod safety and effectiveness in a real-world clinical population.

Methods: This was a retrospective, single-center study with active multiple sclerosis patients treated with fingolimod with at least 12 months of follow-up. Demographic and clinical and imaging characteristics, including annualized relapse rate (ARR), Expanded Disability Status Score, previous treatment, adverse events, treatment duration, and reason for discontinuation, were analyzed.

Metabolic Dysfunction and Peroxisome Proliferator-Activated Receptors (PPAR) in Multiple Sclerosis.

Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease of the central nervous system (CNS) probably caused, in most cases, by the interaction of genetic and environmental factors. This review first summarizes some clinical, epidemiological and pathological characteristics of MS. Then, the involvement of biochemical pathways is discussed in the development and repair of the CNS lesions and the immune dysfunction in the disease.

Massive organ embolization from primary aortic thrombosis.

A 49-year-old woman was hospitalized for acute left foot arterial ischemia. Arterial Doppler revealed occlusion of the dorsalis pedis and posterior tibial arteries. A computed tomography angiography performed to assess abdominal pain showed hepatic, splenic, renal and pancreatic infarctions.

The role of ophthalmic imaging in central nervous system degeneration in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder that can involve any organ system. Central nervous system involvement can be a severe life threatening complication, ultimately resulting in severe neurodegenerative changes. Magnetic resonance imaging suggests that neurodegeneration, which may have deleterious effects on brain function, may occur early in SLE and experimental models suggest that neuroprotection may be feasible and beneficial.

Association between memory B-cells and clinical and immunological features of primary Sjögren's syndrome and Sicca patients.

B-cells play a pivotal role in primary Sjögren's syndrome (pSS) pathogenesis. We aim to (1) evaluate the distribution of B-lymphocyte subpopulations in pSS and Sicca patients, (2) establish cut-off points that discriminate pSS from controls, (3) evaluate the association between memory B-cells and phenotypic features in pSS. We included 57 pSS patients, 68 Sicca and 24 healthy controls.