Physicians Academy
Established in December 2006 by the Kashmir Academy Of Private Physicians
Table Of Contents
Editorial :
 Bacterial Infections in Patients with Leukemia
Article 1 :
 What after a Suicide Attempt?
Article 2 :
 Neglected Child with severe Bronchopneumonia
Picture of The Month :
 Picture of The Month November 2017
Drug Update :
 VELCADE (Bortezomib)
Abstracts from Other Journals :
 Abstracts from Other Journals-November 2017

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Nov 2017 (Volume -11Number -11)

Picture of The Month
Picture of The Month November 2017
Aashob Qazi Ashraf, MD; MS; DNB (MCh); MNAMS; MESSO; FSSO(USA)
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NOVEMBER 2017

Picture of The Month

Aashob Qazi Ashraf, MD; MS; DNB (MCh); MNAMS; MESSO; FSSO(USA)

 

A 50 years old male came with history of one year duration of mass coming out of rectum during defecation. He was pale and puffy, with hoarse voice. He had long history of constipation.

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Author Information: Dr. Aashob Qazi Ashraf, MD; MS; DNB (MCh); MNAMS; MESSO; FSSO(USA) is Senior Consultant, Surgical Oncology in Noora Hospital, Srinagar, Kashmir, India. Email: aashob@gmail.com

 

 Answer of last month’s POTM October 2017

 

A 58 years old male came for treatment of diabetes mellitus. His abdomen showed this. What is the diagnosis?

The correct diagnosis is:

Giant Congenital Melanocytic Nevus

A congenital melanocytic nevus is a proliferation of benign melanocytes that are present at birth or develop shortly after birth. These are usually asymptomatic, however, some may be itchy, particularly larger lesions. It is thought there may be reduced function of sebaceous and eccrine glands, which may result in skin dryness and itching.

There are many classifications. One of these is according to size.

A small congenital melanocytic nevus is  < 1.5 cm in diameter

A medium congenital melanocytic nevus is 1.5–19.9 cm

A large or giant congenital melanocytic nevus is ≥ 20 cm in diameter

Small congenital nevi occur in 1 in 100 births.

Medium congenital nevi occur in 1 in 1000 births.

Giant congenital melanocytic nevi are much rarer (1 in 20,000 live births)

The various types of congenital nevi are Café-au-lait macule, Speckled lentiginous nevus, Satellite lesions, Tardive nevus, Garment nevus and Halo nevus.

Congenital melanocytic nevi usually grow proportionally with the child. Congenital nevi may become smaller and less obvious with time. Rarely some may even disappear. However they may also become darker, raised, more bumpy and hairy, particularly around the time of puberty. Congenital melanocytic nevi are often unsightly, especially when extensive, i.e. large or giant congenital melanocytic nevi. They may therefore result in anxiety and impaired self image, especially when the lesions are in visible areas.

The risk of development of melanoma is greater in early childhood; 70% of melanomas associated with giant congenital melanocytic nevi are diagnosed by the age of ten years. Rarely, other types of tumor may develop within giant congenital melanocytic nevi including benign tumors like lipomas and schwannomas and other malignant tumors including sarcomas. Regular follow-up is recommended.

Reference:

Oakley A. Congenital melanocytic Naevus. DermNet New Zealand. June 2014. https://www.dermnetnz.org/topics/congenital-melanocytic-naevi/

Author Information: Dr. Sarosh A. Khan is Senior Consultant, Internal Medicine and Director, Naseem Medical Center, Baghe-Mehtab, Srinagar, Kashmir, India. Pin: 190019. He is the Editor in Chief of Physicians Academy. Affiliations: Governing Council Member of American College of Physicians (India Chapter) from 2014-2017. Email: drsarosh@gmail.com 


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