A clinical case of gangrenous pyoderma is described, as well as the difficulty of differential diagnosis and treatment of this disease. We carried out a literature review of the materials of foreign and domestic authors describing the course of gangrenous pyoderma using search engines PubMed, Google Scholar, BioMed Central (55 articles).
Importance. Fourniers gangrene occurs as a result of infectious processes of the urogenital tract, in immunocompromised patients with diabetes, obesity, malignant neoplasms. Fournier,s gangrene progresses for two to three weeks, causing tissue destruction. The basis of the treatment of Fourniers gangrene is an emergency surgical intervention in combination with antibacterial and detoxification therapy. The article reflects the importance of differential diagnosis of Fournier,s gangrene with a complicated form of primary syphiloma (phagadenic chancre). Purpose. To demonstrate the diversity of clinical manifestations of Fourniers gangrene, treatment, differential diagnosis. Materials and methods. The literature review of materials of domestic and foreign researchers, in which the etiology, pathogenesis, clinical and laboratory picture, diagnosis, treatment, and prognosis of Fourniers gangrene using the search engines Pubmed, Medline, Cochrane, Elibrary. The authors present the clinical cases of patients with Fournier,s gangrene, clinical features of complicated chancre in a patient with primary syphilis, which are necessary for adequate differential diagnosis. Results. Since 2007 to 2016 were seven men with Fournier,s gangrene on treatment in purulent surgery Department. Patients performed the autopsy, drainage of foci of necrosis, necrectomy systemic antibiotic therapy, followed by autodermoplasty. Conclusions. Fournier,s gangrene rare and severe form of lesions of the external genitalia. The prognosis of the disease is serious and depends on timely and correct treatment. The rise of complicated cases of hard chancre. It is necessary to differentiate Fournier s gangrene with clinical manifestations of syphilis.
A popliteal cyst or Baker’s cyst is easily distinguished from other cystic or solid tumors on the magnetic resonance imaging sections. At the current level of medicine development, many options have been developed for medical and surgical treatments for popliteal cysts; however, there are still disputes on their validity and efficiency. In addition, there is no consensus on the etiology and pathogenesis of the disease. MRI is known to show similar intraarticular changes in asymptomatic patients and articular syndrome patients, which could suggest that intraarticular pathological changes played a secondary role in a number of cases of Baker’s cyst formation. Under these conditions, laser-induced thermotherapy is considered by the authors to be justified. Its main goal is to coagulate the wall of the tissue cyst, which subsequently leads to obliteration of its anastomosis and cavity. Ultrasound control is used to visualize and ensure the safety of manipulation. This paper describes a case of MRI for diagnosing a popliteal cyst and monitoring the efficiency of laser-induced thermotherapy.
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