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Papular Elastorrhexis: DISCUSSION
14 Jan2011
Papular elastorrhexis (PE) is a rare condition, characterized by asymptomatic papules and fragmentation of dermal elastic fibers. In 1987 Bordas et al. described the first case of papular elastorrhexis which consisted of several small yellowish papules on the trunk. It was thought to be a variant of nevus an- elasticus due to the reduction and fragmentation of elastic tissue. Sears et al. suggested that this disorder represented a variant of a connective tissue nevi.
- In: Disease
- Tags: Elastic fiber, Papular elastorrhexis
Papular Elastorrhexis: CASE REPORT
13 Jan2011
A healthy 21-year-old woman presented with a 1- year history of multiple skin-colored papules on the upper back. The history of trauma to the lesions was unremarkable, except for excoriation due to an itching sensation. However, the papules had already been present several months before excoriation. She had no past history of acne and no family history of similar lesions or other skin diseases. The physical examination revealed multiple, white- colored papules dominantly on the upper back (Fig. 1). The lesions were nonfollicular and did not coalesce to form plaques.
- In: Disease
- Tags: Elastic fiber, Papular elastorrhexis
Papular Elastorrhexis
12 Jan2011
INTRODUCTION
Papular elastorrhexis (PE) was first described in 1987 by Bordasl as multiple, discrete, nonfollicular, 1 to 5 mm diameter-sized white papules evenly distributed over the back, chest, shoulders, and upper extremities. It usually occurs in females, first appearing during the second decade of life. It histologically characterizes as decreased and fragmented elastic fibers, with or without changes to the collagen bundles in the reticular dermis.
- In: Disease
- Tags: Elastic fiber, Papular elastorrhexis
This study showed that peripheral intravenous KCl infusion caused significantly more pain at the infusion site when administered in sterile water than in saline. The exact mechanism of infusion-related pain and phlebitis is not known. Irritation, inflammation, and damage to the venous endothelium can be caused by the inherent chemical property, pH, or osmolality of the infusate.
- In: Pain
- Tags: IV infusion, Pain, potassium chloride
After 36 of the intended 60 patients had been enrolled, an interim analysis was conducted. At that time, 7 patients had discontinued the infusion prematurely because of pain. The interim analysis revealed significant differences in pain severity at the end of all 3 infusion periods between the groups (first infusion p = 0.002, second infusion p = 0.002, and third infusion p = 0.042). Based on these results, the study was halted and the remaining 24 patients were not recruited.
- In: Pain
- Tags: IV infusion, Pain, potassium chloride
Consecutive inpatients with hypokalemia requiring intravenous potassium replacement were enrolled in the study after they gave informed consent. This consent was given while they were in a combined medical and surgical ward. The study protocol was reviewed and approved by the Hamilton Health Sciences/McMaster University Research Ethics Review Board.
Patients who had been prescribed one or more intravenous mini-infusions of KCl (10 mmol in 100 mL) through the peripheral vein were randomized into 3 groups: (i)10 mmol KCl in 100 mL sterile water, (ii) 10 mmol KCL in 100 mL 0.9% sodium chloride (NaCl), and (iii) 10 mmol KCl in 100 mL 0.45% NaCl. The KCl solutions for all 3 groups were prepared by the hospital pharmacy (Hamilton Health Sciences, McMaster University Medical Centre Site, Hamilton, Ontario) in identical mini-infusion bags. The randomization code was available in the pharmacy in case of infusion- related problems.
- In: Pain
- Tags: IV infusion, Pain, potassium chloride